MCR Pt B/Immunos

[Guest guest]

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? 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 >>> 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?ThanksAngie 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.

[Guest guest]

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.

[Guest guest]

Hi Michele, The prescription coverage is thru a former employer's benefit and pension program. 1199SEIU Funds that will cover her prescriptions however for medical they will not pay the 20% but what they do is reimburse the patient 50% of the Medicare Part B premium yearly. The supplement she currently has is being paid through AKF and she has no intentions of paying for the supplement insurance once transplanted and AKF no longer pays. ~Angie Angie SantiagoFinancial Coordinator Organ Disease and TransplantationAEMC5401 Old York RdKlein Professional Building, Suite 500Philadelphia, PA 19141- Phone- Fax>>> "Branham, Michele" Monday, March 26, 2012 10:09 AM >>> Is the insurance your patient has truly a supplement plan to Medicare? Michele Branham,Transplant Financial CoordinatorSpiritual AmbassadorFlorida Hospital Transplant Center - Phone - FaxLuke 1:46-47 "My soul Glorifies the Lord and my Spirit rejoices in God my Savior."From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Angie SantiagoSent: Monday, March 26, 2012 9:58 AMTo: txfinancialcoordinators Subject: MCR Pt B/ImmunosHi,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?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 >>> 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?ThanksAngieAngie 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.

[Guest guest]

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? 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 >>> 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?ThanksAngie 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.