What type of providers utilize the ABN form?

The Advance Beneficiary Notice of Noncoverage (ABN) form is primarily utilized by non-participating providers. This is because non-participating providers (NonPAR) are not bound by Medicare’s payment rates and can bill patients for services that may not be covered by Medicare. The ABN serves as a notification to patients that Medicare may deny payment for certain services, allowing them to make an informed decision about whether to proceed with the treatment and understand their financial responsibilities beforehand.

While participating providers (PAR) also may want to communicate with their patients about potential out-of-pocket expenses, they are generally required to accept Medicare's approved amount as payment in full for covered services. PAR providers are less likely to use the ABN in the same way because they have a contractual obligation to the Medicare program that affects how they bill patients.

In summary, the ABN is an important tool for nonPAR providers to protect themselves against potential financial disputes regarding payment for services that may not be covered by Medicare, thereby ensuring that patients are fully aware of their financial obligations.