FPM Toolbox

Medicare

Advance Beneficiary Notice (ABN) - English

A form required for billing Medicare patients for a service when Medicare will not pay because it determines the service is not medically necessary
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Advance Beneficiary Notice (ABN) - Spanish

A form required for billing Medicare patients for a service when Medicare will not pay because it determines the service is not medically necessary
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E/M Services Q&A: How Does Your Medicare Administrative Contractor Interpret the Guidelines?

A reference outlining contractor rules on various portions of Medicare's Documentation Guidelines for Evaluation and Management Services
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Medicare Initial Preventive Physical Examination Encounter Form

An encounter form to ensure all elements of the initial preventive physical exam ("Welcome to Medicare physical") are completed
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Medicare Opt-Out Notice

An agreement form to notify Medicare that you plan to opt out
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Medicare Preventive Physical Exam

An encounter form that details the components required for Medicare annual wellness visits
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Private Contract With Medicare Beneficiary

A contract between you and Medicare patients that they are prohibited from submitting claims to Medicare for reimbursement for services you provide
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Scheduling Resource for Medicare Wellness Visits

A resource to help schedulers communicate with Medicare patients regarding wellness visits
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Wellness Care - Letter to Patients

A sample letter to patients explaining Medicare wellness care
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Wellness Care - Medicare Checkup

A health risk assessment Medicare patients can complete as part of their annual wellness visits
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