ABN delivery is considered to be effective when the notice is:

• Delivered and comprehended by a suitable recipient.

• The correct ABN approved notice with all required blanks completed.
Note: Failure to use the correct notice may lead to providers being found liable.

• Delivered to the beneficiary in person if possible

• Provided far enough in advance of potentially non-covered items or services to allow sufficient time for the beneficiary to consider all available options.

• Explained in its entirety and all beneficiary-related questions are answered.

• Signed by the beneficiary or his representative..

Options for Delivery Other Than In-Person

In circumstances when in-person delivery is not possible, an ABN may be delivered through the following means:
• Telephone.
• Mail.
• Secure fax machine.
• Internet e-mail.

When delivery is not in-person, the contact must be documented in the patient’s records. To be considered effective, the beneficiary cannot dispute such contact. Telephone contacts must be followed immediately by either a hand-delivered, mailed, e-mailed or faxed notice. The beneficiary or representative must sign and retain the notice and send a copy of this signed notice to the provider for the retention in the patient’s record.

The provider must keep a copy of the unsigned notice on file while awaiting receipt of the signed notice. If the beneficiary does not return a signed copy, the provider must document the initial contact and subsequent attempts to obtain a signature in appropriate records or on the notice itself.