American Academy of Professional Coders (AAPC) Practice Exam

What must a provider do regarding the ABN?

1. Complete the form in full and bill the patient immediately

2. Complete the form in full and provide an explanation

3. Only provide the form if a service is denied

4. Ask the patient to complete the form themselves

The correct answer is: Complete the form in full and provide an explanation

The correct answer emphasizes that a provider must complete the Advance Beneficiary Notice of Noncoverage (ABN) in full and provide an explanation to the patient. This process ensures that the patient understands the circumstances under which Medicare may not cover a particular service. Completing the ABN properly is crucial because it serves as a formal notification to the patient regarding the potential for denied Medicare coverage. It clearly outlines the reason for the denial and informs the patient of their financial liability should they choose to proceed with the service. Providing an explanation also empowers patients to make informed decisions about their care, allowing them to weigh the potential benefits of the service against its costs. The other choices miss key elements of the ABN process. Simply completing the form and billing the patient immediately does not provide them with the necessary context or understanding of their situation. Providing the form only if a service is denied neglects the proactive communication that the ABN is intended to facilitate. Finally, asking the patient to complete the form themselves undermines the provider's responsibility to ensure that the patient fully understands the implications of the ABN and the services being discussed.