Guest guest Posted July 9, 2007 Report Share Posted July 9, 2007 Hello all- We are having a problem here with “surgery date” vs “transplant date” for billing purposes on our transplants. Some of our patients come to the OR in the middle of the night and the transplant takes place, based on UNOS guidelines of anastamosis, on one day while the OR date is the prior day. Per our compliance department, we are to use the OR date as the transplant date for billing purposes. However, our transplant team uses the anastamosis as the transplant date. We have been having issues with some of our health plans as they are aware of the actual “transplant” date and then get the bill with another date. We, then, have to explain the difference and that “all surgeries” use the OR date as the surgical date…..Compliance has deemed this to be HIPPA compliant and that we need to follow this for our transplants as well. In doing so, we have run into issues of case rates starting the day prior to transplant…which is then interpreted differently based on “billing” vs. “transplant”. Our billing office wants us to draft a generic letter that can go out with claims; however, even explaining this still begs the question… Is anyone else having this problem, and have you had any way of reconciling the problem? Debbie Mast Supervisor, Senior Transplant Financial Coordinator Member, TFCA Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs Phone: Fax: Quote Link to comment Share on other sites More sharing options...
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