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RE: Medicare PFFS plans

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We have, and have been reimbursed the

Medicare DRG.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH Trnsplnt

Sent: Wednesday, July 02, 2008

2:28 PM

To: TxFinancialCoordinators

Subject:

Medicare PFFS plans

I'm interested to hear from programs who

have transplanted someone w/a Medicare PFFS plan - we are not accepting them

here at this time.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR

97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

Medicare Advantage & Out-of-State Medicare benefits?

Patient has a Medicare Advantage plan in Massachusetts but

wants to explore also being listed for a transplant in Florida.

Would he be able to access his Medicare A

& B benefits for such a listing? He realizes he would have

nothing to cover the gap after Medicare pays their portion and would

self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road,

Burlington,

MA

01805

Ph: /FAX:

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your

use of this message for any purpose is strictly prohibited. If you have

received this communication in error, please delete the message and notify the

sender so that we may correct our records.

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,

We have transplanted a Blue Cross Advantage

Tina Transplant Financial Coordinator Cannon BMT Program2300 St.,3N Parkview/BMT-OncologyNashville, TN 37203(615)342-3388 Phone(615)929-2847 Pager(615)342-7641 FaxTina.@...

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Wednesday, July 02, 2008 1:28 PMTo: TxFinancialCoordinators Subject: Medicare PFFS plans

I'm interested to hear from programs who have transplanted someone w/a Medicare PFFS plan - we are not accepting them here at this time.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 11:21 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Then yes what I have seen with the fee for service plans is they can go anywhere and follow Medicare guidelines.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 2:15 PMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

It is.

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 2:11 PMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Daryl, only if is MA plan is a Fee for service plan, then he does have freedom.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 11:34 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Thanks -- his Medicare Advantage plan says he can use their plan anywhere for services (Florida, Alaska, wherever), as long as that provider accepts Medicare (I called them around the same time sending the email).

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Aguiar, J.Sent: Wednesday, July 02, 2008 11:21 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Not as long as he's still enrolled in the Advantage plan. It takes the place of his Medicare for all services for the duration of the enrollment.

J. Aguiar

Mayo Clinic Arizona

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 8:20 AMTo: TxFinancialCoordinators Subject: Medicare Advantage & Out-of-State Medicare benefits?

Patient has a Medicare Advantage plan in Massachusetts but wants to explore also being listed for a transplant in Florida.

Would he be able to access his Medicare A & B benefits for such a listing? He realizes he would have nothing to cover the gap after Medicare pays their portion and would self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

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, we've had a few referrals for evaluation - but no transplant yet.

Is there a reason why you aren't accepting this type of plan? Just

curious - maybe there's something we are missing here??? Thanks.

Craycraft

Transplant Financial Coordinator

University of Kansas Medical Center

Fax

lcraycraft@...

>>> " on, :LPH Trnsplnt " 07/02/2008 1:27

PM >>>

I'm interested to hear from programs who have transplanted someone w/a

Medicare PFFS plan - we are not accepting them here at this time.

on

Financial Counselor

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

toll free

fax

lmorriso@...

" Life is a tragedy when seen in close-up, but a comedy in long-shot. "

- Charlie Chaplin

Medicare Advantage & Out-of-State

Medicare benefits?

* Patient has a Medicare Advantage plan in Massachusetts but wants

to explore also being listed for a transplant in Florida.

* Would he be able to access his Medicare A & B benefits for such

a listing? He realizes he would have nothing to cover the gap after

Medicare pays their portion and would self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

See our web page at http://www.lahey.org for a full directory of Lahey

sites, staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL

AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the

intended recipient, your use of this message for any purpose is strictly

prohibited. If you have received this communication in error, please

delete the message and notify the sender so that we may correct our

records.

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I wish we could

refuse them…. They’re a pain to work with. The FFS plans are okay,

but the HMO’s, forget about it!

We are non-par w/

Wellcare & there are no par-txp facilities within 90 miles of us (they’re

more like 400 miles away). One of the rep’s told our kidney TFC that the

patient could go to Rochester

General Hospital

because they are par w/ Wellcare—but HELLO!!!! Rochester General doesn’t

do kidney transplants!!! They were clueless how to tell us what we should be

doing with these patients & frankly, so is our hospital—no one wants

to put their foot down &

I got my hands on a

referral request form for Wellcare that we will ask the referring provider to

complete & fax to Wellcare requesting authorization for “out of

network” evaluation. No results to share in terms of whether or not it

worked—still too early to tell.

We all hate the privatization

of Medicare over here… it’s a mess.

Meredith Gray

Liver Transplant Financial Coordinator

University of Rochester Strong

Memorial Hospital

601

Elmwood Avenue Box 602

Rochester,

NY 14642

(fax)

(pager)

This message

contains information which may be confidential and privileged. Unless you are the

addressee (or authorized to receive for the addressee), you may not use, copy

or disclose to anyone the message or any information contained in the message

(including attachments). If you have received the message in error, please

advise sender by reply email and delete the message. Thank you!

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Craycraft

Sent: Wednesday, July 02, 2008

2:41 PM

To: TxFinancialCoordinators

Subject: Re:

Medicare PFFS plans

, we've had a few referrals for evaluation - but

no transplant yet.

Is there a reason why you aren't accepting this type of plan? Just

curious - maybe there's something we are missing here??? Thanks.

Craycraft

Transplant Financial Coordinator

University of Kansas

Medical Center

Fax

lcraycraftkumc (DOT) edu

>>> " on, :LPH Trnsplnt " <lmorrisolhs (DOT) org> 07/02/2008 1:27

PM >>>

I'm interested to hear from programs who have transplanted someone w/a

Medicare PFFS plan - we are not accepting them here at this time.

on

Financial Counselor

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy in long-shot. "

- Charlie Chaplin

Medicare Advantage & Out-of-State

Medicare benefits?

* Patient has a Medicare Advantage plan in Massachusetts but wants

to explore also being listed for a transplant in Florida.

* Would he be able to access his Medicare A & B benefits for such

a listing? He realizes he would have nothing to cover the gap after

Medicare pays their portion and would self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph: /FAX:

See our web page at http://www.lahey.org

for a full directory of Lahey

sites, staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL

AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the

intended recipient, your use of this message for any purpose is strictly

prohibited. If you have received this communication in error, please

delete the message and notify the sender so that we may correct our

records.

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I think the big reasons are lack of contracts (PFFSs don't do contracts) and not being able to count these patients

in the numerator of the Medicare utilization fraction on cost report. I'm very open to bringing good arguments in their favor to my financial committee so please let me know if your programs feel these plans are not an automatic loss.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@...

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

Medicare Advantage & Out-of-StateMedicare benefits?* Patient has a Medicare Advantage plan in Massachusetts but wantsto explore also being listed for a transplant in Florida. * Would he be able to access his Medicare A & B benefits for sucha listing? He realizes he would have nothing to cover the gap afterMedicare pays their portion and would self-finance that portion. Thanks!Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: See our web page at http://www.lahey.org for a full directory of Laheysites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT ISADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIALAND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not theintended recipient, your use of this message for any purpose is strictlyprohibited. If you have received this communication in error, pleasedelete the message and notify the sender so that we may correct ourrecords.

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"We all hate the privatization of Medicare over here… it’s a mess" ..AMEN to that

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@...

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

Medicare Advantage & Out-of-StateMedicare benefits?* Patient has a Medicare Advantage plan in Massachusetts but wantsto explore also being listed for a transplant in Florida. * Would he be able to access his Medicare A & B benefits for sucha listing? He realizes he would have nothing to cover the gap afterMedicare pays their portion and would self-finance that portion. Thanks!Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: See our web page at http://www.lahey.org for a full directory of Laheysites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT ISADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIALAND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not theintended recipient, your use of this message for any purpose is strictlyprohibited. If you have received this communication in error, pleasedelete the message and notify the sender so that we may correct ourrecords.

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P.S. PFFS plans are the fastest-growing segment of MA which is why I'd like our committee to take a closer look at arguments in their favor

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@...

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

Medicare Advantage & Out-of-StateMedicare benefits?* Patient has a Medicare Advantage plan in Massachusetts but wantsto explore also being listed for a transplant in Florida. * Would he be able to access his Medicare A & B benefits for sucha listing? He realizes he would have nothing to cover the gap afterMedicare pays their portion and would self-finance that portion. Thanks!Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: See our web page at http://www.lahey.org for a full directory of Laheysites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT ISADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIALAND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not theintended recipient, your use of this message for any purpose is strictlyprohibited. If you have received this communication in error, pleasedelete the message and notify the sender so that we may correct ourrecords.

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We did the Blue Cross Advantage plan, and they had not worked out their claims process for transplants. They first denied the claim stating that we did not get prior auth, and that we were only approved 7 days and UR did not call them to extend. After arguing with several claims people that this was a drg admission and no prior auth was required, I finally had to go to the case manager and explain what was happening. She then had to go to the claims supervisor and get it worked out. I was a pain, and no one that I spoke to in claims knew what was going on or even wanted to know.

Tina Transplant Financial Coordinator Cannon BMT Program2300 St.,3N Parkview/BMT-OncologyNashville, TN 37203(615)342-3388 Phone(615)929-2847 Pager(615)342-7641 FaxTina.@...

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Wednesday, July 02, 2008 1:54 PMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

"We all hate the privatization of Medicare over here… it’s a mess" ..AMEN to that

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

Medicare Advantage & Out-of-StateMedicare benefits?* Patient has a Medicare Advantage plan in Massachusetts but wantsto explore also being listed for a transplant in Florida. * Would he be able to access his Medicare A & B benefits for sucha listing? He realizes he would have nothing to cover the gap afterMedicare pays their portion and would self-finance that portion. Thanks!Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: See our web page at http://www.lahey.org for a full directory of Laheysites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT ISADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIALAND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not theintended recipient, your use of this message for any purpose is strictlyprohibited. If you have received this communication in error, pleasedelete the message and notify the sender so that we may correct ourrecords.

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what happens with the balances after the drg is paid?

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of TinaSent: Wednesday, July 02, 2008 2:58 PMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

We did the Blue Cross Advantage plan, and they had not worked out their claims process for transplants. They first denied the claim stating that we did not get prior auth, and that we were only approved 7 days and UR did not call them to extend. After arguing with several claims people that this was a drg admission and no prior auth was required, I finally had to go to the case manager and explain what was happening. She then had to go to the claims supervisor and get it worked out. I was a pain, and no one that I spoke to in claims knew what was going on or even wanted to know.

Tina Transplant Financial Coordinator Cannon BMT Program2300 St.,3N Parkview/BMT-OncologyNashville, TN 37203(615)342-3388 Phone(615)929-2847 Pager(615)342-7641 FaxTina.HCAHealthcare

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Wednesday, July 02, 2008 1:54 PMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

"We all hate the privatization of Medicare over here… it’s a mess" ..AMEN to that

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

Medicare Advantage & Out-of-StateMedicare benefits?* Patient has a Medicare Advantage plan in Massachusetts but wantsto explore also being listed for a transplant in Florida. * Would he be able to access his Medicare A & B benefits for sucha listing? He realizes he would have nothing to cover the gap afterMedicare pays their portion and would self-finance that portion. Thanks!Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: See our web page at http://www.lahey.org for a full directory of Laheysites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT ISADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIALAND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not theintended recipient, your use of this message for any purpose is strictlyprohibited. If you have received this communication in error, pleasedelete the message and notify the sender so that we may correct ourrecords.

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They usually pay DRG rate and if they need to go to nursing home usually pay poorly if you can find a home that will take them. Bev>>> "on, :LPH Trnsplnt" 7/2/2008 2:27 PM >>> I'm interested to hear from programs who have transplanted someone w/a Medicare PFFS plan - we are not accepting them here at this time. on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org "Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 11:21 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?Then yes what I have seen with the fee for service plans is they can go anywhere and follow Medicare guidelines.From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 2:15 PMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?It is.Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 2:11 PMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?Daryl, only if is MA plan is a Fee for service plan, then he does have freedom.From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 11:34 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?Thanks -- his Medicare Advantage plan says he can use their plan anywhere for services (Florida, Alaska, wherever), as long as that provider accepts Medicare (I called them around the same time sending the email).From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Aguiar, J.Sent: Wednesday, July 02, 2008 11:21 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?Not as long as he's still enrolled in the Advantage plan. It takes the place of his Medicare for all services for the duration of the enrollment. J. AguiarMayo Clinic ArizonaFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 8:20 AMTo: TxFinancialCoordinators Subject: Medicare Advantage & Out-of-State Medicare benefits?Patient has a Medicare Advantage plan in Massachusetts but wants to explore also being listed for a transplant in Florida. Would he be able to access his Medicare A & B benefits for such a listing? He realizes he would have nothing to cover the gap after Medicare pays their portion and would self-finance that portion. Thanks!Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

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I would like to know if any centers have any rules on patients that

are Medicare only. We are coming acroos many patients like this, and

they do not qualify for Medi-Cal (Medicaid), or have had trouble

getting a medicare advantage or medigap plan. Do any centers require

a financial deposit or have special rules for these patients?

>

>

> I'm interested to hear from programs who have transplanted someone

w/a Medicare PFFS plan - we are not accepting them here at this time.

>

> on

> Financial Counselor

> Legacy Transplant Services

> 1040 NW 22nd Ave Ste 480

> Portland OR 97210

>

> toll free

> fax

> lmorriso@...

>

> " Life is a tragedy when seen in close-up, but a comedy in long-

shot. " - Charlie Chaplin

>

>

> Medicare Advantage & Out-of-

State Medicare benefits?

>

> * Patient has a Medicare Advantage plan in Massachusetts but

wants to explore also being listed for a transplant in Florida.

>

> * Would he be able to access his Medicare A & B benefits for

such a listing? He realizes he would have nothing to cover the gap

after Medicare pays their portion and would self-finance that

portion.

>

> Thanks!

>

> Daryl Battin, LICSW

>

> Financial Coordinator/Social Worker

>

> Lahey Clinic Kidney Transplant

>

> 41 Mall Road, Burlington, MA 01805

>

> Ph: /FAX:

>

> See our web page at http://www.lahey.org for a full directory of

Lahey sites, staff, services and career opportunities.

>

> THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED,

CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you

are not the intended recipient, your use of this message for any

purpose is strictly prohibited. If you have received this

communication in error, please delete the message and notify the

sender so that we may correct our records.

>

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We have them come in and sign a letter that states they understand they will owe $400/month for antirejection medications as well as the Medicare co-pays and deductibles. We also include in that letter that they understand that these charges will be theirs and that we have no mechanism to write off their balances. Bev Larson>>> "susanna.casillas" 7/2/2008 4:08 PM >>>I would like to know if any centers have any rules on patients that are Medicare only. We are coming acroos many patients like this, and they do not qualify for Medi-Cal (Medicaid), or have had trouble getting a medicare advantage or medigap plan. Do any centers require a financial deposit or have special rules for these patients? >> > I'm interested to hear from programs who have transplanted someone w/a Medicare PFFS plan - we are not accepting them here at this time.> > on > Financial Counselor > Legacy Transplant Services > 1040 NW 22nd Ave Ste 480 > Portland OR 97210 > > toll free > fax > lmorriso@... > > "Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin > > > Medicare Advantage & Out-of-State Medicare benefits?> > * Patient has a Medicare Advantage plan in Massachusetts but wants to explore also being listed for a transplant in Florida. > > * Would he be able to access his Medicare A & B benefits for such a listing? He realizes he would have nothing to cover the gap after Medicare pays their portion and would self-finance that portion. > > Thanks!> > Daryl Battin, LICSW> > Financial Coordinator/Social Worker> > Lahey Clinic Kidney Transplant > > 41 Mall Road, Burlington, MA 01805> > Ph: /FAX: > > See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.> > THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.>

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Would you be willing to share that letter with me. I would like to see if we can start using that for our patients.

Stacey Stout Kidney/Pancreas Financial Coordinator O. Strickler Transplant Center (phone) (fax) SAS8W@...

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY A LARSONSent: Wednesday, July 02, 2008 4:13 PMTo: TxFinancialCoordinators Subject: Re: Medicare PFFS plans

We have them come in and sign a letter that states they understand they will owe $400/month for antirejection medications as well as the Medicare co-pays and deductibles. We also include in that letter that they understand that these charges will be theirs and that we have no mechanism to write off their balances. Bev Larson>>> "susanna.casillas" 7/2/2008 4:08 PM >>>

I would like to know if any centers have any rules on patients that are Medicare only. We are coming acroos many patients like this, and they do not qualify for Medi-Cal (Medicaid), or have had trouble getting a medicare advantage or medigap plan. Do any centers require a financial deposit or have special rules for these patients? >> > I'm interested to hear from programs who have transplanted someone w/a Medicare PFFS plan - we are not accepting them here at this time.> > on > Financial Counselor > Legacy Transplant Services > 1040 NW 22nd Ave Ste 480 > Portland OR 97210 > > toll free > fax > lmorriso@... > > "Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin > > > Medicare Advantage & Out-of-State Medicare benefits?> > * Patient has a Medicare Advantage plan in Massachusetts but wants to explore also being listed for a transplant in Florida. > > * Would he be able to access his Medicare A & B benefits for such a listing? He realizes he would have nothing to cover the gap after Medicare pays their portion and would self-finance that portion. > > Thanks!> > Daryl Battin, LICSW> > Financial Coordinator/Social Worker> > Lahey Clinic Kidney Transplant > > 41 Mall Road, Burlington, MA 01805> > Ph: /FAX: > > See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.> > THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.>

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You should be receiving the letter via fax now. Bev>>> "Stout, Stacey A *HS" 7/2/2008 4:16 PM >>>Would you be willing to share that letter with me. I would like to see if we can start using that for our patients. Stacey Stout Kidney/Pancreas Financial Coordinator O. Strickler Transplant Center (phone) (fax) SAS8Wvirginia (DOT) edu From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY A LARSONSent: Wednesday, July 02, 2008 4:13 PMTo: TxFinancialCoordinators Subject: Re: Medicare PFFS plansWe have them come in and sign a letter that states they understand they will owe $400/month for antirejection medications as well as the Medicare co-pays and deductibles. We also include in that letter that they understand that these charges will be theirs and that we have no mechanism to write off their balances. Bev Larson>>> "susanna.casillas" <scasillasllu (DOT) edu> 7/2/2008 4:08 PM >>>I would like to know if any centers have any rules on patients that are Medicare only. We are coming acroos many patients like this, and they do not qualify for Medi-Cal (Medicaid), or have had trouble getting a medicare advantage or medigap plan. Do any centers require a financial deposit or have special rules for these patients? >> > I'm interested to hear from programs who have transplanted someone w/a Medicare PFFS plan - we are not accepting them here at this time.> > on > Financial Counselor > Legacy Transplant Services > 1040 NW 22nd Ave Ste 480 > Portland OR 97210 > > toll free > fax > lmorriso@... > > "Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin > > > Medicare Advantage & Out-of-State Medicare benefits?> > * Patient has a Medicare Advantage plan in Massachusetts but wants to explore also being listed for a transplant in Florida. > > * Would he be able to access his Medicare A & B benefits for such a listing? He realizes he would have nothing to cover the gap after Medicare pays their portion and would self-finance that portion. > > Thanks!> > Daryl Battin, LICSW> > Financial Coordinator/Social Worker> > Lahey Clinic Kidney Transplant > > 41 Mall Road, Burlington, MA 01805> > Ph: /FAX: > > See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.> > THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.>

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Would you mind faxing that letter to me also, and how did you come up with the

$400 dollar figure for anti-rejection meds? Thanks

na Casillas

Transplant Financial Coordinator

Loma University Medical Center

Transplantation Institue

Loma , CA

phone

fax

scasillas@...

Medicare Advantage & Out-of-

State Medicare benefits?

>

> * Patient has a Medicare Advantage plan in Massachusetts but

wants to explore also being listed for a transplant in Florida.

>

> * Would he be able to access his Medicare A & B benefits for

such a listing? He realizes he would have nothing to cover the gap

after Medicare pays their portion and would self-finance that

portion.

>

> Thanks!

>

> Daryl Battin, LICSW

>

> Financial Coordinator/Social Worker

>

> Lahey Clinic Kidney Transplant

>

> 41 Mall Road, Burlington, MA 01805

>

> Ph: /FAX:

>

> See our web page at http://www.lahey.org for a full directory of

Lahey sites, staff, services and career opportunities.

>

> THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED,

CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you

are not the intended recipient, your use of this message for any

purpose is strictly prohibited. If you have received this

communication in error, please delete the message and notify the

sender so that we may correct our records.

>

Confidentiality Note:

The preceding e-mail message (including any attachments) contains information

that may be confidential, protected by applicable legal privileges, or

constitute non-public information. It is intended to be conveyed only to the

designated recipient(s). If you are not an intended recipient of this message,

please notify the sender by replying to this message and then delete it from

your system. Use, dissemination, distribution or reproduction of this message by

unintended recipients is not authorized and may be unlawful.

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Medicare PFFS plans should also be paying

you for the organ, in addition to the DRG payment.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008

11:32 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare PFFS plans

We have, and have been reimbursed the Medicare DRG.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH

Trnsplnt

Sent: Wednesday, July 02, 2008

2:28 PM

To: TxFinancialCoordinators

Subject:

Medicare PFFS plans

I'm interested to hear from programs who have transplanted someone

w/a Medicare PFFS plan - we are not accepting them here at this time.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

-----Original

Message-----

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008

11:21 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Then yes what I have seen with the fee for service plans is they

can go anywhere and follow Medicare guidelines.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

2:15 PM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

It is.

Daryl

Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph:

/FAX:

size=2

width= " 100% " align=center tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008

2:11 PM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Daryl, only if is MA plan is a Fee for service plan, then he does

have freedom.

size=2

width= " 100% " align=center tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

11:34 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Thanks -- his Medicare Advantage plan says he can use their plan anywhere

for services (Florida,

Alaska,

wherever), as long as that provider accepts Medicare (I called them around the

same time sending the email).

size=2

width= " 100% " align=center tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Aguiar, J.

Sent: Wednesday, July 02, 2008

11:21 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Not as long as he's still enrolled in the Advantage plan. It

takes the place of his Medicare for all services for the duration of the

enrollment.

J. Aguiar

Mayo Clinic Arizona

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

8:20 AM

To: TxFinancialCoordinators

Subject:

Medicare Advantage & Out-of-State Medicare benefits?

Patient has a Medicare Advantage plan in Massachusetts

but wants to explore also being listed for a transplant in Florida.

Would he be able to access his Medicare A

& B benefits for such a listing? He realizes he would have

nothing to cover the gap after Medicare pays their portion and would

self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road,

Burlington,

MA

01805

Ph: /FAX:

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your

use of this message for any purpose is strictly prohibited. If you have

received this communication in error, please delete the message and notify the

sender so that we may correct our records.

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That's a big hang up for us Fred, we can't figure out how that would happen. Can't count the kidney in the numerator on the cost report, which would be our way to recover the organ cost on a traditional Medicare patient, and can't make a contract w/the plan to include it above and beyond the DRG.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@...

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Forsthoffer, FredSent: Wednesday, July 02, 2008 3:23 PMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

Medicare PFFS plans should also be paying you for the organ, in addition to the DRG payment.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 11:32 AMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

We have, and have been reimbursed the Medicare DRG.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Wednesday, July 02, 2008 2:28 PMTo: TxFinancialCoordinators Subject: Medicare PFFS plans

I'm interested to hear from programs who have transplanted someone w/a Medicare PFFS plan - we are not accepting them here at this time.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 11:21 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Then yes what I have seen with the fee for service plans is they can go anywhere and follow Medicare guidelines.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 2:15 PMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

It is.

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

size=2 width="100%" align=center tabIndex=-1>

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 2:11 PMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Daryl, only if is MA plan is a Fee for service plan, then he does have freedom.

size=2 width="100%" align=center tabIndex=-1>

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators@yahoogroupscom] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 11:34 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Thanks -- his Medicare Advantage plan says he can use their plan anywhere for services (Florida, Alaska, wherever), as long as that provider accepts Medicare (I called them around the same time sending the email).

size=2 width="100%" align=center tabIndex=-1>

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators@yahoogroupscom] On Behalf Of Aguiar, J.Sent: Wednesday, July 02, 2008 11:21 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Not as long as he's still enrolled in the Advantage plan. It takes the place of his Medicare for all services for the duration of the enrollment.

J. Aguiar

Mayo Clinic Arizona

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators@yahoogroupscom] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 8:20 AMTo: TxFinancialCoordinators Subject: Medicare Advantage & Out-of-State Medicare benefits?

Patient has a Medicare Advantage plan in Massachusetts but wants to explore also being listed for a transplant in Florida.

Would he be able to access his Medicare A & B benefits for such a listing? He realizes he would have nothing to cover the gap after Medicare pays their portion and would self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

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We have it in all of our PFFS

contracts. Perhaps you should have someone look into it.

You should try to get 100% of your organ acquisition charge, instead of

settling for the Medicare Cost report amount. PFFS plans have

to pay minimally what Medicare pays, but there is no maximum, beyond your

ability to get it.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH Trnsplnt

Sent: Wednesday, July 02, 2008

3:36 PM

To: TxFinancialCoordinators

Subject: RE:

Medicare PFFS plans

That's a big hang up for us Fred, we can't

figure out how that would happen. Can't count the kidney in the numerator

on the cost report, which would be our way to recover the organ cost on a

traditional Medicare patient, and can't make a contract w/the plan to

include it above and beyond the DRG.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR

97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

Medicare Advantage & Out-of-State Medicare benefits?

Patient has a Medicare Advantage plan in Massachusetts

but wants to explore also being listed for a transplant in Florida.

Would he be able to access his Medicare A

& B benefits for such a listing? He realizes he would have

nothing to cover the gap after Medicare pays their portion and would

self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road,

Burlington,

MA

01805

Ph: /FAX:

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your

use of this message for any purpose is strictly prohibited. If you have

received this communication in error, please delete the message and notify the

sender so that we may correct our records.

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So, may we ask, are you contacting each plan as you get a referred member and negotiating an individual contract or a blanket agreement?

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@...

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Forsthoffer, FredSent: Wednesday, July 02, 2008 4:22 PMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

We have it in all of our PFFS contracts. Perhaps you should have someone look into it. You should try to get 100% of your organ acquisition charge, instead of settling for the Medicare Cost report amount. PFFS plans have to pay minimally what Medicare pays, but there is no maximum, beyond your ability to get it.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Wednesday, July 02, 2008 3:36 PMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

That's a big hang up for us Fred, we can't figure out how that would happen. Can't count the kidney in the numerator on the cost report, which would be our way to recover the organ cost on a traditional Medicare patient, and can't make a contract w/the plan to include it above and beyond the DRG.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Forsthoffer, FredSent: Wednesday, July 02, 2008 3:23 PMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

Medicare PFFS plans should also be paying you for the organ, in addition to the DRG payment.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 11:32 AMTo: TxFinancialCoordinators Subject: RE: Medicare PFFS plans

We have, and have been reimbursed the Medicare DRG.

size=2 width="100%" align=center tabIndex=-1>

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Wednesday, July 02, 2008 2:28 PMTo: TxFinancialCoordinators Subject: Medicare PFFS plans

I'm interested to hear from programs who have transplanted someone w/a Medicare PFFS plan - we are not accepting them here at this time.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 11:21 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Then yes what I have seen with the fee for service plans is they can go anywhere and follow Medicare guidelines.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators@yahoogroupscom] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 2:15 PMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

It is.

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

size=2 width="100%" align=center tabIndex=-1>

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators@yahoogroupscom] On Behalf Of Kreci, Sent: Wednesday, July 02, 2008 2:11 PMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Daryl, only if is MA plan is a Fee for service plan, then he does have freedom.

size=2 width="100%" align=center tabIndex=-1>

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators@yahoogroupscom] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 11:34 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Thanks -- his Medicare Advantage plan says he can use their plan anywhere for services (Florida, Alaska, wherever), as long as that provider accepts Medicare (I called them around the same time sending the email).

size=2 width="100%" align=center tabIndex=-1>

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators@yahoogroupscom] On Behalf Of Aguiar, J.Sent: Wednesday, July 02, 2008 11:21 AMTo: TxFinancialCoordinators Subject: RE: Medicare Advantage & Out-of-State Medicare benefits?

Not as long as he's still enrolled in the Advantage plan. It takes the place of his Medicare for all services for the duration of the enrollment.

J. Aguiar

Mayo Clinic Arizona

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators@yahoogroupscom] On Behalf Of Battin, Daryl J.Sent: Wednesday, July 02, 2008 8:20 AMTo: TxFinancialCoordinators Subject: Medicare Advantage & Out-of-State Medicare benefits?

Patient has a Medicare Advantage plan in Massachusetts but wants to explore also being listed for a transplant in Florida.

Would he be able to access his Medicare A & B benefits for such a listing? He realizes he would have nothing to cover the gap after Medicare pays their portion and would self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

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We asked the pharmacy to calculate Medicare Allowed on immunosuppressive medications and figured 20% that the patient would owe after insurance. We tried to include outpatient clinic visits etc. These figures do not take into account complications and/or other medications patient may be taking. It only addresses the immunosuppressive medications and Valcyte. BEv>>> "Casillas, na" 7/2/2008 5:45 PM >>>Would you mind faxing that letter to me also, and how did you come up with the $400 dollar figure for anti-rejection meds? Thanksna CasillasTransplant Financial CoordinatorLoma University Medical CenterTransplantation InstitueLoma , CA phone faxscasillasllu (DOT) edu <mailto:scasillasllu (DOT) edu> Medicare Advantage & Out-of-State Medicare benefits?> > * Patient has a Medicare Advantage plan in Massachusetts but wants to explore also being listed for a transplant in Florida. > > * Would he be able to access his Medicare A & B benefits for such a listing? He realizes he would have nothing to cover the gap after Medicare pays their portion and would self-finance that portion. > > Thanks!> > Daryl Battin, LICSW> > Financial Coordinator/Social Worker> > Lahey Clinic Kidney Transplant > > 41 Mall Road, Burlington, MA 01805> > Ph: /FAX: > > See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.> > THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.>Confidentiality Note:The preceding e-mail message (including any attachments) contains information that may be confidential, protected by applicable legal privileges, or constitute non-public information. It is intended to be conveyed only to the designated recipient(s). If you are not an intended recipient of this message, please notify the sender by replying to this message and then delete it from your system. Use, dissemination, distribution or reproduction of this message by unintended recipients is not authorized and may be unlawful.

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How would that be, Fred. When I verify I

am told they follow all Medicare guideline. And when the payments came in

they were the Medicare DRG. Why would they pay extra for the organ ? Do you

have a regulation that states that ?

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Forsthoffer, Fred

Sent: Wednesday, July 02, 2008

6:23 PM

To:

TxFinancialCoordinators

Subject: RE:

Medicare PFFS plans

Medicare PFFS plans should also be paying you for the organ, in

addition to the DRG payment.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008 11:32

AM

To: TxFinancialCoordinators

Subject: RE:

Medicare PFFS plans

We have, and have been reimbursed the Medicare DRG.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH

Trnsplnt

Sent: Wednesday, July 02, 2008

2:28 PM

To: TxFinancialCoordinators

Subject:

Medicare PFFS plans

I'm interested to hear from programs who have transplanted someone

w/a Medicare PFFS plan - we are not accepting them here at this time.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

-----Original

Message-----

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008

11:21 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Then yes what I have seen with the fee for service plans is they

can go anywhere and follow Medicare guidelines.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

2:15 PM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

It is.

Daryl

Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph:

/FAX:

size=2 width= " 100% " align=center

tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008

2:11 PM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Daryl, only if is MA plan is a Fee for service plan, then he does

have freedom.

size=2 width= " 100% " align=center

tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

11:34 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Thanks -- his Medicare Advantage plan says he can use their plan

anywhere for services (Florida,

Alaska,

wherever), as long as that provider accepts Medicare (I called them around the

same time sending the email).

size=2 width= " 100% "

align=center tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Aguiar, J.

Sent: Wednesday, July 02, 2008

11:21 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Not as long as he's still enrolled in the Advantage plan. It

takes the place of his Medicare for all services for the duration of the

enrollment.

J. Aguiar

Mayo Clinic Arizona

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

8:20 AM

To: TxFinancialCoordinators

Subject:

Medicare Advantage & Out-of-State Medicare benefits?

Patient has a Medicare Advantage plan in Massachusetts

but wants to explore also being listed for a transplant in Florida.

Would he be able to access his Medicare A

& B benefits for such a listing? He realizes he would have

nothing to cover the gap after Medicare pays their portion and would

self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road,

Burlington,

MA

01805

Ph: /FAX:

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your

use of this message for any purpose is strictly prohibited. If you have

received this communication in error, please delete the message and notify the

sender so that we may correct our records.

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Guest guest

I track almost all transplanted patients medications as they are

discharged, I create a spread sheet and average them out. Whenever I

have a self pay patient or a patient that does not have 100% immuno

coverage I give them this chart to show actual patient expenses. My

charts are attached in case they can be useful to you. For all expected

expenses I do it specific to the town the patient lives in to include

travel, food & lodging. They use these charts if they are applying for

NTAF funs.

Pat Kreci

Transplant Financial Coordinator

Southwest Fla Regional Medical Ctr

Ft Myers, FL

Medicare Advantage & Out-of-

State Medicare benefits?

>

> * Patient has a Medicare Advantage plan in Massachusetts but

wants to explore also being listed for a transplant in Florida.

>

> * Would he be able to access his Medicare A & B benefits for

such a listing? He realizes he would have nothing to cover the gap

after Medicare pays their portion and would self-finance that

portion.

>

> Thanks!

>

> Daryl Battin, LICSW

>

> Financial Coordinator/Social Worker

>

> Lahey Clinic Kidney Transplant

>

> 41 Mall Road, Burlington, MA 01805

>

> Ph: /FAX:

>

> See our web page at http://www.lahey.org for a full directory of

Lahey sites, staff, services and career opportunities.

>

> THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED,

CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you

are not the intended recipient, your use of this message for any

purpose is strictly prohibited. If you have received this

communication in error, please delete the message and notify the

sender so that we may correct our records.

>

Confidentiality Note:

The preceding e-mail message (including any attachments) contains

information that may be confidential, protected by applicable legal

privileges, or constitute non-public information. It is intended to be

conveyed only to the designated recipient(s). If you are not an intended

recipient of this message, please notify the sender by replying to this

message and then delete it from your system. Use, dissemination,

distribution or reproduction of this message by unintended recipients is

not authorized and may be unlawful.

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Guest guest

Thank you Pat!

Daryl Battin,

LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

Sent: Thursday, July 03, 2008 9:20

AM

To: TxFinancialCoordinators

Subject: RE:

Re: Medicare PFFS plans

I track almost all transplanted patients medications

as they are

discharged, I create a spread sheet and average them out. Whenever I

have a self pay patient or a patient that does not have 100% immuno

coverage I give them this chart to show actual patient expenses. My

charts are attached in case they can be useful to you. For all expected

expenses I do it specific to the town the patient lives in to include

travel, food & lodging. They use these charts if they are applying for

NTAF funs.

Pat Kreci

Transplant Financial Coordinator

Southwest Fla Regional Medical Ctr

Ft Myers, FL

Medicare Advantage & Out-of-

State Medicare benefits?

>

> * Patient has a Medicare Advantage plan in Massachusetts

but

wants to explore also being listed for a transplant in Florida.

>

> * Would he be able to access his Medicare A & B benefits for

such a listing? He realizes he would have nothing to cover the gap

after Medicare pays their portion and would self-finance that

portion.

>

> Thanks!

>

> Daryl Battin, LICSW

>

> Financial Coordinator/Social Worker

>

> Lahey Clinic Kidney Transplant

>

> 41 Mall Road, Burlington, MA 01805

>

> Ph: /FAX:

>

> See our web page at http://www.lahey.org

for a full directory of

Lahey sites, staff, services and career opportunities.

>

> THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED,

CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you

are not the intended recipient, your use of this message for any

purpose is strictly prohibited. If you have received this

communication in error, please delete the message and notify the

sender so that we may correct our records.

>

Confidentiality Note:

The preceding e-mail message (including any attachments) contains

information that may be confidential, protected by applicable legal

privileges, or constitute non-public information. It is intended to be

conveyed only to the designated recipient(s). If you are not an intended

recipient of this message, please notify the sender by replying to this

message and then delete it from your system. Use, dissemination,

distribution or reproduction of this message by unintended recipients is

not authorized and may be unlawful.

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Guest guest

Fred, I was told by the health plan, that they

can not negotiate a rate for PFFS products?

Austria

Specialty Contracting

Methodist Health System

1441 North Beckley Avenue

Dallas,Texas 75203

Phone:

Fax:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

Sent: Thursday, July 03, 2008 8:13

AM

To: TxFinancialCoordinators

Subject: RE:

Medicare PFFS plans

How would that be, Fred. When I verify I am told they follow

all Medicare guideline. And when the payments came in they were the

Medicare DRG. Why would they pay extra for the organ ? Do you

have a regulation that states that ?

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Forsthoffer, Fred

Sent: Wednesday, July 02, 2008

6:23 PM

To: TxFinancialCoordinators

Subject: RE:

Medicare PFFS plans

Medicare PFFS plans should also be paying you for the organ, in

addition to the DRG payment.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008

11:32 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare PFFS plans

We have, and have been reimbursed the Medicare DRG.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH

Trnsplnt

Sent: Wednesday, July 02, 2008

2:28 PM

To: TxFinancialCoordinators

Subject:

Medicare PFFS plans

I'm interested to hear from programs who have transplanted someone

w/a Medicare PFFS plan - we are not accepting them here at this time.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd

Ave Ste 480

Portland

OR 97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

-----Original

Message-----

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008

11:21 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Then yes what I have seen with the fee for service plans is they

can go anywhere and follow Medicare guidelines.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

2:15 PM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

It is.

Daryl

Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph:

/FAX:

size=2 width= " 100% " align=center

tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008

2:11 PM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Daryl, only if is MA plan is a Fee for service plan, then he does

have freedom.

size=2 width= " 100% " align=center tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

11:34 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Thanks -- his Medicare Advantage plan says he can use their plan

anywhere for services (Florida,

Alaska,

wherever), as long as that provider accepts Medicare (I called them around the

same time sending the email).

size=2 width= " 100% "

align=center tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Aguiar, J.

Sent: Wednesday, July 02, 2008

11:21 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare Advantage & Out-of-State Medicare benefits?

Not as long as he's still enrolled in the Advantage plan. It

takes the place of his Medicare for all services for the duration of the

enrollment.

J. Aguiar

Mayo Clinic Arizona

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, July 02, 2008

8:20 AM

To: TxFinancialCoordinators

Subject:

Medicare Advantage & Out-of-State Medicare benefits?

Patient has a Medicare Advantage plan in Massachusetts

but wants to explore also being listed for a transplant in Florida.

Would he be able to access his Medicare A

& B benefits for such a listing? He realizes he would have

nothing to cover the gap after Medicare pays their portion and would

self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road,

Burlington,

MA

01805

Ph: /FAX:

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your

use of this message for any purpose is strictly prohibited. If you have

received this communication in error, please delete the message and notify the

sender so that we may correct our records.

***********************************************************************

This electronic transmission contains information from Methodist Health

System and should be considered confidential and privileged. The

information contained in the above messages is intended only for the

use of the individual(s) and entity(ies) named above. If you are not

the intended recipient, be aware that any disclosure, copying,

distribution, or use of this information is prohibited. If you receive

this transmission in error, please notify the sender immediately by

return e-mail. Methodist Health System, its subsidiaries and

affiliates hereby claim all applicable privileges related to the

transmission of this communication.

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Guest guest

That was my thought as well as I read through some of the previous

emails. When I call for benefits we are advised the out of pocket

amounts and that the follow Medicare guidelines. Our center has not

discussed this coverage in datail, but reading through these emails it

appears we need to do that! We just have not had a transplant yet

through one of these payers.

Craycraft

Transplant Financial Coordinator

University of Kansas Medical Center

Fax

lcraycraft@...

>>> " Kreci, " 07/03/2008 8:13

AM >>>

How would that be, Fred. When I verify I am told they follow all

Medicare guideline. And when the payments came in they were the

Medicare DRG. Why would they pay extra for the organ ? Do you have

a

regulation that states that ?

________________________________

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of

Forsthoffer, Fred

Sent: Wednesday, July 02, 2008 6:23 PM

To: TxFinancialCoordinators

Subject: RE: Medicare PFFS plans

Medicare PFFS plans should also be paying you for the organ, in

addition

to the DRG payment.

________________________________

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

Sent: Wednesday, July 02, 2008 11:32 AM

To: TxFinancialCoordinators

Subject: RE: Medicare PFFS plans

We have, and have been reimbursed the Medicare DRG.

________________________________

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of

on,

:LPH Trnsplnt

Sent: Wednesday, July 02, 2008 2:28 PM

To: TxFinancialCoordinators

Subject: Medicare PFFS plans

I'm interested to hear from programs who have transplanted someone w/a

Medicare PFFS plan - we are not accepting them here at this time.

on

Financial Counselor

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

toll free

fax

lmorriso@...

" Life is a tragedy when seen in close-up, but a comedy in long-shot. "

-

Charlie Chaplin

Medicare Advantage &

Out-of-State Medicare benefits?

* Patient has a Medicare Advantage plan in Massachusetts

but wants to explore also being listed for a transplant in Florida.

* Would he be able to access his Medicare A & B benefits

for such a listing? He realizes he would have nothing to cover the

gap

after Medicare pays their portion and would self-finance that portion.

Thanks!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

See our web page at http://www.lahey.org for a full directory

of

Lahey sites, staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT

IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL

AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the

intended recipient, your use of this message for any purpose is

strictly

prohibited. If you have received this communication in error, please

delete the message and notify the sender so that we may correct our

records.

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