Certified Revenue Cycle Representative (CRCR) Practice Exam

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

1. To collect payment before services are rendered

2. To inform a Medicare beneficiary that Medicare may not pay for the order or service

3. To explain deductible requirements

4. To provide information on secondary insurance

The correct answer is: To inform a Medicare beneficiary that Medicare may not pay for the order or service

The purpose of an Advance Beneficiary Notice of Non-coverage (ABN) is to inform a Medicare beneficiary that Medicare may not pay for the ordered service or item. This notice is essential within the Medicare program, as it serves to communicate the potential for non-coverage before the beneficiary receives the service. The ABN ensures that beneficiaries are aware of their financial responsibility should Medicare decide not to cover the item or service, which allows them to make informed decisions about their healthcare. Providing this notice helps protect both the beneficiary and the healthcare provider. By issuing an ABN, providers can obtain the patient’s consent to proceed with the service and possibly charge them if Medicare denies the claim. This process minimizes confusion and helps beneficiaries understand their rights regarding coverage and payment obligations.