From: Dr. Art LeVine @ iCollect Medical Billing eNewsletter 6-28-2023
Hello Doctors and Staff,
I hope this eNewsletter finds you happy and healthy!
In case you were unaware, 6/30/2023 marks the date you must put into use the new CMS Advance Beneficiary Notice [ABN] form. This form has a tentative expiration date of 1/31/2026 (I say “tentative” because we are talking about the government, right!?). I have placed the CMS link to download the ABN form, in both English and Spanish, below.
Please remember that the ABN form is only meant for those services that are normally covered by Medicare, but where the provider feels Medicare will not reimburse because the provider has deemed the service maintenance care. For Chiropractic this would exclusively cover the three spinal manipulation codes [98940, 98941, 98942] which would be billed with the -GA modifier, instead of the -AT modifier which is only applicable for active care and not maintenance. The ABN form is NOT meant to be used for all other services, which are considered “statutorily non-covered”. In my opinion and experience, it would be a very smart and prudent idea to create a form on your letterhead that basically says something like,
“Dear Patient, Dr. ______ has deemed that the following services are [important, necessary, integral, etc] to determine the cause and extent of your condition (ie, exams, xrays, etc); also, the doctor has deemed that the following services are [important, necessary, integral, etc] to speed and improve your recovery [physical therapies, strapping/taping, braces, etc].
Medicare has stated these services are “statutorily non-covered” when performed by a Chiropractic physician, therefore, you will be responsible for these charges.” Have the patient sign that form, date it, give them a copy and you keep the original.
This way, down the road, if they contest that you never informed them of this responsibility, or forget, or think they should be receiving some form of reimbursement from Medicare you’ll have the proof that you informed them of the rule, the price (based on the relatively new Good Faith Estimate requirement), and they signed the form!
Get this ready for the 6/30/23 start!
https://www.cms.gov/medicare/medicare-general-information/bni/abn
Yours in health and wealth,
Dr. Art
Dr. Arthur I. LeVine
CEO & Founder, iCollect Medical Billing Services, LLC
Past President, Florida Chiropractic Assn.,
Board of Directors, Florida Chiropractic Assn.,
Chairman, Insurance Relations Committee, Florida Chiropractic Assn.,
Co-Chairman, Government Relations Committee, Florida Chiropractic Assn.,
Florida Representative, Congress of Chiropractic State Assns.,
Past Florida Contractor Advisory Council (CAC) Representative
7027 W. Broward Blvd., #229
Plantation, FL 33317
954-530-6232 Office
206-309-4925 Fax to Email
www.icollectmedicalbilling.com
