We can reuse the copy here, just update the template name “Give your patients the freedom to complete an Advance Beneficiary Notice of Noncoverage with any device, anywhere. Streamline the way you collect signatures and consent forms by setting up your form online.
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Sometimes a patient may benefit from a treatment or procedure that may not be covered by Medicare, for a variety of reasons. Easily comply with Medicare standards and inform the patient of this issue up front, by sending this detailed form and requesting an acknowledgement and decision prior to the appointment.
The Advance Beneficiary Notice of Non-coverage Form helps Medicare Fee-for-Service beneficiaries make informed decisions about items and services Medicare usually covers but may not cover in specific situations. For example, the items or services may not be medically necessary for the beneficiary.
The liability falls on you to handle patient data in a compliant way. Patient privacy is a serious topic, legislation from the Health Insurance Portability and Accountability Act to the Patient Protection and Affordable Care Act place heavy fines on medical professionals who mistreat patient information.
A medical release form does not empower your staff to share patient information with just anyone. Depending on what is included in the form, the document may release medical information to the patient’s family, other doctors, insurance providers, attorneys, or anyone who may make healthcare decisions on behalf of the patient.
Print your patients’ submissions after the forms have been completed online. Adjust the formatting and text size to match your original paper forms.
Send an email invitation to your patients to complete your forms. Give patients the freedom to sign, complete, and submit forms with any device, anywhere.
Host your HIPAA compliant online forms and PHI on a dedicated server with a FormDr White Label Enterprise account. Keep your patient’s data secure while collecting form submissions with any device, anywhere, at any time.
Add your logo to your forms and set the colors to match your brand. Pick the background of your forms, customize the gradient of your buttons, and select the field text color.
FormDr gives your practice everything needed to easily send and receive HIPAA compliant forms online. We help practices who: