RE: Activating Medicare B (whentookonlyA earlier)

[Guest guest]

Daryl, Bev is correct. I have had this situation to come up several times with patients who have a good EGHP. Because the patient did not get Part B at the time of dialysis under the other entitlements(age and disability) the patient would need to wait for the enrollment period during the first quarter of the year with an effective date of July 1st. In your case they are asking for the 2728 because the patient has to prove new eligibility for the ESRD entitlement so they can grant coverage outside of the normal enrollment period restrictions.

Julius C. Eason

Transplant Financial Coordinator

Beaumont Hospital Renal Transplant

Royal Oak, MI

(P) , (F)

jeason@...>>> "BEVERLY A LARSON" 9/11/2008 8:06 AM >>>They need the information on a official document about the transplant and they update their record off of that one. We do not send it to the network just give it to the patient to take to Social Security. Bev>>> "Battin, Daryl J." 9/11/2008 8:04 AM >>>

But the 2728 was done when he started dialysis -- ESRD Network says a2728 is only done once for ESRD patients, not a new one at time oftransplant.Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: Page: -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY ALARSONSent: Thursday, September 11, 2008 8:03 AMTo: TxFinancialCoordinators Subject: Re: Activating Medicare B (when tookonlyA earlier)SS does require the 2728 update to open the window for Part B. Bev>>> "Battin, Daryl J." <Daryl.J.BattinLahey (DOT) org> 9/10/2008 4:08 PM >>>I have a patient with active commercial insurance who took only ESRDMedicare A (on dialysis) and now is trying to activate the B (had atransplant today). Social Security told the patient that since hedeclined the B when he took the A, they cannot activate the B withoutdocumentation that he had a kidney transplant (today). They gave thepatient a new 2728 to complete. ESRD Network has told me I am not tocomplete a new 2728 but Social Security is insisting they cannotactivate the Medicare B without official documentation on a 2728 of thetransplant.To settle this case and help this patient (who has huge coinsurance forimmunos), Social Security is faxing me his original dialysis 2728 to addthe transplant information and will accept that but I have never had todo that before????What has been your experience in similar scenarios?Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: Page: 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.