CPB (Certified Professional Biller) Certification Practice Exam

What is the meaning of "Advance Beneficiary Notice (ABN)" in medical billing?

1. Shows the status of outstanding claims from each payer

2. The appearance of a pathologic condition due to a chemical substance

3. Judicial dispute resolution process by an appeals board

4. Document that acknowledges patient responsibility for payment

The correct answer is: Document that acknowledges patient responsibility for payment

The correct answer highlights the role of the Advance Beneficiary Notice (ABN) as a critical document in medical billing. An ABN is specifically designed to inform Medicare patients that services they are about to receive may not be covered by Medicare. By signing the ABN, patients acknowledge their understanding that they may be personally responsible for payment if Medicare denies coverage for those services. This process is essential for transparency between healthcare providers and patients regarding potential financial responsibilities. It provides the patient with a clear understanding that they could be billed out of pocket if the service is deemed non-covered by Medicare, thus protecting the provider from financial loss due to misunderstandings about coverage. The other options do not accurately represent the purpose of the ABN. For example, the first option refers to a status report on claims, which is unrelated to patient payment acknowledgments. The second option describes a medical condition rather than a billing process. The third option mentions a judicial process, which does not pertain to the specifics of patient responsibility in medical billing contexts.