RE: Out-of-state Medicaid Inquiry

[Guest guest]

Hi Gloria,

Out of state Medicaid is a tough one. Your facility and MDs will need to be enrolled/credentialed if they are not already. You will need to process an

authorization request as you do for other plans. They may not process an auth request if you are not enrolled with their plan. Most Medicaid plans will not cover services out of state unless they are not available in the home state. As far as reimbursement

is concerned, your facility will typically have to accept the out of state rate. Your contracting department may be able to negotiate something – it just really depends upon the circumstances. We do kidney and pancreas transplants here.

Deidra

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Townsen, Gloria

Sent: Tuesday, June 19, 2012 11:10 AM

To: 'TxFinancialCoordinators '

Subject: FW: Out-of-state Medicaid Inquiry

Hello Everyone,

I would like to know if your facility accepts out-of-state Medicaid for transplant services. If so, how is reimbursement handled, what have been the challenges you have faced, and what solid organs are transplanted? Your assistance

would be greatly appreciated.

Gloria C. Townsend

Financial Coordinator

University of North Carolina Health Care

UNC Center for Transplant Care

101 Manning Drive

Chapel Hill, NC 27514

Tele#:

Fax#:

Email: gtownsen@...

[Guest guest]

It might be helpful to check with the

Medicaid specialists in your facility’s Patient Accounts Department. The

specialist or contracting manager will know if the facility has agreements for

Medicaid in surrounding states.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Deidra M. Simano

Sent: Tuesday, June 19, 2012 10:39

AM

To:

TxFinancialCoordinators

Subject:

RE: Out-of-state Medicaid Inquiry

Hi Gloria,

Out of state Medicaid is a tough one. Your facility

and MDs will need to be enrolled/credentialed if they are not

already. You will need to process an authorization request as you do for

other plans. They may not process an auth request if you are not

enrolled with their plan. Most Medicaid plans will not cover services out

of state unless they are not available in the home state. As far as

reimbursement is concerned, your facility will typically have to accept the out

of state rate. Your contracting department may be able to negotiate

something – it just really depends upon the circumstances. We do

kidney and pancreas transplants here.

Deidra

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Townsen, Gloria

Sent: Tuesday, June 19, 2012 11:10

AM

To:

'TxFinancialCoordinators '

Subject:

FW: Out-of-state Medicaid Inquiry

Hello Everyone,

I would like to

know if your facility accepts out-of-state Medicaid for transplant

services. If so, how is reimbursement handled, what have been the

challenges you have faced, and what solid organs are transplanted? Your

assistance would be greatly appreciated.

Gloria C. Townsend

Financial

Coordinator

University of North Carolina Health Care

UNC Center for Transplant Care

101 Manning Drive

Chapel Hill, NC 27514

Tele#: (919)

966-2008

Fax#:

Email: gtownsen@...

[Guest guest]

It might be helpful to check with the

Medicaid specialists in your facility’s Patient Accounts Department. The

specialist or contracting manager will know if the facility has agreements for

Medicaid in surrounding states.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Deidra M. Simano

Sent: Tuesday, June 19, 2012 10:39

AM

To:

TxFinancialCoordinators

Subject:

RE: Out-of-state Medicaid Inquiry

Hi Gloria,

Out of state Medicaid is a tough one. Your facility

and MDs will need to be enrolled/credentialed if they are not

already. You will need to process an authorization request as you do for

other plans. They may not process an auth request if you are not

enrolled with their plan. Most Medicaid plans will not cover services out

of state unless they are not available in the home state. As far as

reimbursement is concerned, your facility will typically have to accept the out

of state rate. Your contracting department may be able to negotiate

something – it just really depends upon the circumstances. We do

kidney and pancreas transplants here.

Deidra

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Townsen, Gloria

Sent: Tuesday, June 19, 2012 11:10

AM

To:

'TxFinancialCoordinators '

Subject:

FW: Out-of-state Medicaid Inquiry

Hello Everyone,

I would like to

know if your facility accepts out-of-state Medicaid for transplant

services. If so, how is reimbursement handled, what have been the

challenges you have faced, and what solid organs are transplanted? Your

assistance would be greatly appreciated.

Gloria C. Townsend

Financial

Coordinator

University of North Carolina Health Care

UNC Center for Transplant Care

101 Manning Drive

Chapel Hill, NC 27514

Tele#: (919)

966-2008

Fax#:

Email: gtownsen@...

[Guest guest]

No we do not

Dorinda S. Frye, Auth Rep

Hema/Onc, Infusion, BMT

Akron Children's Hospital

One Perkins Square

Akron, OH 44308

office

fax

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Townsen,

Gloria

Sent: Tuesday, June 19, 2012 11:10 AM

To: 'TxFinancialCoordinators '

Subject: FW: Out-of-state Medicaid Inquiry

Hello

Everyone,

I

would like to know if your facility accepts out-of-state Medicaid for

transplant services. If so, how is reimbursement handled, what have been

the challenges you have faced, and what solid organs are transplanted?

Your assistance would be greatly appreciated.

Gloria C. Townsend

Financial

Coordinator

University

of North Carolina Health Care

UNC

Center for Transplant Care

101

Manning Drive

Chapel

Hill, NC 27514

Tele#:

Fax#:

Email:

gtownsen@...