[Amy Lawhorn]

We have a patient with Medicare as 2nd ins, and their primary insurance pays a higher allowable on a product. Can we use an ABN when Medicare is 2nd? or is it only used when Medicare is primary?

[HEATHER]

If I understand you right, you are saying you would use the ABN to get the
patient to pay the difference (if any) between what the primary allows/pays
and what Medicare pays - but that wouldn't be considered a denial -
therefore an ABN really wouldn't be necessary. ABN's are usually only used
when you expect a claim to receive a medical necessity denial.

[leejgbt]

Originally Posted by Amy Lawhorn

We have a patient with Medicare as 2nd ins, and their primary insurance pays a higher allowable on a product. Can we use an ABN when Medicare is 2nd? or is it only used when Medicare is primary?

If you bill Medicare IN ANY POSITION then Medicare rules apply. Therefore, you can only collect up to the allowed amount UNLESS you do not accept assignment. It has been my experience that this usually is not a good thing to do if you did not collect the co-pay up front (which in this instance you cannot do).