Teleconference/Webinar Presenter: Duane C. Abbey, Ph.D., CFP

Teleconference Webinar Title: ABNs: Effective Utilization and Compliance

Teleconference/Webinar Level: Intermediate to Advanced Level

Related Teleconference/Webinar Presentations: Various coding, billing and chargemaster Webinar/Teleconferences along with various compliance Webinar/Teleconferences

Teleconference/Webinar Objectives:

a. To review the concept and use of ABNs (Advance Beneficiary Notices).
b. To review the rules and regulations surrounding the use of ABNs and related types of notices.
c. To understand how the NCDs (National Coverage Decisions) and LCDs (Local Coverage Decisions) fit into the ABN process.
d. To appreciate the coding and billing difficulties surrounding the proper use of modifiers in connection with ABNs.
e. To review all of the various CMS forms related to the ABN process.
f. To appreciate the need to be sensitive to patient communications in the use of ABNs.
g. To understand the proper role of special computer software in the determination of and issuance of ABNs.

Teleconference/Webinar Outline/Agenda:

I. Overview of ABNs
   a. Basic ABN Concept
   b. Medical Necessity versus Non-Covered Issues
   c. Services and items requiring the use of ABNs
   d. CMS rules and regulations references
   e. Expanding scope and coverage for ABNs

II. Key Definitions and Concepts
   a. ABNs vs. NONCs (Notices of Non-Coverage)
   b. New Hospital Letter ABNs
   c. Associated CMS Forms
   d. Basic Financial Limitation for the Medicare Program

III. NCDs and LCDs
   a. Review of LCD/NCD Development Process
   b. Relationship of LCDs and NCDs to ABNs

IV. ABN Process
   a. Determining Need for ABN
   b. Properly Executing the ABN
   c. Compliance Issues Surrounding the ABN Process

V. Billing Considerations
   a. Special Modifiers
   b. Additional Billing Requirements
   c. Patient Communications

VI. Case Studies, Examples and Exercises

Prerequisites for Participating: General knowledge of coding billing and reimbursement.

Target Audience: Coding Personnel, Billing and Claims Transaction Personnel, Chargemaster Coordinators, Financial Analysts, Compliance Personnel, Nurses, Physicians and Other Interested Personnel

Attendance Certificate: Upon attending this course you will receive a 2 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.