well elaborated questions and answers guaranteed A+ score What form is provided to a patient to indicate a service may not be covered by Medicare and the patient may be responsible for the charges? Selected d. Answer: ABN Correct d. Answer: ABN Response Rationale: An Advanced Beneficiary Notice (ABN) is used when a Medicare Feedback: beneficiary requests or agrees to receive a procedure or service that Medicare may not cover. This form notifies the patient of potential out of p...