Get Cms R 131

The Cms R 131 form, known as the Advance Beneficiary Notice (ABN), is crucial for patients who need to make informed choices about laboratory tests that Medicare may not cover. This guide provides clear, step-by-step instructions for completing the form online to ensure you understand your options and responsibilities.

Follow the steps to successfully complete the Cms R 131 form online.

1. Press the ‘Get Form’ button to access the Cms R 131 online form and open it in your preferred editing program.
2. Begin by filling in the patient's name and Medicare number (HICN) in the designated fields at the top of the form.
3. Read the introductory section carefully. It outlines that Medicare may not pay for the laboratory tests listed and explains your choices regarding those tests.
4. Review the reasons why Medicare is likely to deny payment, which are provided in the form. Ensure you understand the implications.
5. Estimate the cost of the laboratory tests by filling in the blank for 'Estimated Cost' provided on the form.
6. Choose one of the options provided by checking the appropriate box. Decide whether you want to receive the laboratory tests or not.
7. If you choose Option 1, indicate your understanding of the terms by acknowledging that you may have to pay upfront and that you can appeal Medicare's decision. If you opt for Option 2, acknowledge that you will not be receiving the tests.
8. Sign and date the form in the space provided. If applicable, a person acting on behalf of the patient should also sign.
9. Once the form is complete, save the changes made. You can then download, print, or share the completed form as needed.

Complete your Cms R 131 form online today to ensure you understand your healthcare options.