Ambulatory: Updated Advanced Beneficiary (ABN) Statuses

Dec. 27, 2024

On Tuesday, Jan. 7, you will see changes to the ABN Status list in Epic, making it easier to select the appropriate status from available options.

In an effort to optimize workflows, the ABN statuses in Epic have been changed to be more efficient. Some statuses have been removed based on volume of use and feedback from clinicians. Other options have been changed to ensure clarity after review by Informatics, Compliance, and Revenue Cycle. The information below lists the new options and when to use them. Please refer to Epic Proportions for more information. Subscribe to the newsletter here to receive the weekly updates to your email.

To reduce your ABN workflow burden, please select one of the first two Provider ABN statuses at the time of order entry only. The collection of signed ABN waivers will occur later by office, laboratory, or imaging staff using the three ABN Signed statuses when the specimen is being collected or when the imaging procedure is being performed. If your office routinely collects laboratory specimens, please instruct your staff to collect ABN signature waiver at the time of specimen collection.

• Provider: ABN Discussed. Await Signature. [205] = Providers placing orders when the patient is present to discuss ABN, select this option. This allows the provider to place the order while also allowing lab or radiology staff the ability to complete their process as usual later and avoid the need for a new order. Patient will sign during lab/imaging procedure.
• Provider: ABN Not Discussed. Patient Not Present. [206] = Providers placing orders when the patient is not available or present, select this option. This allows the provider to place the order while also allowing lab or radiology staff the ability to complete their process as usual later and avoid the need for a new order. Lab/imaging will need to discuss ABN and sign.
• ABN Signed, Service Accepted (Option 1 – Bill Medicare) [3] = This status indicates that a patient has signed the form, wants to receive the service, and agrees to be financially responsible for the service if Medicare does not pay. This option should only be used by the person who is presenting the ABN to the patient for signature.
• ABN Signed, Service Accepted (Option 2 – Do not Bill Medicare) [9] = This status indicates that a patient has signed the form, wants to receive the service, agrees to be financially responsible for the service, and agrees not to bill Medicare. This option should only be used by the person who is presenting the ABN to the patient for signature.
• ABN Signed, Service Declined [6] = This status indicates that a patient has signed the form and does not want to receive the service. Typically, the clinician cancels the order in this situation. If a patient signs the form and declines the service, but the physician believes it is important to proceed with the service at Corewell Health’s expense, the test should not be canceled.
• Notice Printed [2] = This status is automatically assigned to an ABN when the ABN is printed. In practice, "ABN Printed" can function as either an initial or intermediate status because staff can print a copy of the ABN before or after presenting the form to the patient.
• Notice Triggered [1] = This status is automatically assigned to new ABN forms. Indicates an ABN warning has been prompted. The order/procedure will NOT be able to be signed when the ABN is in this state.