RE: Social Worker Eval

[Guest guest]

There is no separate charge for the social worker evaluation, therefore, we do not bill for these services. >>> .M.Hogan@LaheyOrg 10/31/02 04:48PM >>>

Hi All,

Wondering how other centers handle the psychosocial evaluation billing. Does the social worker bill out his/her time?

Thanks, Pat Hogan Lahey Clinic

[Guest guest]

Thanks for your responses. I'm curious as to why that is. If they are licensed social workers and are credentialed and if they had a "clientele" they would be able to bill for their services. Is there any ruling or regs with Medicare regarding this? I was asked this question by our kidney social worker. All our doctors and psychiatrists work for the hospital also but genterate a bill for their services when they see a patient. The social workers here at Lahey Clinic in general don't bill for their services because it is not specific. However, the transplant social workers do counseling and evaluations to specific patients. So why shouldn't they be able to generate charges (and revenue) for that? Am I making this way too complicated? Do your social workers do just your transplant patients or do they do other services for the hospital also? Thanks again for all your input.

Pat Hogan

Transplant Financial Coord

Lahey Clinic

Burlington,MA

Social Worker Eval

Hi All,

Wondering how other centers handle the psychosocial evaluation billing. Does the social worker bill out his/her time?

Thanks, Pat Hogan Lahey Clinic

[Guest guest]

AT OU Medical Center hospitals in OKC, our social workers have other duties

besides the tx patients. ljm

> Social Worker Eval

>

>

>

> Hi All,

>

> Wondering how other centers handle the psychosocial evaluation

> billing.

> Does the social worker bill out his/her time?

>

> Thanks,

> Pat Hogan

> Lahey Clinic

>

>

>

>

[Guest guest]

This is put on our medicare cost report .

M@...

>>> sweber@... 11/01/02 07:58AM >>>

We don't either. The SW are all hospital employees and we don't bill for

their time.

Sue Weber

Heart & Liver Transplant Financial Specialist

The Methodist Hospital

6565 Fannin, SM 477

Houston, Texas 77030

Phone : 713/790-5964

FAX : 713/790-3041

Email : sweber@...

Social Worker Eval

Hi All,

Wondering how other centers handle the psychosocial evaluation billing.

Does the social worker bill out his/her time?

Thanks,

Pat Hogan

Lahey Clinic

[Guest guest]

HI Pat,

The Medicare Conditions of participation indicate that there must be a

Social Work evaluation as a part of the pre-transplant evaluation.

In general Medicare only pays for diagnosis and treatment. In this

case, the potential recipient or potential live donor has already been

" diagnosed " and what is being asked of the social worker is to

determine, within the parameters of the evaluation protocol, if the

" patient " meets the listing criteria or is an appropriate

donor. There is no traditional " care " rendered, therefore

there is no billable service rendered.

The time that is spent by the social worker in the pre-transplant

evaluation process, which includes but is not necessarily limited to the

interview, the writing of the conclusion, making the necessary entry into

the chart, follow up with the dialysis unit, follow up evaluations,etc.

should be logged to make sure that the appropriate costs associated with

the social worker are transferred to the appropriate organ acquisition

cost center on the Medicare Cost Report. It is this

" reclassification " process that moves the cost of the social

worker to the appropriate line on the Medicare Cost Report that allows

Medicare to pay the Hospital for a proportionate share of the cost of

social work evaluation services. The reclassification is only

necessarily if the social worker is not directly " employed " by

the transplant department.

In many cases the transplant social workers do work for

" departments " other than pre-transplant (they round on patients

on the floor, they see patients in post transplant clinic, they see

patients on other floors). In those cases it will be necessary for

the social worker to do time studies to assure that only time spent in

the pre-transplant evaluation process is charged to the appropriate Organ

Acquisition Cost Center on the Medicare Cost Report.

Hope this has helped,

Bill

P. Vaughan

Health Systems Concepts, Inc.

At 09:01 AM 11/1/02, you wrote:

Thanks

for your responses. I'm curious as to why that is. If they

are licensed social workers and are credentialed and if they had a

" clientele " they would be able to bill for their

services. Is there any ruling or regs with Medicare regarding

this? I was asked this question by our kidney social worker.

All our doctors and psychiatrists work for the hospital also but

genterate a bill for their services when they see a patient. The

social workers here at Lahey Clinic in general don't bill for their

services because it is not specific. However, the transplant social

workers do counseling and evaluations to specific patients. So why

shouldn't they be able to generate charges (and revenue) for

that? Am I making this way too complicated? Do your

social workers do just your transplant patients or do they do other

services for the hospital also? Thanks again for all your

input.

Pat

Hogan

Transplant Financial

Coord

Lahey

Clinic

Burlington,MA

Social Worker Eval

Hi All,

Wondering how other centers handle the psychosocial evaluation billing.

Does the social worker bill out his/her time?

Thanks,

Pat Hogan

Lahey Clinic

[Guest guest]

That is very helpful. Thanks for the explanation. How did we all survive without this group??

Pat Hogan

Social Worker Eval

Hi All,

Wondering how other centers handle the psychosocial evaluation billing.

Does the social worker bill out his/her time?

Thanks,

Pat Hogan

Lahey Clinic