When in doubt, get out those ABNs

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06/03/2019

Have you ever been in Best Buy, simply trying to purchase whatever electronic device and been forced to listen to *The Spiel? It’s been a few years for me, but I seem to recall it had to do with them trying to sell you some sort of warranty and now matter how politely or firmly you try to stop the cashier from wasting their breath (and your time), they are required by the Corporate Overlords to do it any way.

I was reminded of this recently while reporting a story about ongoing confusion regarding ABNs and when providers are required to educate beneficiaries on the use of ABNs.

The answer: Even if the provider is non-participating AND even if the beneficiary has every intention of paying for said item with cash, you must advice them that item may be covered by Medicare.

As Andrea Stark advised: It’s always best to err on the side of full and utter transparency if there’s even the slightest chance your customer looks like they might have Medicare.

Using my mom as an example: If my 70-year-old mother takes a **cane up to the front counter at CVS, in theory, they should be sending her back to the pharmacy where the pharmacist would presumably explain about Medicare.

I am pretty sure my mom would have been irritated to have to hobble back to the pharmacy and wait in line to hear the spiel when she has a credit card in hand, ready to pay.

That goes for the mom-and-pop providers as well as the CVS and Walgreens of the world, something I didn’t include in the story (space, my kingdom for a few more column inches). I should have however, as many providers, like the one who emailed today to ask that very question, probably still wonder if they are taking it on the chin while the big guys get away with it.

For an online like Amazon, they could have a disclaimer at say, the "checkout" point (or elsewhere) stating that Medicare may pay for the item.

Does all this mean the government is throwing out consumerism or the patient’s right to choose what products they want or the right to pay however they choose? Of course not, but it does serve as a reminder to providers everywhere not to take any chances that the DME item you sold for cash today won’t come back with someone wondering why they paid full price while someone else had Medicare pay for theirs and demanding a refund on the item.

*I have avoided Best Buy ever since and have no idea if this practice is still in effect.

**My mom actually did buy a cane at CVS when we visited Vegas. I suspect she paid cash right at the front counter. Fun fact: She proceeded to leave the cane behind all over the strip.

 

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