Here's a better way to present your first visit fees for non-covered services. Use this super-simple worksheet, rather than the unnecessary (and ugly!) Medicare ABN.
During the financial consultation, your staff simply enters the range of your customary fees for non-covered services in the yellow fields, and the patient's first-visit responsibility in the green. Enter the fee for their cost of the adjustment, add them up and presto! You've explained how your first visit Medicare fees are computed.
The simple layout provides a visual explanation that seniors find helpful. Request a signature, make a copy for your files and you're done.
This tear sheet can replace your excluded services first visit ABN.