tci ED Coding & Reimbursement Alert - 2006 Issue 6

Reader Questions: Follow CMS 'Duress' Rule When Considering ABNs

Question: Are our ED physicians permitted to discuss advance beneficiary notices (ABNs) with ED patients, or does that conflict with EMTALA (Emergency Medical Treatment and Labor Act) regulations?Ohio Subscriber Answer: It is a common misconception that discussing ABNs with ED patients violates patient anti-dumping laws.  While EMTALA requires that physicians screen and stabilize patients prior to inquiring about insurance coverage, the policy doesn't bar payment questions altogether, as long as asking such questions does not delay treatment or create an -economic coercion- that causes the patient to leave the ED. After the physician completes screening and...

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