Advance Beneficiary Notice (ABN)
We use and stay current with updates to the Centers for Medicare and Medicaid Services (CMS) Advance Beneficiary Notice (ABN) form. Available in English
, the TriCore ABN lists all laboratory tests that have limited coverage under Medicare.
Please present the ABN form on our behalf to Medicare patients whose specimens you collect when there is genuine doubt that Medicare will pay for a laboratory test. Before collecting the specimen, ask the patient to sign the form, which indicates that Medicare may not provide coverage for a test or tests and that they may be held responsible for the charges. Please provide the patient with a copy of the signed ABN form, and send the original to TriCore along with the requisition and specimen.
If we collect your patient’s specimen at one of our Patient Care Centers
, we’ll distribute the form in appropriate cases.
Use the links below to access helpful information and downloadable copies of the ABN:
Contact TriCore’s compliance officer at 505-938-8330
or toll-free at 800-245-3296 Ext. 8330,
or via email at firstname.lastname@example.org