What notice explains why Medicare denies a particular service?

The correct answer is the Advance Beneficiary Notice (ABN). This document serves as an important communication tool between healthcare providers and Medicare beneficiaries. When a provider believes that a service may not be covered by Medicare, the ABN is issued to inform the patient. It outlines why the service might be denied, giving the patient the option to either proceed with the service and understand that they may be responsible for the costs if denied, or to forego the service.

The ABN is essential because it helps ensure that patients are well informed about their potential financial obligations before receiving services. In contrast, other options do not serve this specific purpose. For example, while a Medicare Summary Notice provides a summary of services billed to Medicare and includes payment information, it does not specifically notify beneficiaries about non-coverage prior to service. The Eligibility Review Document and Claim Denial Notice also do not provide an upfront explanation regarding potential denials in advance of receiving care. The ABN's role in patient communication about service coverage sets it apart as the prominent choice in this context.