Hello. Here is the link to the Medicare Northwest web site:
http://medicare.regence.com/medicare_part_a/whats_new/index.html
Below is an excerpt from their site under "Billing non-covered charges":
(the first option on the list). Scroll to page 4:
"There are three different types of such notices given in different settings
for specific types of care:
1. Notices of non coverage are given to eligible inpatients receiving or
previously eligible for non-hospice services covered under Medicare Part
A....but services no longer meet coverage guidelines...Beneficiaries in
these settings never receive ABN's
2. ABN's and HHABN's....These forms are used for Part B and hospice services
ONLY"
3. Payment Liability Condition 3........."
I think this information supports the SNFs' continued use of the Medicare
Denial of Benefits letter (the one we have always used) for Medicare "cut"
purposes and not switching to the ABN 10055 form for that purpose. But I do
think that all this information is contradictory at times or at the least is
pretty confusing.
One term that I've never heard of (under the number one instruction) is
"sarasett notice". Has anyone ever heard of this term?
Thank you,
Winona Phelps
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