If a provider suspects that a Medicare procedure may not be covered, which document should the MAA complete?

When a provider suspects that a Medicare procedure may not be covered, the appropriate document for the Medical Administrative Assistant (MAA) to complete is the Advance Beneficiary Notice (ABN). The ABN serves as a notification to the patient that a specific procedure or service may not be covered by Medicare. It informs the patient that they may be personally responsible for the costs associated with the service if Medicare denies coverage.

The ABN allows the patient to make an informed decision about whether or not to proceed with the service, understanding the financial implications. By obtaining the patient's signature on this notice, the practice is also protected from potential issues regarding billing for services that might not be reimbursed by Medicare.

In contrast, the other documents mentioned, such as remittance advice, Medicare Summary Notice, and Explanation of Benefits, are related to the claims process or post-service notifications rather than preemptively informing the patient about potential coverage issues. Therefore, the ABN is specifically designed for situations where there may be uncertainty about coverage, making it the correct choice in this context.