Client fussing because Medicare denied payment (not medically necessary) for 3 lab tests the PATIENT requested. The lab tech gave him the ABN form that listed 3 tests that MAY NOT be covered but FAILED to include the "retail" cost for each test.
Patient checked the box indicating he agreed to be responsible for payment in the even Medicare denied the claim.
Lab billed him $300 for the tests that could have been performed at a walk in lab for $140. He is blaming everyone but himself, but he (essentially) signed a blank check.
Page 4, section 6 of the attached form has this notice:
if for some reason the notifier is unable to
provide a good faith estimate of projected costs at the time of ABN delivery, the
notifier may indicate in the cost estimate area that no cost estimate is available. We
would not expect either of these last two scenarios to be routine or frequent practices,
but the beneficiary would have the option of signing the ABN and accepting liability
in these situations.
I say he is liable because he signed it, but I have never encountered this before.
What do you think?
Patient checked the box indicating he agreed to be responsible for payment in the even Medicare denied the claim.
Lab billed him $300 for the tests that could have been performed at a walk in lab for $140. He is blaming everyone but himself, but he (essentially) signed a blank check.
Page 4, section 6 of the attached form has this notice:
if for some reason the notifier is unable to
provide a good faith estimate of projected costs at the time of ABN delivery, the
notifier may indicate in the cost estimate area that no cost estimate is available. We
would not expect either of these last two scenarios to be routine or frequent practices,
but the beneficiary would have the option of signing the ABN and accepting liability
in these situations.
I say he is liable because he signed it, but I have never encountered this before.
What do you think?