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Important Documents
Important Documents and Notices
Question | Answer |
---|---|
A notice that a doctor, supplier, or provider gives a Medicare beneficiary before furnishing an item or service if they believe Medicare may deny payment. | Advance Beneficiary Notice (ABN) |
The legal obligation of providers to explain use and disclosure of patient's protected health information (PHI). | Notice of Privacy Practices |
Needs at least 1 witness and need to happen before rendering a service/procedure; it is important that original or scanned copies are part of a patient's health record. | Written Consent |
Permission granted by the patient or the patient's representative to release information for reasons other than treatment, payment, or health care operations. | Authorization |
A patient's permission evident by signature for treatment, payment, or health care operations. | Consent |
A document supplied by the insurance payer, sent to the provider, that provides notice and explanation of reasons for payment, adjustment, denial and/or uncovered charges of a claim. | Remittance Advice (RA) |
Notification by the physician to a patient that a service will not be paid. | Notice of Exclusion from Medicare Benefits |
Written recommendation to a specialist. | Referral |
Describes the services rendered, payment covered, and benefit limits and denials; sent to patient from insurance company. | Explanation of Benefits (EOB) |
Document that outlines the amounts billed by the provider and what the patient must pay to provider; sent to Medicare patients. | Medicare Summary Notice (MSN) |
The process by which the provider contacts the insurance carrier to see if the proposed procedure is covered by a patient's insurance policy. | Authorization |
A written request for verification of benefits. | Predetermination |