Guest guest Posted March 20, 2012 Report Share Posted March 20, 2012 Good Afternoon, Does Medicare Part B have to be billed for the immunos? If a patient has Medicare AB and also a RX coverage not thru Medicare part D but thru a retiree program that will pay for the immunos, does Medicare part B have to be billed? I have a patient who post transplant will have supplement insurance but only for the first month. We are encouraging her to obtain another supplement or Medicaid for the 20%. However, the patient doesn't want us to bill her immunos to Part B but her retiree prescription coverage. Has anyone had this situation before? Is this allowable? Thanks Angie Angie SantiagoFinancial Coordinator Organ Disease and TransplantationAEMC5401 Old York RdKlein Professional Building, Suite 500Philadelphia, PA 19141- Phone- Fax This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2012 Report Share Posted March 26, 2012 Is the insurance your patient hastruly a supplement plan to Medicare? Michele Branham,TransplantFinancial CoordinatorSpiritualAmbassadorFlorida HospitalTransplant Center -Phone -FaxLuke 1:46-47 " My soul Glorifies the Lord and my Spirit rejoicesin God my Savior. " From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of AngieSantiagoSent: Monday, March 26, 2012 9:58 AMTo: txfinancialcoordinators Subject: MCR Pt B/Immunos Hi, I was re-sending out this question. Ifa patient has Medicare AB and also a RX coverage not thru Medicare part D butthru a retiree program that will pay for the immunos, does Medicare part B haveto be billed? Ihave a patient who post transplant will have supplement insurance but onlyfor the first month. We are encouraging her to obtain another supplementor Medicaid for the 20%. However, the patient doesn't want us to bill herimmunos to Part B but her retiree prescription coverage. Hasanyone had this situation before? Is this allowable? ThanksAngie Angie SantiagoFinancial Coordinator Organ Disease and TransplantationAEMC5401 Old York RdKlein Professional Building, Suite 500Philadelphia, PA 19141- Phone- Fax>>> " Angie Santiago " Tuesday,March 20, 2012 12:09 PM >>> GoodAfternoon,DoesMedicare Part B have to be billed for the immunos? Ifa patient has Medicare AB and also a RX coverage not thru Medicare part D butthru a retiree program that will pay for the immunos, does Medicare part B haveto be billed? Ihave a patient who post transplant will have supplement insurance but onlyfor the first month. We are encouraging her to obtain another supplementor Medicaid for the 20%. However, the patient doesn't want us to bill herimmunos to Part B but her retiree prescription coverage.Hasanyone had this situation before? Is this allowable?ThanksAngie AngieSantiagoFinancial Coordinator Organ Disease and TransplantationAEMC5401 Old York RdKlein Professional Building, Suite 500Philadelphia, PA 19141- Phone- FaxThis message is intended for the use of the person or entity to which it isaddressed and may contain information that is privileged and confidential, thedisclosure of which is governed by applicable law. If you are not the intendedrecipient, or the employee or agent responsible to deliver it to the intendedrecipient, you are hereby notified that any disclosure, copying, ordistribution of this information is strictly prohibited. If you have receivedthis message by error, please notify the sender immediately to arrange forreturn or destruction of these documents. This message is intended for the use of the person or entity to which it isaddressed and may contain information that is privileged and confidential, thedisclosure of which is governed by applicable law. If you are not the intendedrecipient, or the employee or agent responsible to deliver it to the intendedrecipient, you are hereby notified that any disclosure, copying, ordistribution of this information is strictly prohibited. If you have receivedthis message by error, please notify the sender immediately to arrange forreturn or destruction of these documents. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 26, 2012 Report Share Posted March 26, 2012 have her apply for HealthWell premium assistance. () If approved they will pay her premiums up to $4000 per year. As long as she has proof that the supplemental is paying for the Immuno drugs. Amellia Gay, TFC and White Temple, TX fax >>> "Angie Santiago" 3/26/2012 10:13 AM >>> Hi Amelia, Yes, thank you very much. I guess the patient will need to pick up the supplement because she will need to maintain her Medicare Part B after transplant for her follow up visits. Thanks ~Angie Angie SantiagoFinancial Coordinator Organ Disease and TransplantationAEMC5401 Old York RdKlein Professional Building, Suite 500Philadelphia, PA 19141- Phone- Fax>>> "Amellia Gay" Monday, March 26, 2012 10:19 AM >>> Pt does not get to choose who the Drug is filed with any more than they can choose who to file medical benefits with. If medicare paid for the transplant and is in primary place then it has to be billed to Medicare B. If Medicare B in secondary place, pt must use pharmacy contracted to file Medicare B and they will pay Pt's copay. If medicare B termed and A still active, then commercial can be billed alone. Does this answer your question? Amellia Gay and White Transplant >>> "Angie Santiago" 3/26/2012 8:58 AM >>> Hi, I was re-sending out this question. If a patient has Medicare AB and also a RX coverage not thru Medicare part D but thru a retiree program that will pay for the immunos, does Medicare part B have to be billed? I have a patient who post transplant will have supplement insurance but only for the first month. We are encouraging her to obtain another supplement or Medicaid for the 20%. However, the patient doesn't want us to bill her immunos to Part B but her retiree prescription coverage. Has anyone had this situation before? Is this allowable? Thanks Angie Angie SantiagoFinancial Coordinator Organ Disease and TransplantationAEMC5401 Old York RdKlein Professional Building, Suite 500Philadelphia, PA 19141- Phone- Fax>>> "Angie Santiago" Tuesday, March 20, 2012 12:09 PM >>> Good Afternoon, Does Medicare Part B have to be billed for the immunos? If a patient has Medicare AB and also a RX coverage not thru Medicare part D but thru a retiree program that will pay for the immunos, does Medicare part B have to be billed? I have a patient who post transplant will have supplement insurance but only for the first month. We are encouraging her to obtain another supplement or Medicaid for the 20%. However, the patient doesn't want us to bill her immunos to Part B but her retiree prescription coverage. Has anyone had this situation before? Is this allowable? Thanks Angie Angie SantiagoFinancial Coordinator Organ Disease and TransplantationAEMC5401 Old York RdKlein Professional Building, Suite 500Philadelphia, PA 19141- Phone- FaxThis message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents. This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents. This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2012 Report Share Posted March 30, 2012 We have a kidney transplant patient who is receiving premium assistance through Healthwell. He was approved for a capped amount of $2,000 per calendar year. We just depleted his capped amount. I had heard previously from Healthwell that if the patient runs out of funds and if Healthwell has more available, he may be able to receive additional funding. I have also heard what Amellia states in the email below from other folks – regarding $4,000 for premium assistance. However, when I just called Healthwell I was told that he cannot apply for more funds, that is not accurate, and that he only can receive the $2,000 for assistance. The representative referred me to Patient Advocate Foundation at 1-. Has anyone been successful in obtaining additional funds through Healthwell? In addition, has anyone used the Patient Advocate Foundation? Thanks, Gibbins Transplant Financial Coordinator Halifax Health Center for Transplant Services P F Electronic communications originating from or sent to Halifax Health are subject to monitoring and public inspection under § 119.07, Florida Statutes. This message and any attachments are the property of Halifax Health and are intended to be received only by the individuals or entities identified in the message. If you have received this message in error, please take notice: 1) that any use, copying, printing, forwarding or distribution of this message in any form is strictly prohibited, and 2) please notify the Compliance Department at (386) 254-4278 and/or forward the message to compliance@..., and please delete or destroy all copies of the message and any attachments From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Amellia Gay Sent: Monday, March 26, 2012 11:48 AM To: txfinancialcoordinators Subject: Re: MCR Pt B/Immunos have her apply for HealthWell premium assistance. () If approved they will pay her premiums up to $4000 per year. As long as she has proof that the supplemental is paying for the Immuno drugs. Amellia Gay, TFC and White Temple, TX fax >>> " Angie Santiago " 3/26/2012 10:13 AM >>> Hi Amelia, Yes, thank you very much. I guess the patient will need to pick up the supplement because she will need to maintain her Medicare Part B after transplant for her follow up visits. Thanks ~Angie Angie Santiago Financial Coordinator Organ Disease and Transplantation AEMC 5401 Old York Rd Klein Professional Building, Suite 500 Philadelphia, PA 19141 - Phone - Fax >>> " Amellia Gay " Monday, March 26, 2012 10:19 AM >>> Pt does not get to choose who the Drug is filed with any more than they can choose who to file medical benefits with. If medicare paid for the transplant and is in primary place then it has to be billed to Medicare B. If Medicare B in secondary place, pt must use pharmacy contracted to file Medicare B and they will pay Pt's copay. If medicare B termed and A still active, then commercial can be billed alone. Does this answer your question? Amellia Gay and White Transplant >>> " Angie Santiago " 3/26/2012 8:58 AM >>> Hi, I was re-sending out this question. If a patient has Medicare AB and also a RX coverage not thru Medicare part D but thru a retiree program that will pay for the immunos, does Medicare part B have to be billed? I have a patient who post transplant will have supplement insurance but only for the first month. We are encouraging her to obtain another supplement or Medicaid for the 20%. However, the patient doesn't want us to bill her immunos to Part B but her retiree prescription coverage. Has anyone had this situation before? Is this allowable? Thanks Angie Angie Santiago Financial Coordinator Organ Disease and Transplantation AEMC 5401 Old York Rd Klein Professional Building, Suite 500 Philadelphia, PA 19141 - Phone - Fax >>> " Angie Santiago " Tuesday, March 20, 2012 12:09 PM >>> Good Afternoon, Does Medicare Part B have to be billed for the immunos? If a patient has Medicare AB and also a RX coverage not thru Medicare part D but thru a retiree program that will pay for the immunos, does Medicare part B have to be billed? I have a patient who post transplant will have supplement insurance but only for the first month. We are encouraging her to obtain another supplement or Medicaid for the 20%. However, the patient doesn't want us to bill her immunos to Part B but her retiree prescription coverage. Has anyone had this situation before? Is this allowable? Thanks Angie Angie Santiago Financial Coordinator Organ Disease and Transplantation AEMC 5401 Old York Rd Klein Professional Building, Suite 500 Philadelphia, PA 19141 - Phone - Fax This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents. This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents. This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information is strictly prohibited. If you have received this message by error, please notify the sender immediately to arrange for return or destruction of these documents. Quote Link to comment Share on other sites More sharing options...
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