Advance Beneficiary Notice of Noncoverage (ABN)
An Advance Beneficiary Notice of Noncoverage (ABN) is a Medicare waiver of liability that providers are required to give a Medicare patient for services provided that may not be covered or considered.
Please, read and sign your ABN so you can make an informed decision about your care.
NOTE
- Medicare will ONLY cover MNT for diagnoses of diabetes and non-dialysis kidney disease, when a Medicare beneficiary has been referred by a physician. We do have a Medical Referral form from our website that your doctor can complete.
- If Medicare doesn’t pay because you do not have the Medical Referral Form signed by your doctor o because you do not meet the diagnose criteria, you may have to pay.
Medicare does not pay for everything, even some care that you or your health care provider have good reason to think you need. We expect Medicare may not pay for Medical Nutrition Therapy listed below.
WHAT YOU NEED TO DO NOW:
• Read this notice, so you can make an informed decision about your care.
• Ask us any questions that you may have after you finish reading.
Choose an option below about whether to received Medical Nutrition Therapy (D) listed above.