billing differences in organ procurement

[Guest guest]

Hi!!

I'm wondering if I can get some information on the difference(s) (if there are

any) in billing for organ procurement on a live donor when the recipient is in

another location? If so, what are they?

I'm trying to understand both sides. For example, the donor being at our

facility and the organ then being sent to the recipient in at organization; and

also an organ being procured from a live donor at another organization and the

recipient of that organ being at my organization.

Thank you in advance, and I appreciate your comments. I'm not a TFC but

instead am in reimbursement working on the cost report. I am just " a BIT "

confused by this.

Lavery

[Guest guest]

Hi –

I have attached a document from UNOS that may help get you started. Feel free to give me a call.

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 kellyjlavery

Sent: Friday, June 29, 2012 3:34 PM

To: TxFinancialCoordinators

Subject: billing differences in organ procurement

Hi!!

I'm wondering if I can get some information on the difference(s) (if there are any) in billing for organ procurement on a live donor when the recipient is in another location? If so, what are they?

I'm trying to understand both sides. For example, the donor being at our facility and the organ then being sent to the recipient in at organization; and also an organ being procured from a live donor at another organization and the recipient of that organ being

at my organization.

Thank you in advance, and I appreciate your comments. I'm not a TFC but instead am in reimbursement working on the cost report. I am just " a BIT " confused by this.

Lavery

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1 of 1 File(s)

UNOS Paired Exchange Financial Fact Sheet_Jan2011.pdf

[Guest guest]

Hi –

I have attached a document from UNOS that may help get you started. Feel free to give me a call.

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 kellyjlavery

Sent: Friday, June 29, 2012 3:34 PM

To: TxFinancialCoordinators

Subject: billing differences in organ procurement

Hi!!

I'm wondering if I can get some information on the difference(s) (if there are any) in billing for organ procurement on a live donor when the recipient is in another location? If so, what are they?

I'm trying to understand both sides. For example, the donor being at our facility and the organ then being sent to the recipient in at organization; and also an organ being procured from a live donor at another organization and the recipient of that organ being

at my organization.

Thank you in advance, and I appreciate your comments. I'm not a TFC but instead am in reimbursement working on the cost report. I am just " a BIT " confused by this.

Lavery

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

1 of 1 File(s)

UNOS Paired Exchange Financial Fact Sheet_Jan2011.pdf

[Guest guest]

Hi ,A donor is a donor. When the pair is in the same transplant center, the evaluation of the donor is the responsibility of the transplanting center. No insurance is to be billed for evaluation. Physician evaluation consultations are the responsibility of the transplanting center and are not billed to any insurance company.At the time of donation the inpatient stay for the donor is written off to the transplant center for inclusion on the Cost Report and is not billed to any insurance. The Physicians and Surgeons that provide services to the Donor are billed to and paid by the recipients insurance unless the transplant is a global and then the Physicians and Surgeons are paid by the transplanting center and those fees are NOT put on the Cost Report.When the donor is in one transplant center and the recipient is in another, the donor is evaluated and the evaluation services are covered by the donor center and not billed to any insurance just like above.At the time of donation the inpatient stay for the donor is written off to the transplant center for inclusion on the Cost Report and is not billed to any insurance. The donor bill (charges) are then reduced to cost utilizing Medicare Cost Reporting Data reported on the D-4 Part I. A copy of the charges, the D-4 Part I and the computation of the cost are sent to the recipient center, the recipient center pays the cost of the recovery at the donor center. The amount received from the recipient center is offset on the line on D-4, Part III, Revenue for Organs Sold, the organ is counted as a live donor organ recovered and is counted as a medicare organ in the numerator and denominator. The Physicians and Surgeons that provide services to the Donor are billed to and paid by the recipients insurance unless the transplant is a global and then the Physicians and Surgeons are paid by the transplanting center and those fees are NOT put on the Cost Report. The financial coordinator at the donor and recipient center work together to make sure that the donor physicians and surgeons are paid for their services. If Medicare is the primary payer, the recipient center provides the donor center with the recipients medicare information. IF there is a global contract, with the NKR, there is an agreed upon amount that is paid by the recipient center, the financial coordinators provide billing information to the physicians and surgeons. If the recipient has another group insurance, the financial coordinators obtain necessary information and permissions from the payer to assure that the recovery physicians and surgeons get paid. If there is no mechanism for the recovery docs go get paid, then generally, the case should not proceed.If you have any questions, please let me know.Thanks,BillReply-To: <TxFinancialCoordinators >Date: Friday, June 29, 2012 3:33 PMTo: <TxFinancialCoordinators >Subject: billing differences in organ procurement

Hi!!

I'm wondering if I can get some information on the difference(s) (if there are any) in billing for organ procurement on a live donor when the recipient is in another location? If so, what are they?

I'm trying to understand both sides. For example, the donor being at our facility and the organ then being sent to the recipient in at organization; and also an organ being procured from a live donor at another organization and the recipient of that organ being at my organization.

Thank you in advance, and I appreciate your comments. I'm not a TFC but instead am in reimbursement working on the cost report. I am just "a BIT" confused by this.

Lavery