Donor Coverage

[Guest guest]

Hi everyone,

A son wants to donate to his father. They both have Blue Cross insurance plans

but they are on completely separate plans (meaning, the son is not a dependent

and has his own plan with his wife). The Customer Service rep from the son's

Blue Cross plan told me that the son's has " donor benefits " that will cover him

at 100% as long as he pays $150/co-pay per day during his hospitalization.

Donors shouldn't be billed at all. How do I get the father's Blue Cross plan to

pay for his son, the donor? My problem seems to be that with Blue Cross they

need a denial from the donor's insurance before they will cover the donor on the

recipient's insurance.

Any ideas on how to get the son covered on his father's plan as he shouldn't

have to pay at all for donation?

Thanks!

Maureen

[Guest guest]

Will do, thanks Bill! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Bill VaughanSent: Thursday, May 17, 2012 12:35To: TxFinancialCoordinators Subject: Re: Donor Coverage Hi ,I will start digging later, if you don't hear from me by noon tomorrow, please remind me. Thanks,Bill Reply-To: <TxFinancialCoordinators >Date: Thursday, May 17, 2012 2:58 PMTo: " 'TxFinancialCoordinators ' " <TxFinancialCoordinators >Subject: RE: Donor Coverage Hi Bill,Can you point me to the regulation that states that a transplant center is not allowed to bill for pre-eval services and donor services?Thanks, From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Bill Vaughan! Sent: Thursday, May 17, 2012 10:40To: TxFinancialCoordinators Subject: Re: Donor Coverage Hi Maureen,Blue Cross is the worst when it comes to an Insurance company thinking that their contract trumps Medicare. If the recipient is Medicare primary or secondary or just entitled or in the pre entitlement period, there is nothing in regulations that allows a transplant center to bill an insurance company for evaluation services or if the donor passes, for the donation services. The only place that regulation allows for billing is for complications due to donation post transplant. The question becomes, would a transplant center rather be out of compliance with an Insurance contract or with Medicare. Hope this helps,Thanks,Bill Reply-To: <TxFinancialCoordinators >Date: Thursday, May 17, 2012 11:33 AMTo: <TxFinancialCoordinators >Subject: Donor Coverage Hi everyone,A son wants to donate to his father. They both have Blue Cross insurance plans but they are on completely separate plans (meaning, the son is not a dependent and has his own plan with his wife). The Customer Service rep from the son's Blue Cross plan told me that the son's has " donor benefits " that will cover him at 100% as long as he pays $150/co-pay per day during his hospitalization. Donors shouldn't be billed at all. How do I get the father's Blue Cross plan to pay for his son, the donor? My problem seems to be that with Blue Cross they need a denial from the donor's insurance before they will cover the donor on the recipient's insurance.Any ideas on how to get the son covered on his father's plan as he shouldn't have to pay at all for donation?Thanks!Maureen****************** 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.****************** CONFIDENTIALITY DISCLAIMER ******************

The information contained in this e-mail may be confidential. IF YOU

RECEIVED THIS IN ERROR, please call the Virginia Mason Privacy Officer

through the Virginia Mason Operator at . Thank you.

Patients: E-mail is NOT considered secure. By choosing to communicate

with Virginia Mason by e-mail, you will assume the risk of a confidentiality

breach. Please do not rely on e-mail communication if you or a family

member is injured or is experiencing a sudden change in health status. If you need emergency attention, call 911.