...An ABN, or advanced beneficiary notice, contains a list of all the items or services that Medicare is not responsible to pay for. It also includes an estimate of what the costs will be to the beneficiary for the items and services that will not be paid for by Medicare and an explanation as to why Medicare may not pay for those services...Interestingly, if a healthcare facility, such as a hospital, provides a patient with an ABN document that is outdated, that patient is not liable for any of the charges for services or procedures. This in turn places the healthcare facility at risk for fully covering the service...Patients who have received an ABN ultimately have the option not to sign the document...