What is the purpose of the Advanced Beneficiary Notice?

• A. To identify services that may not be covered
• B. To Request a Second Medical Opinion
• C. To Authorize the Hospital to Share Records
• D. To Inform Patients of Potential Medicare Non-Coverage and Their Options

Answer: (D)

The Advanced Beneficiary Notice is used when Medicare may not pay for a planned service. Its main function is to inform the patient that there could be non-coverage and to lay out the options the patient has if that happens. By giving this notice and the estimated cost in advance, the patient can decide whether to proceed and pay out of pocket, or decline the service to avoid potential charges. It also provides documentation that the patient was warned before the service was provided, which helps protect both the patient and the provider.

It isn’t about requesting a second medical opinion, nor about authorizing the release of records, and it’s not merely a list of services that may not be covered.