Guest guest Posted February 22, 2007 Report Share Posted February 22, 2007 Yes, he has at least 2 options: he can request to have his Medicare A go back 12 months and his B retro to the 1st of the month transplant takes place, or start them together in the transplant month. It seems to be taking about 6-8 weeks for Medicare apps to process so he may not show up in the CWF til April or so, but it will have the retro dates of entitlement on it. Medicare will be secondary for him until he completes the COB period which began when he started PD, regardless of having postponed his application. If you have a friendly pharmacist, he/she may be willing to hold the immuno copays until the Medicare system is ready to process those secondary claims. on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@... "Ring out old shapes of foul disease Ring out the narrowing lust of gold; Ring out the thousand wars of old, Ring in the thousand years of peace." - Alfred Lord Tennyson -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Antoine, Beverly A.Sent: Thursday, February 22, 2007 10:41 AMTo: TxFinancialCoordinators Subject: MEDICARE Hi everyone I have a patient coming in for a Kidney tx next week. He has been on PD since Nov. '06. He is eligible for Medicare but he has not applied for it yet. Will he still be able to get his immuno once he is Tx. under Medicare part B if he does not have it the day he is tx.? He has ghp which is primary at this time. Thanks Beverly lsumc IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2007 Report Share Posted February 22, 2007 Thanks alot the info was very helpful beverly From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Thursday, February 22, 2007 1:00 PMTo: TxFinancialCoordinators Subject: RE: MEDICARE Yes, he has at least 2 options: he can request to have his Medicare A go back 12 months and his B retro to the 1st of the month transplant takes place, or start them together in the transplant month. It seems to be taking about 6-8 weeks for Medicare apps to process so he may not show up in the CWF til April or so, but it will have the retro dates of entitlement on it. Medicare will be secondary for him until he completes the COB period which began when he started PD, regardless of having postponed his application. If you have a friendly pharmacist, he/she may be willing to hold the immuno copays until the Medicare system is ready to process those secondary claims. on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org "Ring out old shapes of foul disease Ring out the narrowing lust of gold; Ring out the thousand wars of old, Ring in the thousand years of peace." - Alfred Lord Tennyson -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Antoine, Beverly A.Sent: Thursday, February 22, 2007 10:41 AMTo: TxFinancialCoordinators Subject: MEDICARE Hi everyone I have a patient coming in for a Kidney tx next week. He has been on PD since Nov. '06. He is eligible for Medicare but he has not applied for it yet. Will he still be able to get his immuno once he is Tx. under Medicare part B if he does not have it the day he is tx.? He has ghp which is primary at this time. Thanks Beverly lsumc IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2007 Report Share Posted December 4, 2007 UHC stays primary for 30months then Medicare is primary (if she is under 65, she will lose her Medicare 36 months after transplant) So she may be Medicare primary only for 6 months then it disappears because she is no longer disabled due to ESRD. Patti Montemayor, RN CCTC Transplant Coordinator and White Hospital 2401 S. 31st Street Temple, TX 76508 254/724-8448 FAX 254/724-8772 >>> Mayabar@... 12/4/2007 10:16 AM >>> I have a kidney transplanted patient that at the time of transplant she had United Healthcare thru her husband's policy. When she was transplanted United Healthcare stay primary because at the time of transplant patient was not on Dialysis. Does this sound like its right? or Medicare should be primary. Transplant was done 9/26/07. Help!!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2007 Report Share Posted December 4, 2007 If she applied for Medicare after her transplant it will retro back to 9/1/07. It will begin a COB period of 30 months. When that period is up then Medicare will become primary. Betsy -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of AyabarrenoSent: Tuesday, December 04, 2007 8:17 AMTo: TxFinancialCoordinators Subject: Medicare I have a kidney transplanted patient that at the time of transplant she had United Healthcare thru her husband's policy. When she was transplanted United Healthcare stay primary because at the time of transplant patient was not on Dialysis. Does this sound like its right? or Medicare should be primary. Transplant was done 9/26/07. Help!!!!IMPORTANT WARNING: 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 byapplicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED.If you have received this message in error, please notify us immediatelyby calling and destroy the related message. Thank You for your cooperation. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2007 Report Share Posted December 4, 2007 If the patient wasn’t on dialysis yet, then yes UHC would stay primary, the COB rule only goes into effect if they go on dialysis, and I’m not sure if when transplanted, MC would only be in place 36 months anyway so it wouldn’t matter much. Pat Kreci Transplant Financial Coordinator Southwest Fla Regional Medical Center Ft Myers, FL From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Ayabarreno Sent: Tuesday, December 04, 2007 11:17 AM To: TxFinancialCoordinators Subject: Medicare I have a kidney transplanted patient that at the time of transplant she had United Healthcare thru her husband's policy. When she was transplanted United Healthcare stay primary because at the time of transplant patient was not on Dialysis. Does this sound like its right? or Medicare should be primary. Transplant was done 9/26/07. Help!!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2007 Report Share Posted December 4, 2007 Pt has to complete the 30 month Coordination of Benefit Period before Medicare is prime. Pt qualified for Medicare at the time of transplant, i.e. 1st day of month transplant took place.....then the UHC has to complete the 30 month COB before Medicare will be primary. Medicare will be secondary to the UHC.>>> " Ayabarreno" 12/4/2007 11:16 AM >>>I have a kidney transplanted patient that at the time of transplant she had United Healthcare thru her husband's policy. When she was transplanted United Healthcare stay primary because at the time of transplant patient was not on Dialysis. Does this sound like its right? or Medicare should be primary. Transplant was done 9/26/07. Help!!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2007 Report Share Posted December 4, 2007 Hi Pt still has to go through the 30mt cob period. UHC will remain primary for 30 mts. Beverly Antoine, LPN Transplant Financial Coordinator LSU-UMC Laffayette, LA bantoi@... From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Ayabarreno Sent: Tuesday, December 04, 2007 10:17 AM To: TxFinancialCoordinators Subject: Medicare I have a kidney transplanted patient that at the time of transplant she had United Healthcare thru her husband's policy. When she was transplanted United Healthcare stay primary because at the time of transplant patient was not on Dialysis. Does this sound like its right? or Medicare should be primary. Transplant was done 9/26/07. Help!!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2007 Report Share Posted December 4, 2007 Thank you for all your answers. >>> " Antoine, Beverly A. " 12/04/07 12:05 PM >>> Hi Pt still has to go through the 30mt cob period. UHC will remain primary for 30 mts. Beverly Antoine, LPN Transplant Financial Coordinator LSU-UMC Laffayette, LA bantoi@... ________________________________ From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Ayabarreno Sent: Tuesday, December 04, 2007 10:17 AM To: TxFinancialCoordinators Subject: Medicare I have a kidney transplanted patient that at the time of transplant she had United Healthcare thru her husband's policy. When she was transplanted United Healthcare stay primary because at the time of transplant patient was not on Dialysis. Does this sound like its right? or Medicare should be primary. Transplant was done 9/26/07. Help!!!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2008 Report Share Posted January 15, 2008 If his disability was due to a non-renal condition then yes he would continue with benefits. Stoops From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of s2r8q9 Sent: Tuesday, January 15, 2008 11:29 AM To: TxFinancialCoordinators Subject: Medicare I have a pt that is post kidney transplant for his 3rd year. He has kept M'care because of his disability, but received a letter from M'care stating that it has been 36 months and his I/S coverage has ended. Correct me if I'm wrong but I thought that if the pt remained M'care eligible because of disability that Part B would continue to cover the I/S meds? Thanks for any feed back. Stacey Stout Financial Coordinator Kidney/Pancreas O.Strickler Transplant Center University of Virginia (phone) (fax) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2008 Report Share Posted January 15, 2008 If his disability was due to a non-renal condition then yes he would continue with benefits. Stoops From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of s2r8q9 Sent: Tuesday, January 15, 2008 11:29 AM To: TxFinancialCoordinators Subject: Medicare I have a pt that is post kidney transplant for his 3rd year. He has kept M'care because of his disability, but received a letter from M'care stating that it has been 36 months and his I/S coverage has ended. Correct me if I'm wrong but I thought that if the pt remained M'care eligible because of disability that Part B would continue to cover the I/S meds? Thanks for any feed back. Stacey Stout Financial Coordinator Kidney/Pancreas O.Strickler Transplant Center University of Virginia (phone) (fax) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 15, 2008 Report Share Posted January 15, 2008 If his disability was due to a non-renal condition then yes he would continue with benefits. Stoops From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of s2r8q9 Sent: Tuesday, January 15, 2008 11:29 AM To: TxFinancialCoordinators Subject: Medicare I have a pt that is post kidney transplant for his 3rd year. He has kept M'care because of his disability, but received a letter from M'care stating that it has been 36 months and his I/S coverage has ended. Correct me if I'm wrong but I thought that if the pt remained M'care eligible because of disability that Part B would continue to cover the I/S meds? Thanks for any feed back. Stacey Stout Financial Coordinator Kidney/Pancreas O.Strickler Transplant Center University of Virginia (phone) (fax) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 24, 2009 Report Share Posted June 24, 2009 Thanks for replying from your cell in leavenworth; I enjoy seeing my older pts very much and they make up a third of my patients so it makes sense to sign up; the forms and instructions are doable. Will check the wiki re more info. Thank you, Jean. WHere are you for one thing? if many people where you live are elderly and eldery wihtout a lot of financial resources, the question could be will you have enough business if you do NOT take medicare?Few elderly people are going to want to pay you cash if they have medicare - though in some areas they will value teh exta service and be willing to work with you This may take conversation with local collegaues about your community YOu c an opt out or be nonpar there are some rules about when, and renewng those statuses every so often Ihtink-megan lewis on this list serv i think is the resource I would ask or check the wiki www.idealhealthwikispaces.com The jailtime threat and fines do seem ominous but do not seem t ohappen to real people that I know of..wriitng to you from my cell at leavenworth...... Trying to start an IMP practice; would participation in Medicare be worth it for an FP or is it not worth the paperwork and risk for jail time if you make mistakes? Is it ok to sign up now and get out later or are you held captive? Is it recommended for IMPs with the goal of being able to take care of elderly patient or does it spell the death of the IMP? -- If you are a patient please allow up to 24 hours for a reply by email/please note the new email address. Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org Quote Link to comment Share on other sites More sharing options...
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