Denial of Care

[forthemiddle]

22. Patients generally don't see the Medicare denials

Most providers already know what Medicare will and will not be covered, so they stay away from many treatments. According to CMS guidelines, if a doctor prescribes, or performs a service that they know is not covered, they must have the patient sign an ABN , or an Advanced Notice of Non Coverage.
If the provider does not get that signed prior to delivering the service they are not allowed to bill the patient.

Because of this, Providers generally don’t offer those services, or they have to write it off.

For everyone that emphatically states that Medicare never denies service, it’s because their provider didn’t offer it.

Unless I missed it, the article never mentioned what the treatment denied was, I am guessing it was either something deemed experimental, or it was something that a cheaper alternative was available.