RE: GHI Denial

[Guest guest]

She had no prior coverage. She got insurance after being dx with ESRD. Will Medicare pay anything on the bill or will the pt be responsible for the entire bill.

Thanks

Bev

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, DeborahSent: Thursday, July 26, 2007 1:11 PMTo: TxFinancialCoordinators Subject: RE: GHI Denial

Yes, the plans can deny coverage until the pe-x is over. Is the pre-x waived if the patient had prior coverage or is it mandatory for transplant under the policy?

If only for prior coverage, have you checked with the patient to see if they had prior coverage they can provide to the current plan?

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Antoine, Beverly A.Sent: Thursday, July 26, 2007 10:41 AMTo: TxFinancialCoordinators Subject: GHI Denial

Hi Has anyone experience a situation where GhI deny due to pre-exist. Will Medicare pays for Tx or will they deny it also. I have a pt ready to go but she has a pre exist that is not up until 3/3/08. She has Medicare secondary.

Thanks bev