Re: Donor bills

[Guest guest]

Hi ,The inpatient stay for the donor is written off to the/billed to the/Logged for the Kidney Acquisition Cost Center. No bill for the inpatient stay is sent anywhere. Physician and surgeon fees are billed to the recipients payer. The donor plan does not get billed, the deductibles and co insurance are written off. The donor does not receive a bill.Hope this helps,Thanks,BillReply-To: <TxFinancialCoordinators >Date: Wednesday, April 18, 2012 11:50 AMTo: "TxFinancialCoordinators " <TxFinancialCoordinators >Subject: Donor bills

Hello all- need your help/advice: Scenario: Recipient and donor both have insurance through the state of MT (BCBS). Donation occurred and we sent the donor bills to the recipients plan. We are now being told by BCBS that 1) if recipient and donor both are both members of the state, then the bills need to be processed under the donor’s benefits, and that 2) the only time the recipients plan would be billed is if the donor is completely uninsured or does not have donation benefits. We checked with the donor plan for an exclusion but unfortunately were told that the donor does indeed have donation benefits IF they are donating!

to a state of MT employee. What are other centers doing in this scenario? Would you bill the donor plan and write-off deductibles and co-insurance? Or would your center incur the costs as courtesy to the donor? Thanks for any direction! ****************** CONFIDENTIALITY DISCLAIMER ******************

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[Guest guest]

OK Bill, please confirm for me that I understand this correctly:1. Donor inpatient “facility” charges are directed to the KACCa. If Medicare- placed on the Cost Reportb. If commercial insurance- is included in the SAC charge and billed2. Donor “physician” charges are billed to the recipient’s insurance regardless if it is Medicare or commercial insurance3. If a donor has complications: a. 1st 90 days- KACC?? b. after that then to the recipient’s insurance (for what period of time?)Thanks very much! M. Christiansen, BAS, RNTransplant Financial Case Manager DeVos Heart and Lung Transplant Program100 Michigan NEMC 231Grand Rapids, MI 49503Phone: Pager: Fax: lisa.christiansen@... From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Bill VaughanSent: Wednesday, April 18, 2012 4:58 PMTo: TxFinancialCoordinators Subject: Re: Donor bills Hi ,The inpatient stay for the donor is written off to the/billed to the/Logged for the Kidney Acquisition Cost Center. No bill for the inpatient stay is sent anywhere. Physician and surgeon fees are billed to the recipients payer. The donor plan does not get billed, the deductibles and co insurance are written off. The donor does not receive a bill. Hope this helps,Thanks,Bill Reply-To: <TxFinancialCoordinators >Date: Wednesday, April 18, 2012 11:50 AMTo: " TxFinancialCoordinators " <TxFinancialCoordinators >Subject: Donor bills Hello all- need your help/advice: Scenario: Recipient and donor both have insurance through the state of MT (BCBS). Donation occurred and we sent the donor bills to the recipients plan. We are now being told by BCBS that 1) if recipient and donor both are both members of the state, then the bills need to be processed under the donor’s benefits, and that 2) the only time the recipients plan would be billed is if the donor is completely uninsured or does not have donation benefits. We checked with the donor plan for an exclusion but unfortunately were told that the donor does indeed have donation benefits IF they are donating! to a state of MT employee. What are other centers doing in this scenario? Would you bill the donor plan and write-off deductibles and co-insurance? Or would your center incur the costs as courtesy to the donor? Thanks for any direction! ****************** CONFIDENTIALITY DISCLAIMER ****************** The information contained in this e-mail may be confidential. IF YOURECEIVED THIS IN ERROR, please call the Virginia Mason Privacy Officerthrough the Virginia Mason Operator at . Thank you. Patients: E-mail is NOT considered secure. By choosing to communicatewith Virginia Mason by e-mail, you will assume the risk of a confidentialitybreach. Please do not rely on e-mail communication if you or a familymember is injured or is experiencing a sudden change in health status. If you need emergency attention, call 911.

[Guest guest]

Reply-To: <TxFinancialCoordinators >Date: Thursday, April 19, 2012 10:25 AMTo: <txfinancialcoordinators >Subject: RE: Donor bills

OK Bill, please confirm for me that I understand this correctly:1. Donor inpatient “facility” charges are directed to the KACCa. If Medicare- placed on the Cost Report YESb. If commercial insurance- is included in the SAC charge and billed YES AND NO THE FACILITY CHARGES ARE PLACED ON THE COST REPORT. A SAC IS PLACED ON THE RECIPIENTS BILL. 2. Donor “physician” charges are billed to the recipient’s insurance regardless if it is Medicare or commercial insurance. DONOR EVALUATION CHARGES ARE BILLED TO THE TRANSPLANT CENTER AND PAID AT 100% OF MEDICARE. AT THE TIME OF DONATION DONOR PHYSICIAN CHARGES ARE BILLED TO THE RECIPIENTS INSURANCE, BOTH COMMERCIAL AND MEDICARE3. If a donor has complications: a. 1st 90 days- KACC?? FOR COMPLICATIONS HOSPITAL AND PHYSICIAN CHARGES ARE BILLED TO THE RECIPIENTS PAYERb. after that then to the recipient’s insurance (for what period of time?) NO TIME LIMIT AS LONG AS THEY ARE COMPLICATIONS.NOT MENTIONED, WELL BABY VISITS, ROUTINE FOLLOW UP IS BILLED TO THE KACC.Thanks very much! M. Christiansen, BAS, RNTransplant Financial Case Manager DeVos Heart and Lung Transplant Program100 Michigan NEMC 231Grand Rapids, MI 49503Phone: Pager: Fax: lisa.christiansen@... From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Bill VaughanSent: Wednesday, April 18, 2012 4:58 PMTo: TxFinancialCoordinators Subject: Re: Donor bills Hi ,The inpatient stay for the donor is written off to the/billed to the/Logged for the Kidney Acquisition Cost Center. No bill for the inpatient stay is sent anywhere. Physician and surgeon fees are billed !

to the recipients payer. The donor plan does not get billed, the deductibles and co insurance are written off. The donor does not receive a bill. Hope this helps,Thanks,Bill Reply-To: <TxFinancialCoordinators >Date: Wednesday, April 18, 2012 11:50 AM!

To: "TxFinancialCoordinators " <TxFinancialCoordinators >Subject: Donor bills Hello all- need your help/advice: Scenario: Recipient and donor both have insurance through the state of MT (BCBS). Donation occurred and we sent the donor bills to the recipients !

plan. We are now being told by BCBS that 1) if recipient and donor both are both members of the state, then the bills need to be processed under the donor’s benefits, and that 2) the only time the recipients plan would be billed is if the donor is completely uninsured or does not have donation benefits. We checked with the donor plan for an exclusion but unfortunately were told that the donor does indeed have donation benefits IF they are donating! to a state of MT employee. What are other centers doing in this scenario? Would you bill the donor plan and write-off deductibles and co-insurance? Or would your center incur the costs as courtesy to the donor? !

Thanks for a

ny direction! ****************** CONFIDENTIALITY DISCLAIMER ****************** The information contained in this e-mail may be confidential. IF YOURECEIVED THIS IN ERROR, please call the Virginia Mason Privacy Officerthrough the Virginia Mason Operator at . Thank you. Patients: E-mail is NOT considered secure. By choosing to communicatewith Virginia Mason by e-mail, you will assume the risk of a confidentialitybreach. Please do not rely on e-mail communication if you or a familymember is injured or is experiencing a sudden change in health status. If you need emergency attention, call 911.