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What is a 医疗保险豁免/提前受益人通知(ABN)?
An Advance Beneficiary Notice (ABN) is a written notice from Medicare (
标准政府表格CMS-R-131) given to you before receiving certain items or services, notifying you:
- Medicare may deny payment for that specific procedure or treatment
- You will be personally responsible for full payment if Medicare denies payment
An ABN gives you the opportunity to accept or refuse 项目或服务 and protects you from unexpected financial liability in cases where Medicare denies payment. 它还为您提供了对医疗保险决定提出上诉的权利.
如果我收到ABN表格，我有什么选择?
You have the option to receive 项目或服务 or to refuse them. 无论哪种情况, you should choose one option on the form by checking the box provided, 然后在提供的空白处签名并注明日期.
如果您选择接收项目或服务:
你必须选择“选项1”
- 在表格上签名并注明日期
- 索赔将寄给联邦医疗保险. 在医疗保险做出决定时，你可能会被收费
- If Medicare does pay, you will be refunded any payments that are due to you
- If Medicare denies payment, you will be personally responsible for full payment
- 你将有权对医疗保险的决定提出上诉
如果您选择不接收项目或服务:
你必须选择“选项3”
- 在表格上签名并注明日期
- 你的索赔不会被送到医疗保险
虽然医疗保险可能不会支付你的物品或服务, there may be a good reason for your physician recommending them. 你应该把你的拒绝通知你的医生.
What if I refuse to sign an ABN, but I want 项目或服务 anyway?
If you refuse to sign, one of two actions will take place:
- 卡尔弗特医疗系统可以决定 不提供 项目或服务
- A second person will witness your refusal to sign the agreement, and you 将会收到 项目或服务. 然而, you may be held liable because you have been notified of the likelihood of a Medicare denial.
When I am liable for payment because I signed an ABN, how much can I be charged?
当您签署ABN并承担付款责任时, 你必须自己支付物品或服务的费用, either out of pocket or by some other insurance coverage that you may have in additionto Medicare. Medicare fee schedule amounts and balance billing limits do not apply. The amount of the bill is a matter between you and 网上买球软件. 成本估算包含在ABN的方框中. 然而, please keep in mind that this is just an estimate and may or may not reflectthe exact cost of the service being performed.
Why do I routinely receive an ABN for certain items or services?
Certain items or services that are covered by Medicare are only covered up to a certain number of times within a specified amount of time. Examples of these "frequency limited" services include laboratory tests, 一些预防性筛查测试和疫苗接种. If you receive an ABN that gives a frequency limit as its reason, it means that Medicare will not pay if you exceed that limit on the service.
abn是否意味着医疗保险正在减少覆盖范围?
No. abn的运作根本不是为了减少覆盖范围. Only if and when Medicare does deny the claim do you become liable for paying personally for the service or item. If Medicare decides to pay the claim, you have lost nothing by signing the ABN.
Who do I contact if I have more questions about my Medicare coverage?
For more information about your Medicare coverage, please contact Medicare directly:
电话:800-633-4227(免费电话)
网站:
www.医疗保险.政府