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How Often Should Chiropractors Have Their Patients Sign A New Advance Beneficiary Notice (ABN)?

chiropractor abnBy: Zach Simpson

Over the years I have come to grasp that ABNs although very useful are quite difficult to implement appropriately for chiropractic practices. My goal for this article is to help practices understand how often ABNs should actually be signed by their Medicare beneficiary patients. A question I am typically asked about ABNs is when should a patient sign a new one? Many offices have the misconception that a new ABN should be signed by Medicare beneficiaries at the beginning of each year which is not the case.

Medicare only requires that the ABN form be completed before the first spinal chiropractic manipulative treatment is rendered for maintenance, wellness, palliative, and/or supportive care. Until one of the following takes place the ABN remains active:

  • In the event a new condition or active treatment is initiated the current ABN would be rendered invalid because the active treatment would likely meet Medicare’s medical necessity guidelines and be considered eligible for payment again; or
  • The current ABN on file is more than twelve (12) months old. In the event the ABN is more than twelve (12) months old an updated ABN must be signed in order to continue maintenance care. Once the new ABN is signed it shall be valid for twelve (12) more months or until another active treatment is initiated.

Key Takeaway: ABNs need to be renewed on a rolling twelve (12) month basis, meaning that ABNs expire for each patient on different dates. Therefore, there is no reason to automatically make all patients sign a new ABN at the beginning of the calendar year, because this constitutes an improper use of an ABN which may invalidate all of the ABNs you have in place.

ABNs are a tricky document that have severe impacts on practice’s financial statuses. Therefore, it is always best to consult a healthcare attorney to clarify any confusion you may have on how to properly implement and administer ABNs to your Medicare patient base.