Lessening Liability Using the ABN and GFE Forms

Nearly half of eligible Medicare patients are enrolled in a Part C Medicare Advantage plan. With the increased competition of Part C private plans, many Medicare Advantage Plans (Part C) have expanded covered services when rendered by a chiropractor. Original Part B Medicare has recently released a new version of the ABN form for mandatory use. The issue we face is that the Part C Medicare Advantage plans are expressly prohibited from using the ABN form under any circumstance. Doctors and staff must understand when to use the ABN and other forms and how to bill for the services properly. Dr. Mario Fucinari will clear the confusion about when to issue the proper forms and how to complete the documents. This course was originally presented by Dr. Mario Fucinari on September 19, 2023, and sponsored by ChiroHealthUSA.

• •Distinguish between Medicare Part B and Part C (Medicare Advantage) coverage policies and their implications for chiropractic services
• •Identify when the ABN (Advance Beneficiary Notice) form is required, prohibited, or optional based on plan type
• •Understand the purpose and proper completion of the GFE (Good Faith Estimate) form and its role in patient financial transparency
• •Learn correct billing procedures for services covered under Original Part B Medicare versus Part C Medicare Advantage plans
• •Recognize common compliance pitfalls when issuing forms to Medicare patients and how to avoid them
• •Apply practical strategies for documenting patient notifications and protecting your practice from liability
• •Implement office protocols to ensure staff correctly matches the appropriate form to each patient's plan type