Protect patients from unexpected liability for charges associated with Medicare claims and protect your institution from allegations of Medicare fraud with Medicare Advance Beneficiary Notification.

Medicare Advance Beneficiary Notification is part of MedAssets’ Access Integrity suite of solutions designed to help providers manage and complete all registration activities necessary for financial clearance. 

• Improves Medicare compliance and reduces the risk of potential fines for billing of uncovered services to Medicare 
• Improves patient satisfaction by clarifying the patient’s rights and obligations prior to service
• Reduces bad debt, denials, unnecessary write-offs and RAC adjustments
• Eliminates the difficult task of manually gathering and searching LCD and NCD data
• Supports evaluation of ordering patterns at the physician or department level
• Identifies reimbursable secondary procedures along with required modifiers to assure appropriate reimbursement before services are provided
• Ensures timely policy updates for compliance and secure access for authorized users
• Generates customized ordering screens by department with relevant CPT and ICD-9 codes
• Identifies frequently checked procedures and diagnoses to enhance productivity
• Creates and maintains CPT and ICD-9 codes, descriptions and charges from the hospital chargemaster to improve data integrity

Assure your institution complies with CMS rules for Advance Beneficiary Notification (ABN) for services that may be denied by Medicare. This fast, intuitive online solution leverages MedAssets’ core reference tool, KnowledgeSource^®, to provide accurate up-to-date verification of both local and national medical review policies. In addition, it produces compliant ABNs when necessary.

For customers with MedAssets’ Medicare Direct Claims Management, the same medical necessity content is used to check compliance on the front end and to perform a final medical necessity check prior to claims submission. These actions can help you avoid fraud allegations for unintentional submission of uncovered services. ABN conditions are automatically linked with the appropriate claims, eliminating manual ABN matching and updating appropriate condition and occurrence codes.