RE: Txp form used in educating the pt.

February 11, 2008

These are all the Financial Agreement forms (we currently have made up) that we use here at Nazih Zuhdi Transplant Institute in Oklahoma City. Some of the information may have changed with 2008 and, I may not have used it yet but for the most part these should be applicable to a lot of situations.

We use these when we sit down with the patient at their individual financial consult and review their benefits and the cost of transplant. We also have them check with their insurance company to see if the figures are correct.

What I have been running into lately is a whole lot of pharmacies who will not give co pay information unless they have permission from the patient to talk with me. Any of you running into this also???

Have a great week - hope this helps and is useful information.

Thanks ~

Christie Houghton Transplant Financial Coordinator Nazih Zuhdi Transplant Institute Integris Baptist Medical Center 3300 NW Expressway Oklahoma City, OK 73112 Office: Fax: 405.713-7690

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Drayton, PamelaSent: Monday, February 11, 2008 11:35 AMTo: TxFinancialCoordinators Subject: Txp form used in educating the pt.Importance: High

Are there any centers that have a form that they give to the patients showing them in detail their actual benefits for transplants? For example, pt has Medicare A, B, & D – they have the donut hole, co-pays, etc. – is there something that we can give to the pt as part of their education. We currently use a worksheet but were wondering if other centers have something that is a bit nicer.

Pamela N. Drayton

Data/Financial Coordinator-Renal Txp Dept F-4

Newark Beth Israel Medical Center

Newark, NJ 07112

phone

fax

Pdraytonsbhcs

________________________________________________________________ Important news about our email communicationsSaint Barnabas Health Care System has implemented secure messaging services. To learn more about SBHCS Secure Messaging, go to:http://userawareness.zixcorp.com/sbhcs/If you need assistance with retrieving a secure email, please email sbhcsaccountssbhcs or visit http://userawareness.zixcorp.com/sbhcs/partners/receiving.php

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February 11, 2008

These are all the Financial Agreement forms (we currently have made up) that we use here at Nazih Zuhdi Transplant Institute in Oklahoma City. Some of the information may have changed with 2008 and, I may not have used it yet but for the most part these should be applicable to a lot of situations.

We use these when we sit down with the patient at their individual financial consult and review their benefits and the cost of transplant. We also have them check with their insurance company to see if the figures are correct.

What I have been running into lately is a whole lot of pharmacies who will not give co pay information unless they have permission from the patient to talk with me. Any of you running into this also???

Have a great week - hope this helps and is useful information.

Thanks ~

Christie Houghton Transplant Financial Coordinator Nazih Zuhdi Transplant Institute Integris Baptist Medical Center 3300 NW Expressway Oklahoma City, OK 73112 Office: Fax: 405.713-7690

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Drayton, PamelaSent: Monday, February 11, 2008 11:35 AMTo: TxFinancialCoordinators Subject: Txp form used in educating the pt.Importance: High

Are there any centers that have a form that they give to the patients showing them in detail their actual benefits for transplants? For example, pt has Medicare A, B, & D – they have the donut hole, co-pays, etc. – is there something that we can give to the pt as part of their education. We currently use a worksheet but were wondering if other centers have something that is a bit nicer.

Pamela N. Drayton

Data/Financial Coordinator-Renal Txp Dept F-4

Newark Beth Israel Medical Center

Newark, NJ 07112

phone

fax

Pdraytonsbhcs

________________________________________________________________ Important news about our email communicationsSaint Barnabas Health Care System has implemented secure messaging services. To learn more about SBHCS Secure Messaging, go to:http://userawareness.zixcorp.com/sbhcs/If you need assistance with retrieving a secure email, please email sbhcsaccountssbhcs or visit http://userawareness.zixcorp.com/sbhcs/partners/receiving.php

This e-mail may contain identifiable health information that is subject to protection under state and federal law. This information is intended to be for the use of the individual named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited and may be punishable by law. If you have received this electronic transmission in error, please notify us immediately by electronic mail (reply).

February 11, 2008

These are all the Financial Agreement forms (we currently have made up) that we use here at Nazih Zuhdi Transplant Institute in Oklahoma City. Some of the information may have changed with 2008 and, I may not have used it yet but for the most part these should be applicable to a lot of situations.

We use these when we sit down with the patient at their individual financial consult and review their benefits and the cost of transplant. We also have them check with their insurance company to see if the figures are correct.

What I have been running into lately is a whole lot of pharmacies who will not give co pay information unless they have permission from the patient to talk with me. Any of you running into this also???

Have a great week - hope this helps and is useful information.

Thanks ~

Christie Houghton Transplant Financial Coordinator Nazih Zuhdi Transplant Institute Integris Baptist Medical Center 3300 NW Expressway Oklahoma City, OK 73112 Office: Fax: 405.713-7690

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Drayton, PamelaSent: Monday, February 11, 2008 11:35 AMTo: TxFinancialCoordinators Subject: Txp form used in educating the pt.Importance: High

Are there any centers that have a form that they give to the patients showing them in detail their actual benefits for transplants? For example, pt has Medicare A, B, & D – they have the donut hole, co-pays, etc. – is there something that we can give to the pt as part of their education. We currently use a worksheet but were wondering if other centers have something that is a bit nicer.

Pamela N. Drayton

Data/Financial Coordinator-Renal Txp Dept F-4

Newark Beth Israel Medical Center

Newark, NJ 07112

phone

fax

Pdraytonsbhcs

________________________________________________________________ Important news about our email communicationsSaint Barnabas Health Care System has implemented secure messaging services. To learn more about SBHCS Secure Messaging, go to:http://userawareness.zixcorp.com/sbhcs/If you need assistance with retrieving a secure email, please email sbhcsaccountssbhcs or visit http://userawareness.zixcorp.com/sbhcs/partners/receiving.php

This e-mail may contain identifiable health information that is subject to protection under state and federal law. This information is intended to be for the use of the individual named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited and may be punishable by law. If you have received this electronic transmission in error, please notify us immediately by electronic mail (reply).

February 11, 2008

Have we ever been this

precise in our financial agreements in writing?

Daryl Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic --

KidneyTransplant

41 Mall Road

Burlington, MA 01805

PH: /FAX:

Txp form used in educating the pt.

Importance: High

Are there any centers that have a form

that they give to the patients showing them in detail their actual benefits for

transplants? For example, pt has Medicare A, B, & D – they have

the donut hole, co-pays, etc. – is there something that we can give

to the pt as part of their education. We currently use a worksheet but

were wondering if other centers have something that is a bit nicer.

Pamela N.

Drayton

Data/Financial

Coordinator-Renal Txp Dept F-4

Newark Beth

Israel Medical Center

Newark, NJ

07112

phone

fax

Pdraytonsbhcs

________________________________________________________________

Important news about our email communications

Saint Barnabas Health Care System has implemented secure messaging services.

To learn more about SBHCS Secure Messaging, go to:

http://userawareness.zixcorp.com/sbhcs/

If you need assistance with retrieving a secure email, please email

sbhcsaccountssbhcs or visit http://userawareness.zixcorp.com/sbhcs/partners/receiving.php

This e-mail may contain

identifiable health information that is subject to protection under state and

federal law. This information is intended to be for the use of the individual

named above. If you are not the intended recipient, be aware that any disclosure,

copying, distribution or use of the contents of this information is prohibited

and may be punishable by law. If you have received this electronic transmission

in error, please notify us immediately by electronic mail (reply).

This e-mail may contain identifiable health information that is subject

to protection under state and federal law. This information is intended to be

for the use of the individual named above. If you are not the intended

recipient, be aware that any disclosure, copying, distribution or use of the

contents of this information is prohibited and may be punishable by law. If you

have received this electronic transmission in error, please notify us

immediately by electronic mail (reply).

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February 11, 2008