Use the Medicare ABN template to enter basic information on the Medicare ABN form.
Click the Forms link, and double-click Medicare ABN from the list.
Click the Service Types field to select the service and items, which may not be covered by Medicare.
Enter the Identification Number for the patient.
Click the Items or Services field to type in items or services.
If the patient received an injection, click the Injections field to select it.
Click the Reason Medicare May Not Pay field to select a reason.
Click the Estimated Cost field and type in the estimated cost of the items and services.
Select the check box for Option 1, Option 2, or Option 3 based on the patient’s response. You can also leave this blank for the patient to select it once printed.
Select the Done check box. This enters the name of the logged-in user, with a date and timestamp.
Click the ABN Form document button to generate the document.
