Certified Revenue Cycle Representative (CRCR) Practice Exam

What is the purpose of an ABN (Advance Beneficiary Notice of Non-coverage)?

1. Inform beneficiaries about premium increases

2. Notify beneficiaries that Medicare may not pay for a service

3. Explain the coverage limitations of a plan

4. Provide a summary of the patient’s medical history

The correct answer is: Notify beneficiaries that Medicare may not pay for a service

The purpose of an Advance Beneficiary Notice of Non-coverage (ABN) is to notify beneficiaries that Medicare may not pay for a specific service or item that they are about to receive. This notice informs patients when a healthcare provider believes that Medicare may deny payment due to a variety of reasons, such as the service not being deemed medically necessary or not covered under the beneficiary's plan. By providing an ABN, providers ensure that beneficiaries understand the potential financial responsibility they may incur if Medicare denies payment. This transparency enables beneficiaries to make informed decisions about their healthcare services and associated costs. The other options do not accurately reflect the purpose of an ABN. Notifications related to premium increases, coverage limitations of a plan, or summaries of a patient's medical history serve different functions that are not specifically tied to the purpose of informing beneficiaries about potential non-coverage by Medicare.