Cirius Group, Inc.
CIRIUS GROUP, INC.
COMPLIANCE
MEDICARE ABN 
Greetings!
 
March 1, 2009 all providers (including independent laboratories),physicians, practitioners,and suppliers will use the revised ABN form CMS-R-131 for all situations where Medicare payment is expected to be denied. Note-Skilled nursing facilities(SNFs) must use the revised ABN for items/services expected to be denied under Medicare Part B only. In general, the ABN form must be kept 5 years from discharge/completion delivery of care, where there are not other state law requirements.
Medicare ABN Compliance
 
The revised ABN form combined both the General Use ABN (CMS-R-131-G), and the Lab ABN (CMS-R-131-L) for the physician ordered laboratory tests. Important-The revised ABN eliminates any widespread need for the Notice of Exclusion from Medicare Benefits (NEMB) used in voluntary notification situations.
An ABN is to be provided to Medicare patients PRIOR to clinical care. Only those Medicare services performed in an outpatient setting require validation of medical necessity. In the case of emergency or urgent care services an ABN is not required. It is the obligation of every provider to inform Medicare patients if services that do not meet medical necessity. Medical necessity is predicated on Medicare local and national coverage polices which can change monthly.    
In This Issue
Medicare ABN Compliance
Cirius Medicare ABN Solution
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Cirius Medicare ABN Solution
 
Ensure compliance with the CURRENT CMS ABN form; validate local and national policies for medical necessity PRIOR to rendered services using the Cirius Group Patient Access ABN solution. Our powerful, easy to use software performs edits quickly, searches by required medical code sets and produces control reports.
  •          Verify 100% of Medicare outpatient care prior to service
  •          Accurate, Reliable and Timely delivery of LCD and NCD policies
  •          Reduce Medicare claim denials
  •          Validate and cross reference for medical necessity  
  •          Generate an approved and revised CMS ABN form
  •          Report and track ordering patterns and more
  •          Eliminate write offs and increase cash collections
With Cirius Patient Access ABN solution you can rest assured that compliant best practices are in place.
 
Schedule a Cirius ABN webinar to learn more. 
 
Sincerely,
 
Jayne Kroner 
Business Development
Cirius Group, Inc.
(925)685-9300