To inform a Medicare beneficiary that Medicare certainly or probably won't pay for a product or service, the provider must issue an ABN to the beneficiary or the beneficiary's:

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An Advance Beneficiary Notice (ABN) is a notice given to Medicare beneficiaries to convey that Medicare is not likely to provide coverage for a specific service or item. The ABN must be given to the beneficiary or their authorized representative to ensure they are aware they might be responsible for the payment.

To Inform a Medicare Beneficiary That Medicare Certainly or Probably