RE: GHP denying donor charges

[Guest guest]

Hi ,

If the recipients insurance wants a denial

from the donor’s insurance we suggest that you get signed permission from

the donor to call their insurance and request a denial. If the donor does

not want to give permission then they should probably be disqualified, I would

fully understand a donor not wanting their insurance to know, I personally

wouldn’t.

Then call the donor’s insurance and

ask for a denial, most of the time it will not be a problem because the

insurance company does not want to pay for anything they don’t have

to. If they ask why, tell them that the Social Security Act (please see

attached) indicates that the donor has no financial responsibility for the

donation, read it to them and if they ask fax it to them. The vast

majority of the time, the insurance company will agree to the denial.

The recipients insurance does not care,

their job is to pay as little as possible and still be within their

contract.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Fornash, M.

Sent: Tuesday, December 02, 2008

11:48 AM

To: TxFinancialCoordinators

Subject:

GHP denying donor charges

Has

anyone seen an increase in recipients insurance wanting a denial from the

donors insurance before they will pay? We have had several come up

lately and wanted to make sure we approached it correctly. It is

not something we agree with ethically. Does anyone know if there are any

regulations regarding this billing practice?

Thanks

so much! Bill, are you out there?

Fornash

Transplant

Financial Coordinator

Kidney

& Pancreas

Mayo

Clinic ville

(904)

953.6062 phone

(904)

953.2681 fax

fornash.angelamayo (DOT) edu

[Guest guest]

Talking about after the transplant has

been done and then processing the claim for the donor surgery etc?

Daryl Battin,

LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

Page:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Helms, Tina

Sent: Tuesday, December 02, 2008

11:53 AM

To: TxFinancialCoordinators

Subject: RE:

GHP denying donor charges

When I

started this position in 07' I was told it was unethical, but I to am being

told this time and time again.

GHP denying donor charges

Has

anyone seen an increase in recipients insurance wanting a denial from the

donors insurance before they will pay? We have had several come up

lately and wanted to make sure we approached it correctly. It is

not something we agree with ethically. Does anyone know if there are any

regulations regarding this billing practice?

Thanks

so much! Bill, are you out there?

Fornash

Transplant

Financial Coordinator

Kidney

& Pancreas

Mayo

Clinic ville

(904)

953.6062 phone

(904)

953.2681 fax

fornash.angelamayo (DOT) edu

size=1 width="100%" align=center>

Confidentiality

Notice: This e-mail message, including any attachments, is for the sole use of

the intended recipient(s) and may contain confidential and privileged

information. Any unauthorized review, use, disclosure or distribution is

prohibited. If you are not the intended recipient, please contact the sender by

reply e-mail and destroy all copies of the original message.

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.

[Guest guest]

Thanks so much for the expertise, Bill - Just what I was looking for.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of VaughanSent: Tuesday, December 02, 2008 12:09 PMTo: TxFinancialCoordinators Subject: RE: GHP denying donor charges

Hi ,

If the recipients insurance wants a denial from the donor’s insurance we suggest that you get signed permission from the donor to call their insurance and request a denial. If the donor does not want to give permission then they should probably be disqualified, I would fully understand a donor not wanting their insurance to know, I personally wouldn’t.

Then call the donor’s insurance and ask for a denial, most of the time it will not be a problem because the insurance company does not want to pay for anything they don’t have to. If they ask why, tell them that the Social Security Act (please see attached) indicates that the donor has no financial responsibility for the donation, read it to them and if they ask fax it to them. The vast majority of the time, the insurance company will agree to the denial.

The recipients insurance does not care, their job is to pay as little as possible and still be within their contract.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Fornash, M.Sent: Tuesday, December 02, 2008 11:48 AMTo: TxFinancialCoordinators Subject: GHP denying donor charges

Has anyone seen an increase in recipients insurance wanting a denial from the donors insurance before they will pay? We have had several come up lately and wanted to make sure we approached it correctly. It is not something we agree with ethically. Does anyone know if there are any regulations regarding this billing practice?

Thanks so much! Bill, are you out there?

Fornash Transplant Financial Coordinator Kidney & Pancreas Mayo Clinic ville (904) 953.6062 phone (904) 953.2681 fax fornash.angelamayo (DOT) edu

[Guest guest]

That’s what we thought – would

require different communication with insurance than if before the transplant.

We do tell our donors they will not have expenses themselves – and if

a claim sent to their insurance it might actually get paid and might effect

their deductible, annual out-of-pocket, life benefit, or other factor.

Seems need to have a contact at the donor

insurance (if we had that insurance information) who can quickly approve a

denial (and send them a copy of Bill’s attachment). Or, better yet,

would the recipient insurance accept Bill’s attachment as the reason the

donor insurance is not to pay?

Daryl Battin,

LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

Page:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Toby, M.

Sent: Tuesday, December 02, 2008

1:10 PM

To: TxFinancialCoordinators

Subject: RE:

GHP denying donor charges

Yes.

Chris

Toby

Contracting

& Payer Relations

Mayo

Clinic

(Fax)

CONFIDENTIALITY

NOTICE

This

message and any included attachments are from Mayo Clinic and are intended only

for the addressee. The information contained in this message is confidential

and may constitute inside or non-public information under international,

federal, or state securities laws. Unauthorized forwarding, printing, copying,

distribution, or use of such information is strictly prohibited and may be

unlawful. If you are not the addressee, please promptly delete this message and

notify the sender of the delivery error by e-mail.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Tuesday, December 02, 2008

12:42 PM

To: TxFinancialCoordinators

Subject: RE:

GHP denying donor charges

Talking about after the transplant has been done and then

processing the claim for the donor surgery etc?

Daryl

Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

Page:

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Helms, Tina

Sent: Tuesday, December 02, 2008

11:53 AM

To: TxFinancialCoordinators

Subject: RE:

GHP denying donor charges

When I started this position in

07' I was told it was unethical, but I to am being told this time and time

again.

-----Original

Message-----

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]On Behalf Of Fornash, M.

Sent: Tuesday, December 02, 2008

11:48 AM

To: TxFinancialCoordinators

Subject:

GHP denying donor charges

Has

anyone seen an increase in recipients insurance wanting a denial from the

donors insurance before they will pay? We have had several come up

lately and wanted to make sure we approached it correctly. It is

not something we agree with ethically. Does anyone know if there are any

regulations regarding this billing practice?

Thanks

so much! Bill, are you out there?

Fornash

Transplant

Financial Coordinator

Kidney

& Pancreas

Mayo

Clinic ville

(904)

953.6062 phone

(904)

953.2681 fax

fornash.angelamayo (DOT) edu

size=1

width= " 100% " align=center>

Confidentiality

Notice: This e-mail message, including any attachments, is for the sole use of

the intended recipient(s) and may contain confidential and privileged

information. Any unauthorized review, use, disclosure or distribution is

prohibited. If you are not the intended recipient, please contact the sender by

reply e-mail and destroy all copies of the original message.

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.

[Guest guest]

Can someone resend the Social Security Act Attachment .. I don't see the attachment.

Thanks

Barrow

Liver/Small Bowel Transplant Financial Counselor

Reagan UCLA Medical Center

Transplant Administration

- phone

- fax

mbarrow@...

GHP denying donor charges

Has anyone seen an increase in recipients insurance wanting a denial from the donors insurance before they will pay? We have had several come up lately and wanted to make

sure we approached it correctly. It is not something we agree with ethically. Does anyone know if there are any regulations regarding this billing practice?

Thanks so much! Bill, are you out there?

Fornash

Transplant Financial Coordinator

Kidney & Pancreas

Mayo Clinic ville

(904) 953.6062 phone

(904) 953.2681 fax

fornash.angelamayo (DOT) edu

IMPORTANT WARNING: This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential. You, the recipient,

are obligated to maintain it in a safe, secure and confidential manner. Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by

return email, and delete this message from your computer.

[Guest guest]

Hello All!

Can anyone contact me if you use the OTTR Transplant system?

We are having a technical difficulty with our documentation process.

We are documenting our financial information in the Insurance Providers

tabs, but then the info is disappearing and re-appearing in the ALL DOCS

section. The OTTR System people don’t seem to know what is going on

so I want to see if this happens to any of you or not.

HELP!!!! Please contact me…please see my info

below:

Thanks!!!

Jerusa

Irad Jerusa Campos

Financial Counselor

Abdominal Organ Transplant Program

University of Southern California University

Hospital

1510 San Pablo St. #200

Los Angeles, CA 90033

Ph#:

Pgr#:

Fx#:

Email: jerusa.campos@...

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

Sent: Tuesday, December 02, 2008

9:09 AM

To: TxFinancialCoordinators

Subject: RE:

GHP denying donor charges

Hi ,

If the recipients insurance wants a denial from the donor’s

insurance we suggest that you get signed permission from the donor to call

their insurance and request a denial. If the donor does not want to give

permission then they should probably be disqualified, I would fully understand

a donor not wanting their insurance to know, I personally wouldn’t.

Then call the donor’s insurance and ask for a denial, most of

the time it will not be a problem because the insurance company does not want

to pay for anything they don’t have to. If they ask why, tell them

that the Social Security Act (please see attached) indicates that the donor has

no financial responsibility for the donation, read it to them and if they ask

fax it to them. The vast majority of the time, the insurance company will

agree to the denial.

The recipients insurance does not care, their job is to pay as

little as possible and still be within their contract.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Fornash, M.

Sent: Tuesday, December 02, 2008

11:48 AM

To: TxFinancialCoordinators

Subject:

GHP denying donor charges

Has

anyone seen an increase in recipients insurance wanting a denial from the

donors insurance before they will pay? We have had several come up

lately and wanted to make sure we approached it correctly. It is

not something we agree with ethically. Does anyone know if there are any

regulations regarding this billing practice?

Thanks

so much! Bill, are you out there?

Fornash

Transplant

Financial Coordinator

Kidney

& Pancreas

Mayo

Clinic ville

(904)

953.6062 phone

(904)

953.2681 fax

fornash.angelamayo (DOT) edu

[Guest guest]

Does anyone have the

CPT code for BK virus DNA by PCR Blood (serum) and Urine?

Best Regards

Romero

Kidney

Transplant Financial Coordinator

USC University Hospital

1510 San Pablo St.

Los Angeles Ca. 90033

Fax

Pgr:

2.Romero@...

P Please

don't print this e-mail unless you really need to

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

Sent: Tuesday, December 02, 2008

9:09 AM

To: TxFinancialCoordinators

Subject: RE:

GHP denying donor charges

Hi ,

If the recipients insurance wants a denial from the donor’s

insurance we suggest that you get signed permission from the donor to call

their insurance and request a denial. If the donor does not want to give

permission then they should probably be disqualified, I would fully understand

a donor not wanting their insurance to know, I personally wouldn’t.

Then call the donor’s insurance and ask for a denial, most of

the time it will not be a problem because the insurance company does not want

to pay for anything they don’t have to. If they ask why, tell them

that the Social Security Act (please see attached) indicates that the donor has

no financial responsibility for the donation, read it to them and if they ask

fax it to them. The vast majority of the time, the insurance company will

agree to the denial.

The recipients insurance does not care, their job is to pay as

little as possible and still be within their contract.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Fornash, M.

Sent: Tuesday, December 02, 2008

11:48 AM

To: TxFinancialCoordinators

Subject:

GHP denying donor charges

Has

anyone seen an increase in recipients insurance wanting a denial from the

donors insurance before they will pay? We have had several come up

lately and wanted to make sure we approached it correctly. It is

not something we agree with ethically. Does anyone know if there are any

regulations regarding this billing practice?

Thanks

so much! Bill, are you out there?

Fornash

Transplant

Financial Coordinator

Kidney

& Pancreas

Mayo

Clinic ville

(904)

953.6062 phone

(904)

953.2681 fax

fornash.angelamayo (DOT) edu

[Guest guest]

we use 87799

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Romero, 3Sent: Friday, December 05, 2008 3:18 PMTo: TxFinancialCoordinators Subject: RE: GHP denying donor charges

Does anyone have the CPT code for BK virus DNA by PCR Blood (serum) and Urine?

Best Regards

Romero

Kidney Transplant Financial Coordinator

USC University Hospital

1510 San Pablo St.

Los Angeles Ca. 90033

Fax

Pgr:

2.Romerotenethealth

P Please don't print this e-mail unless you really need to

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of VaughanSent: Tuesday, December 02, 2008 9:09 AMTo: TxFinancialCoordinators Subject: RE: GHP denying donor charges

Hi ,

If the recipients insurance wants a denial from the donor’s insurance we suggest that you get signed permission from the donor to call their insurance and request a denial. If the donor does not want to give permission then they should probably be disqualified, I would fully understand a donor not wanting their insurance to know, I personally wouldn’t.

Then call the donor’s insurance and ask for a denial, most of the time it will not be a problem because the insurance company does not want to pay for anything they don’t have to. If they ask why, tell them that the Social Security Act (please see attached) indicates that the donor has no financial responsibility for the donation, read it to them and if they ask fax it to them. The vast majority of the time, the insurance company will agree to the denial.

The recipients insurance does not care, their job is to pay as little as possible and still be within their contract.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Fornash, M.Sent: Tuesday, December 02, 2008 11:48 AMTo: TxFinancialCoordinators Subject: GHP denying donor charges

Has anyone seen an increase in recipients insurance wanting a denial from the donors insurance before they will pay? We have had several come up lately and wanted to make sure we approached it correctly. It is not something we agree with ethically. Does anyone know if there are any regulations regarding this billing practice?

Thanks so much! Bill, are you out there?

Fornash Transplant Financial Coordinator Kidney & Pancreas Mayo Clinic ville (904) 953.6062 phone (904) 953.2681 fax fornash.angelamayo (DOT) edu