Page Description

If you order tests that are not reimbursable by the patient's insurance company, you may need to print an ABN for the patient to sign. Use the ABN Status/Print page to view or print an Advance Beneficiary Notice (ABN) for the order. You also use this page to record whether or not the patient has signed the ABN to agree to pay for the ordered tests, even if the insurance company will not.

The format for the ABN that Copia uses for Medicare insurance companies, has three columns: "Laboratory Tests," "Reason Medicare May Not Pay," and "Estimated Cost." Data is enumerated per order choice, so an ABN with four reimbursement problems on three order choices would look like this:

Laboratory Tests:
1.  Sodium
2.  Potassium
3.  Potassium
4.  Research OC

Reason Medicare May Not Pay:
1.  Medicare does not pay for these tests for your condition
2.  Medicare does not pay for these tests for your condition
3.  Medicare does not pay for these tests as often as this (denied as too frequent)
4.  Medicare does not pay for experimental or research use tests

Estimated Cost:
2.  $3.99
3.  $3.99
4.  $1000
Note: If an order choice does not have an estimate cost established in the Order Choices administration page, then Copia does not display a cost.

An ABN is a contract between the patient and your practice whereby the patient agrees to pay for the tests ordered, even though insurance may not. Copia determines whether or not an ABN is required based on the diagnosis code(s) entered for the order and the patient's insurance. An ABN is not required if the patient is selected as the payor for the order; however, depending on the administration settings for your signed in location, Copia may allow you to print ABNs for patients without insurance, it may automatically create an ABN when you save an order, and/or it may require you to select a status of "Signed," "Signed/Don't Bill," or "Refused to Sign" when you save an order that requires an ABN. You must have the necessary security right to modify the ABN status on complete orders.

Copia determines whether an Advance Beneficiary Notice (ABN) is required based on the selected diagnosis and the patient's insurance, the frequency limits for the order choice, and whether the order choice is set as a research/experimental order choice. In addition, if the setting to fail all diagnosis codes is set for the order choice, then Copia always triggers an ABN for that order choice, no matter what the diagnosis code is.

When Copia creates an ABN for an order, it displays the combined estimated cost of all order choices on the order that have estimated costs defined on the Order Choices administration page. If no order choices have defined estimated costs, then Copia does not display any cost information.

Note that you must have a PDF print driver installed in order to view and print ABNs. If you do not have a PDF print driver installed, Copia displays a page with instructions on how to obtain a PDF print driver. If you do not wish to install a PDF driver, click the Back button to return to the previous page.

Note that when the administrative setting to skip collection is set for an ordering location, Copia automatically sends orders to the host testing location when they are placed. However, before it sends the order, Copia displays this page so you may assign an ABN signed status before Copia sends the electronic messages to the host. In addition, when the administrative setting to automatically mark ordered samples as collected is set for an ordering location, Copia displays this page so you may assign an ABN signed status at the conclusion of placing an order rather than at the time of sample collection.

For more help, click one of the following links:

• Accessing this Page
• Printing the ABN
• Updating the ABN Status

Accessing this Page

• Click the ABN link on the Collect Samples page.
• Click the ABN button on the Order Patient Samples page.
• Click the ABN warning text on the Pending Collection page (when running in batch collection mode).
• Click the Blank ABN button on the Order Patient Samples page. Note that you must add this button to the Order Patient Samples page using a layout template.

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Printing the ABN

1. Each Order Choice that has a potential reimbursement problem is listed with the Reason that the insurance company may not pay for the test in the ABN Status section.
2. Select one or more of the order choices to have Copia update the ABN Status/Print page with the ABN for the selected order choices. You may have Copia automatically select all order choices by default by modifying your settings on the Application page. See the Application topic.
3. Use the scroll bar on the right side of the page to view the ABN(s). Depending on the administration settings, Copia may create multiple copies of the ABN to print.
4. Select the Display ABN in Spanish option to view the displayed ABN in Spanish. Clear this option to view the displayed ABN in English. You may set the default value for this option for each patient in the Demographics page. See the Demographics topic.
5. Click Print to open the standard print dialogs. Change the print settings as desired and then click Print. Copia will print the ABN according to the settings you established in the print dialogs (number of copies, printer destination, etc.).
6. Once you have printed the ABN, have the patient sign the form if appropriate. You may then update the Status of the ABN. See "Updating the ABN Status" below.
7. Click Cancel to close the ABN Status/Print page and return to the preceding page.

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Updating the ABN Status

1. Select one or more checkboxes for order choices in the Assign column. These are the order choices to which you wish to assign a status.
2. Select an option from the Signed Status drop-down list for each order choice to indicate whether or not the patient has signed the ABN for the selected order choices, or select the Assign checkbox below the list of order choices and select an option from the Assign ___ to all selected order choices drop-down list to apply the selected status to all of the order choices you selected above. The available statuses are:
• Refused to Sign: Select this option to indicate that the patient would not sign the ABN.
• Signed: Select this option to indicate that the patient has signed the ABN.
• Signed/Don't Bill: Select this option to indicate that the patient has signed the ABN, but that the patient should not be billed for the testing.
• Unsigned: Select this option to indicate that the patient has not yet signed the ABN. This is the default setting Copia uses when it first creates the ABN.

If you select the "Refused to Sign" option and the system-wide administration setting is enabled to cancel generating an exception for this status, the Order Patient Samples and Collect Samples pages behave visually as if an ABN status of "Signed" was assigned, including not coloring the ABN button text or links red, as well as not producing an exception when you mark the sample as collected.

Depending on the administration settings for your signed in location, Copia may require you to select a status of "Signed," "Signed/Don't Bill," or "Refused to Sign" when you save an order that requires an ABN, and it may or may not display the "Refused to Sign" option.

3. You will be prompted to update the status of unsigned ABNs before you save the changes to the Collected status in the Collect Samples page (if an ABN is required). Click OK on the prompt to continue updating the Collected status. See the Collect Samples topic.
4. Click Save to record the status change, close the ABN Status/Print page, and return to the preceding page.
5. Click Cancel to close the ABN Status/Print page and return to the preceding page without saving your changes.

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