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RE: Small Group

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ESRD Medicare 30-month coordination rules apply regardless of the number of employees a group has it could be 2 or 20,000...the EGHP will be primary during the first 30-months the patient was eligible for ESRD Medicare...your pt's 30-mo coord period would be 9-1-06 thru 2-28-09 during which time the EGHP is primary and Medicare secondary. ESRD rules always override any other rules.

Hope this helps to clarify this.

Tyler

Sacred Heart Med Ctr

Spokane, WA

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Drayton, PamelaSent: Monday, March 05, 2007 11:23 AMTo: TxFinancialCoordinators Subject: Small Group

We have a patient who has Aetna coverage through his wife. She works as a bookkeeper for a company of about 8 people. Pt also has Medicare cove eff 9/1/06. Pt FDD was 6/1/06. Since this is a small group would Aetna be primary or do ESRD rules take precedent? Pt does not work.

Pamela N. Drayton

Data/Financial Coordinator-Renal Txp Dept F-4

Newark Beth Israel Medical Center

Newark, NJ 07112

phone

fax

Pdraytonsbhcs

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