ABN forms

Looking for some advice as to how and when labs have their patients sign ABN forms. Is it mandatory to have the price of tests listed on the ABN form? How do labs handle patients who refuse to sign? Any advice or info would be most helpful.

yes

you need a price- your lab should give you a price list. If they refuse to sign, don't do the test. They have to agree to pay. If you walk in a restaurant and tell them you are not paying, you don't get fed. An ABN lab test is no different. Remember the ABN is only for a test that Medicare is unlikely to pay for, not for every test.

Abn

Can you use an ABN for a procedure/test being done that is not covered by an insurance company and the patient does not have Medicare?

yes you can

[Can you use an ABN for a procedure/test being done that is not covered by an insurance company and the patient does not have Medicare?]


You should read the contract to be sure you can bill the patient; you do not need to use an ABN but it certainly is nice proof if the patient decides not to pay.

waiver of liability Medicare modifiers

GA, GZ, GY, GX
GA = signed ABN, may not cover, required by payer policy
GZ = medical necessity denial, not signed
GY = never cover by Medicare law
GX = non-covered charges only, voluntary ABN notice of liability