ABN & HHCCN Webinar - This 1 hr & 26 min webinar was created by Home Care Alliance in MA. It will not be able to be viewed on the tablet, but will be able to be viewed on any other computer. Handouts for Webinar.
Important Regulatory Information about HHABN
CMS has eliminated the current HHABN (all 3 forms).
Effective 12/9/13, the HHABN will no longer be valid. It has been replaced by 2 forms ABN - (Advance Beneficiary Notice) and HHCCN (Home Health Change of Care Notice)
New Forms will be are available in all offices by Friday 12/6. These forms may be used now, but must be used on 12/9/2013 or after. Any old form issued after 12/8/13 will need to be re-issued. Please discard any old forms in your possession.
Most sections of the new forms have been prefilled with checkbox choices.
ABN for Dually Eligible patients (Medicare/Medicaid) will be printed with specific language recently given to us by MassHealth for use when initiating services under MassHealth. This will be available as a photocopy until printed forms are received.
Further information will be provided at Team Meetings and on HHVNA Education Website
Key Points for Valid Completion of ABN and HHCCN
No abbreviations allowed
Traditional Medicare only
1.
Top of form: Fill in patient name and ID (NOT Medicare # or SSN)
Top of form: Fill in patient name and ID (NOT Medicare # or SSN)2.Bottom of form: Patient signature and date must be completed by patient or representative.
Bottom of form: Patient signature and date must be completed by patient or representative. a.If patient can’t sign/date, representative can sign with the “Rep” after name
If patient can’t sign/date, representative can sign with the “Rep” after name b.If patient refuses to sign, document circumstances on form
If patient refuses to sign, document circumstances on form c.If unable to deliver in person, fully explain via telephone, document, mail to patient
If unable to deliver in person, fully explain via telephone, document, mail to patient 3.Give a copy to patient, original to CSC
Give a copy to patient, original to CSCABN (Advance Beneficiary Notice):
This form is used when the patient may want the services to continue and may be financially liable for payment.
•Check the box for applicable discipline
Check the box for applicable discipline •Enter specific frequency – no abbreviations for example: 3 times per week, 2 visits per month
Enter specific frequency – no abbreviations for example: 3 times per week, 2 visits per month •Check the box for reason why items/services are not covered by Medicare, or enter at “other”
Check the box for reason why items/services are not covered by Medicare, or enter at “other” •Potential cost is prefilled; no check box needed
Potential cost is prefilled; no check box needed •Options - Patient must choose:
Options - Patient must choose: oOption 1: Services will continue, Medicare will review to determine if service are covered
Option 1: Services will continue, Medicare will review to determine if service are covered oOption 2: Services will continue, patient will be responsible for payment. Option 2 is also used
Option 2: Services will continue, patient will be responsible for payment. Option 2 is also used for dually eligible patients when changing from Medicare to Medicaid. See ABN[2]below
oOption 3: Services will end. No patient liability.
Option 3: Services will end. No patient liability. •The ABN is effective for up to one year and must be issued annually for ongoing services. HHABNs
The ABN is effective for up to one year and must be issued annually for ongoing services. HHABNs issued prior to December 9, 2013 for ongoing services will remain in effect for up to one year from
the date of issuance
ABN [2] Dually Eligible
This form is identical to the above ABN, but has an additional statement in the “Additional Information” section which is required by MassHealth:
“WE WILL BILL YOUR MEDICAID PLAN. WE WILL BILL MEDICARE ONLY IF YOUR MEDICAID PLAN
INSTRUCTS US TO DO SO”.
Direct patient to choose Option 2.
HHCCN (Home Health Change of Care Notice)
Use this form to notify a patient of an unplanned decrease or termination of a service.
1.Check the box for applicable discipline
Check the box for applicable discipline2.Check “will end”; or “will be reduced to” and enter specific frequency – no abbreviations
Check “will end”; or “will be reduced to” and enter specific frequency – no abbreviations3.Check reason for change or enter reason under “other”
Check reason for change or enter reason under “other”4.Select one choice :
Select one choice : a.Your doctor has ordered the change
Your doctor has ordered the change b.Your agency has decided to stop home care services
Your agency has decided to stop home care services 
