Re: Medicare secondary to BC

[Guest guest]

If his BC is primary and Medicare secondary, my experience has been that Medicare will not pay. M. Christiansen, BAS, RNTransplant Financial Case Manager DeVos Heart and Lung Transplant Program100 Michigan NEMC 231Grand Rapids, MI 49503Phone: Pager: Fax: lisa.christiansen@... From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of ericbelen7Sent: Tuesday, January 24, 2012 1:38 PMTo: TxFinancialCoordinators Subject: Medicare secondary to BC Patient has no OON benefits with his BC. If he chooses to pursue a not-contracted facility, will Medicare coverhis transplant or not?I know for Medicaid, if a patient purposely did not use his primary benefits, Medicaid will not cover. Is it the same for Medicare?

[Guest guest]

Thats what I thought. Thanks :-)

>

> If his BC is primary and Medicare secondary, my experience has been that

Medicare will not pay.

>

> M. Christiansen, BAS, RN

> Transplant Financial Case Manager

> DeVos Heart and Lung Transplant Program

> 100 Michigan NE

> MC 231

> Grand Rapids, MI 49503

> Phone: Pager: Fax:

> lisa.christiansen@...

>

>

> From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of ericbelen7

> Sent: Tuesday, January 24, 2012 1:38 PM

> To: TxFinancialCoordinators

> Subject: Medicare secondary to BC

>

>

>

> Patient has no OON benefits with his BC. If he chooses to pursue a

not-contracted facility, will Medicare coverhis transplant or not?

>

> I know for Medicaid, if a patient purposely did not use his primary benefits,

Medicaid will not cover. Is it the same for Medicare?

>

[Guest guest]

If medicare is secondary they will not pick up the difference and perhaps not

anything if a patient purposely goes out of network with their primary insurance

policy

Whitney Folsom, TFC

ETMC Transplant Program

1100 E Lake St ste 340

Tyler, TX 75701

phone

fax

wlfolsom@...

>>> ericbelen7 1/24/2012 12:38 PM >>>

Patient has no OON benefits with his BC. If he chooses to pursue a

not-contracted facility, will Medicare coverhis transplant or not?

I know for Medicaid, if a patient purposely did not use his primary benefits,

Medicaid will not cover. Is it the same for Medicare?

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[Guest guest]

What about single case agreements that are done OON??

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 Whitney

Folsom

Sent: Tuesday, January 24, 2012 1:51 PM

To: TxFinancialCoordinators

Subject: Re: Medicare secondary to BC

If medicare is secondary they will not pick up

the difference and perhaps not anything if a patient purposely goes out of

network with their primary insurance policy

Whitney Folsom, TFC

ETMC Transplant Program

1100 E Lake St ste 340

Tyler, TX 75701

phone

fax

wlfolsom@...

>>> ericbelen7

1/24/2012 12:38 PM >>>

Patient has no OON benefits with his BC. If he chooses to pursue a

not-contracted facility, will Medicare coverhis transplant or not?

I know for Medicaid, if a patient purposely did not use his primary benefits,

Medicaid will not cover. Is it the same for Medicare?

===========================================================

This message is confidential, intended only

for the named recipient(s) and may contain

information that is privileged or exempt from

disclosure under applicable law. If you are

not the intended recipient(s), you are notified

that the dissemination, distribution or copying

of this message is strictly prohibited. If you

received this message in error, or are not the

named recipient(s), please notify the sender

and delete this e-mail from your computer.

ETMC has implemented secure messaging for

certain types of messages. For more information

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http://www.etmc.org/mail/

Thank you.

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This electronic mail transmission, including any attached files, may contain confidential and/or privileged information for the sole use of the intended recipient(s). It is not intended for transmission to, or receipt by, any unauthorized parties. Any review, use, distribution, dissemination, downloading, copying or disclosure by others is strictly

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[Guest guest]

Medicare will deny the claim. You may want

to Out of Network case agreement with BC

Wanda Cabrera

Operations & Finance Manager

Newark Beth Israel

Medical Center

Heart Failure and Transplant Program

201

Lyons Avenue, Suite L4

Newark, NJ 07112

Tel : Fax:

email: wcabrera@...

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of ericbelen7

Sent: Tuesday, January 24, 2012

1:38 PM

To: TxFinancialCoordinators

Subject:

Medicare secondary to BC

Patient has no OON benefits with his BC. If he chooses

to pursue a not-contracted facility, will Medicare coverhis transplant or not?

I know for Medicaid, if a patient purposely did not use his primary benefits,

Medicaid will not cover. Is it the same for Medicare?

[Guest guest]

That would be an exception. But there would need to be a pretty good reason why

the commercial insurance would bother going through an LOA when they have their

own in-network providers

>

> What about single case agreements that are done OON??

>

> 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 Whitney Folsom

> Sent: Tuesday, January 24, 2012 1:51 PM

> To: TxFinancialCoordinators

> Subject: Re: Medicare secondary to BC

>

>

>

> If medicare is secondary they will not pick up the difference and perhaps not

anything if a patient purposely goes out of network with their primary insurance

policy

>

> Whitney Folsom, TFC

> ETMC Transplant Program

> 1100 E Lake St ste 340

> Tyler, TX 75701

> phone

> fax

> wlfolsom@...<mailto:wlfolsom%40etmc.org>

>

> >>> ericbelen7 <ericbelen7@...<mailto:ericbelen7%40yahoo.com>> 1/24/2012 12:38

PM >>>

> Patient has no OON benefits with his BC. If he chooses to pursue a

not-contracted facility, will Medicare coverhis transplant or not?

>

> I know for Medicaid, if a patient purposely did not use his primary benefits,

Medicaid will not cover. Is it the same for Medicare?

>

> ===========================================================

> This message is confidential, intended only

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> information that is privileged or exempt from

> disclosure under applicable law. If you are

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> that the dissemination, distribution or copying

> of this message is strictly prohibited. If you

> received this message in error, or are not the

> named recipient(s), please notify the sender

> and delete this e-mail from your computer.

>

> ETMC has implemented secure messaging for

> certain types of messages. For more information

> about our secure messaging system, go to:

>

> http://www.etmc.org/mail/

>

> Thank you.

> ===========================================================

>

>

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unauthorized parties. Any review, use, distribution, dissemination, downloading,

copying or disclosure by others is strictly

>

> prohibited. If you are not the intended recipient (or authorized to receive

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