RE: Managed Care Medicare/ Medicare Advantage Plans

[Guest guest]

Yes, those plans follow all Medicare

guidelines.

Pat Kreci

Transplant Financial Coordinator

Southwest Fl Regional Medical

Center

Ft Myers, FL

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of sclarkleach

Sent: Tuesday, June 24, 2008 11:01

AM

To:

TxFinancialCoordinators

Subject:

Managed Care Medicare/ Medicare Advantage Plans

Can someone tell me whether or not we have to follow

the same billing

guidelines for Medicare Advantage and/ or Medicare Managed Care plans

as we do Medicare. For example, if a patient has Physician's Health

Choice, should we not bill them (PHC) directly for evaluation testing?

Thanks Much,

Sarita

Seton Heart Transplant

Austin Texas

[Guest guest]

Thanks!

>

> Yes, those plans follow all Medicare guidelines.

>

> Pat Kreci

>

> Transplant Financial Coordinator

>

> Southwest Fl Regional Medical Center

>

> Ft Myers, FL

>

>

>

> ________________________________

>

> From: TxFinancialCoordinators

> [mailto:TxFinancialCoordinators ] On Behalf Of

> sclarkleach

> Sent: Tuesday, June 24, 2008 11:01 AM

> To: TxFinancialCoordinators

> Subject: Managed Care Medicare/ Medicare

> Advantage Plans

>

>

>

> Can someone tell me whether or not we have to follow the same

billing

> guidelines for Medicare Advantage and/ or Medicare Managed Care

plans

> as we do Medicare. For example, if a patient has Physician's Health

> Choice, should we not bill them (PHC) directly for evaluation

testing?

>

> Thanks Much,

>

> Sarita

> Seton Heart Transplant

> Austin Texas

>

>

[Guest guest]

At

one point I heard that patients with Medicare Advantage Plans could not be

counted as Medicare patients for the Medicare Cost report?

Also,

as an aside, need to read fine print of Medicare Advantage Plans. For

example, we have one that people ending signing up for where they only pay

80% of the immunos and the patient is responsible for 20%.

Daryl Battin,

LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Kreci,

Sent: Tuesday, June 24, 2008 12:12

PM

To:

TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

Yes, those plans follow all Medicare guidelines.

Pat Kreci

Transplant Financial Coordinator

Southwest Fl Regional

Medical Center

Ft Myers, FL

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of sclarkleach

Sent: Tuesday, June 24, 2008 11:01

AM

To: TxFinancialCoordinators

Subject:

Managed Care Medicare/ Medicare Advantage Plans

Can

someone tell me whether or not we have to follow the same billing

guidelines for Medicare Advantage and/ or Medicare Managed Care plans

as we do Medicare. For example, if a patient has Physician's Health

Choice, should we not bill them (PHC) directly for evaluation testing?

Thanks Much,

Sarita

Seton Heart Transplant

Austin Texas

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

I agree with Daryl on his second point...I've had to work with a number of patients to help them get off their Medicare Advantage Plan and back onto regular Medicare and a Medigap, so that they could have decent prescription coverage for their immunosuppressive meds. I've talked to 2 MA "sales" people to educate them as to why their plan is not good coverage for a person considering a transplant.

Tyler

Financial Coordinator

Sacred Heart Med Ctr

Spokane WA

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Tuesday, June 24, 2008 10:22 AMTo: TxFinancialCoordinators Subject: RE: Managed Care Medicare/ Medicare Advantage Plans

At one point I heard that patients with Medicare Advantage Plans could not be counted as Medicare patients for the Medicare Cost report?

Also, as an aside, need to read fine print of Medicare Advantage Plans. For example, we have one that people ending signing up for where they only pay 80% of the immunos and the patient is responsible for 20%.

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci, Sent: Tuesday, June 24, 2008 12:12 PMTo: TxFinancialCoordinators Subject: RE: Managed Care Medicare/ Medicare Advantage Plans

Yes, those plans follow all Medicare guidelines.

Pat Kreci

Transplant Financial Coordinator

Southwest Fl Regional Medical Center

Ft Myers, FL

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of sclarkleachSent: Tuesday, June 24, 2008 11:01 AMTo: TxFinancialCoordinators Subject: Managed Care Medicare/ Medicare Advantage Plans

Can someone tell me whether or not we have to follow the same billing guidelines for Medicare Advantage and/ or Medicare Managed Care plans as we do Medicare. For example, if a patient has Physician's Health Choice, should we not bill them (PHC) directly for evaluation testing?Thanks Much,SaritaSeton Heart Transplant Austin Texas

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

that's my understanding too Darryl - MA kidneys are not KACC kidneys.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@...

"Life is a tragedy when seen in close-up, but a comedy in long-shot." - Charlie Chaplin

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Battin, Daryl J.Sent: Tuesday, June 24, 2008 10:22 AMTo: TxFinancialCoordinators Subject: RE: Managed Care Medicare/ Medicare Advantage Plans

At one point I heard that patients with Medicare Advantage Plans could not be counted as Medicare patients for the Medicare Cost report?

Also, as an aside, need to read fine print of Medicare Advantage Plans. For example, we have one that people ending signing up for where they only pay 80% of the immunos and the patient is responsible for 20%.

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph: /FAX:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kreci, Sent: Tuesday, June 24, 2008 12:12 PMTo: TxFinancialCoordinators Subject: RE: Managed Care Medicare/ Medicare Advantage Plans

Yes, those plans follow all Medicare guidelines.

Pat Kreci

Transplant Financial Coordinator

Southwest Fl Regional Medical Center

Ft Myers, FL

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of sclarkleachSent: Tuesday, June 24, 2008 11:01 AMTo: TxFinancialCoordinators Subject: Managed Care Medicare/ Medicare Advantage Plans

Can someone tell me whether or not we have to follow the same billing guidelines for Medicare Advantage and/ or Medicare Managed Care plans as we do Medicare. For example, if a patient has Physician's Health Choice, should we not bill them (PHC) directly for evaluation testing?Thanks Much,SaritaSeton Heart Transplant Austin Texas

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

If MA kidneys are

not reported on the KACC do we bill these patients as commercial insurance?

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoi@...

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH

Trnsplnt

Sent: Tuesday, June 24, 2008 12:26

PM

To:

TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

that's my understanding too Darryl - MA

kidneys are not KACC kidneys.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR

97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

Managed Care Medicare/ Medicare Advantage Plans

Can

someone tell me whether or not we have to follow the same billing

guidelines for Medicare Advantage and/ or Medicare Managed Care plans

as we do Medicare. For example, if a patient has Physician's Health

Choice, should we not bill them (PHC) directly for evaluation testing?

Thanks Much,

Sarita

Seton Heart Transplant

Austin Texas

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your

use of this message for any purpose is strictly prohibited. If you have

received this communication in error, please delete the message and notify the

sender so that we may correct our records.

[Guest guest]

MA kidneys are not in the numerator of the

Medicare utilization fraction on the D-6 worksheet, but are in the denominator.

All eval costs for all payers are posted on the cost report. Commercial

insurance is never billed.

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Antoine, Beverly A.

Sent: Tuesday, June 24, 2008 11:14

AM

To:

TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

If MA kidneys are not reported on the KACC do we bill

these patients as commercial insurance?

Beverly Antoine,

LPN

Transplant

Financial Coordinator

LSU-UMC

Laffayette, LA

bantoilsuhsc (DOT) edu

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH Trnsplnt

Sent: Tuesday, June 24, 2008 12:26

PM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

that's my understanding too Darryl - MA kidneys are not KACC

kidneys.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

-----Original

Message-----

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]On Behalf Of Battin, Daryl J.

Sent: Tuesday, June 24, 2008 10:22

AM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

At one point I heard that

patients with Medicare Advantage Plans could not be counted as Medicare

patients for the Medicare Cost report?

Also, as an

aside, need to read fine print of Medicare Advantage Plans. For

example, we have one that people ending signing up for where they only pay

80% of the immunos and the patient is responsible for 20%.

Daryl

Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington, MA

01805

Ph:

/FAX:

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

Sent: Tuesday, June 24, 2008 12:12

PM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

Yes, those plans follow all Medicare guidelines.

Pat Kreci

Transplant Financial Coordinator

Southwest Fl Regional Medical Center

Ft Myers,

FL

size=2

width= " 100% " align=center tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of sclarkleach

Sent: Tuesday, June 24, 2008 11:01

AM

To: TxFinancialCoordinators

Subject:

Managed Care Medicare/ Medicare Advantage Plans

Can

someone tell me whether or not we have to follow the same billing

guidelines for Medicare Advantage and/ or Medicare Managed Care plans

as we do Medicare. For example, if a patient has Physician's Health

Choice, should we not bill them (PHC) directly for evaluation testing?

Thanks Much,

Sarita

Seton Heart Transplant

Austin Texas

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your

use of this message for any purpose is strictly prohibited. If you have

received this communication in error, please delete the message and notify the

sender so that we may correct our records.

[Guest guest]

Does anyone have a list of all 2008 Medicare

Advantage Plans? If you have, please email me the list.

Thanks,

Mila Kirkpatrick

Bone Marrow and Solid Organ Transplant Revenue Analyst

Methodist Specialty and Transplant Hospital

8201 Ewing

Halsell Drive

San , Texas 78229

Telephone No.

Fax

No.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Forsthoffer, Fred

Sent: Tuesday, June 24, 2008 2:32

PM

To:

TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

MA kidneys are not in the numerator of the Medicare utilization

fraction on the D-6 worksheet, but are in the denominator. All

eval costs for all payers are posted on the cost report. Commercial

insurance is never billed.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Antoine, Beverly A.

Sent: Tuesday, June 24, 2008 11:14

AM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

If MA kidneys are not reported on the KACC do we bill

these patients as commercial insurance?

Beverly Antoine,

LPN

Transplant

Financial Coordinator

LSU-UMC

Laffayette, LA

bantoilsuhsc (DOT) edu

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH Trnsplnt

Sent: Tuesday, June 24, 2008 12:26

PM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

that's my understanding too Darryl - MA kidneys are not KACC

kidneys.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

-----Original

Message-----

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]On Behalf Of Battin, Daryl J.

Sent: Tuesday, June 24, 2008 10:22

AM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

At one point I heard that

patients with Medicare Advantage Plans could not be counted as Medicare

patients for the Medicare Cost report?

Also, as an aside,

need to read fine print of Medicare Advantage Plans. For example, we

have one that people ending signing up for where they only pay 80% of the

immunos and the patient is responsible for 20%.

Daryl

Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph:

/FAX:

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

Sent: Tuesday, June 24, 2008 12:12

PM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

Yes, those plans follow all Medicare guidelines.

Pat Kreci

Transplant Financial Coordinator

Southwest Fl Regional

Medical

Center

Ft Myers, FL

size=2 width= " 100% " align=center

tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of sclarkleach

Sent: Tuesday, June 24, 2008 11:01

AM

To: TxFinancialCoordinators

Subject:

Managed Care Medicare/ Medicare Advantage Plans

Can

someone tell me whether or not we have to follow the same billing

guidelines for Medicare Advantage and/ or Medicare Managed Care plans

as we do Medicare. For example, if a patient has Physician's Health

Choice, should we not bill them (PHC) directly for evaluation testing?

Thanks Much,

Sarita

Seton Heart Transplant

Austin Texas

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your

use of this message for any purpose is strictly prohibited. If you have

received this communication in error, please delete the message and notify the

sender so that we may correct our records.

[Guest guest]

Do you have a copy of the Medicare &

You 2008 for your state? There is a list in the back of that booklet.

Daryl Battin,

LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Kirkpatrick Mila

Sent: Tuesday, June 24, 2008 4:22

PM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

Does anyone have a list of all 2008 Medicare Advantage Plans?

If you have, please email me the list.

Thanks,

Mila Kirkpatrick

Bone Marrow and Solid Organ Transplant Revenue Analyst

Methodist Specialty and Transplant Hospital

8201

Ewing Halsell Drive

San , Texas 78229

Telephone No.

Fax

No.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Forsthoffer, Fred

Sent: Tuesday, June 24, 2008 2:32

PM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

MA kidneys are not in the numerator of the Medicare utilization

fraction on the D-6 worksheet, but are in the denominator. All

eval costs for all payers are posted on the cost report. Commercial

insurance is never billed.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Antoine, Beverly A.

Sent: Tuesday, June 24, 2008 11:14

AM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

If MA kidneys are not reported on the KACC do we bill

these patients as commercial insurance?

Beverly Antoine,

LPN

Transplant

Financial Coordinator

LSU-UMC

Laffayette, LA

bantoilsuhsc (DOT) edu

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH Trnsplnt

Sent: Tuesday, June 24, 2008 12:26

PM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

that's my understanding too Darryl - MA kidneys are not KACC

kidneys.

on

Financial

Counselor

Legacy

Transplant Services

1040 NW 22nd

Ave Ste 480

Portland

OR 97210

toll free

fax

lmorrisolhs (DOT) org

" Life is a tragedy when seen in close-up, but a comedy

in long-shot. " - Charlie Chaplin

-----Original

Message-----

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]On Behalf Of Battin, Daryl J.

Sent: Tuesday, June 24, 2008 10:22

AM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

At one point I heard that

patients with Medicare Advantage Plans could not be counted as Medicare

patients for the Medicare Cost report?

Also, as an

aside, need to read fine print of Medicare Advantage Plans. For

example, we have one that people ending signing up for where they only pay

80% of the immunos and the patient is responsible for 20%.

Daryl

Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington, MA 01805

Ph:

/FAX:

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

Sent: Tuesday, June 24, 2008 12:12

PM

To: TxFinancialCoordinators

Subject: RE:

Managed Care Medicare/ Medicare Advantage Plans

Yes, those plans follow all Medicare guidelines.

Pat Kreci

Transplant Financial Coordinator

Southwest Fl Regional

Medical

Center

Ft Myers, FL

size=2 width= " 100% " align=center

tabIndex=-1>

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of sclarkleach

Sent: Tuesday, June 24, 2008 11:01

AM

To: TxFinancialCoordinators

Subject:

Managed Care Medicare/ Medicare Advantage Plans

Can

someone tell me whether or not we have to follow the same billing

guidelines for Medicare Advantage and/ or Medicare Managed Care plans

as we do Medicare. For example, if a patient has Physician's Health

Choice, should we not bill them (PHC) directly for evaluation testing?

Thanks Much,

Sarita

Seton Heart Transplant

Austin Texas

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT

MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM

DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use

of this message for any purpose is strictly prohibited. If you have received

this communication in error, please delete the message and notify the sender so

that we may correct our records.

[Guest guest]

So do we bill the Medicare Advantage Plans directly for the eval

testing or not? Does anyone have a definitive answer?

Thanks Again.

>

> * At one point I heard that patients with Medicare Advantage

Plans

> could not be counted as Medicare patients for the Medicare Cost

report?

>

>

>

>

>

> * Also, as an aside, need to read fine print of Medicare

Advantage

> Plans. For example, we have one that people ending signing up for

where

> they only pay 80% of the immunos and the patient is responsible for

20%.

>

>

>

> Daryl Battin, LICSW

>

> Financial Coordinator/Social Worker

>

> Lahey Clinic Kidney Transplant

>

> 41 Mall Road, Burlington, MA 01805

>

> Ph: /FAX:

>

>

>

> ________________________________

>

> From: TxFinancialCoordinators

> [mailto:TxFinancialCoordinators ] On Behalf Of Kreci,

>

> Sent: Tuesday, June 24, 2008 12:12 PM

> To: TxFinancialCoordinators

> Subject: RE: Managed Care Medicare/

Medicare

> Advantage Plans

>

>

>

> Yes, those plans follow all Medicare guidelines.

>

> Pat Kreci

>

> Transplant Financial Coordinator

>

> Southwest Fl Regional Medical Center

>

> Ft Myers, FL

>

>

>

> ________________________________

>

> From: TxFinancialCoordinators

> [mailto:TxFinancialCoordinators ] On Behalf Of

> sclarkleach

> Sent: Tuesday, June 24, 2008 11:01 AM

> To: TxFinancialCoordinators

> Subject: Managed Care Medicare/ Medicare

> Advantage Plans

>

>

>

> Can someone tell me whether or not we have to follow the same

billing

> guidelines for Medicare Advantage and/ or Medicare Managed Care

plans

> as we do Medicare. For example, if a patient has Physician's Health

> Choice, should we not bill them (PHC) directly for evaluation

testing?

>

> Thanks Much,

>

> Sarita

> Seton Heart Transplant

> Austin Texas

>

>

>

>

>

> See our web page at http://www.lahey.org for a full directory of

Lahey sites, staff, services and career opportunities.

>

> THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED,

CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you

are not the intended recipient, your use of this message for any

purpose is strictly prohibited. If you have received this

communication in error, please delete the message and notify the

sender so that we may correct our records.

>

[Guest guest]

Check the email from Forsthoffer, Fred

[Fred.Forsthoffer@...] that came in yesterday – that might

help.

Daryl Battin,

LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of sclarkleach

Sent: Wednesday, June 25, 2008

11:40 AM

To:

TxFinancialCoordinators

Subject:

Re: Managed Care Medicare/ Medicare Advantage Plans

So do we bill the Medicare Advantage Plans directly

for the eval

testing or not? Does anyone have a definitive answer?

Thanks Again.

>

> * At one point I heard that patients with Medicare Advantage

Plans

> could not be counted as Medicare patients for the Medicare Cost

report?

>

>

>

>

>

> * Also, as an aside, need to read fine print of Medicare

Advantage

> Plans. For example, we have one that people ending signing up for

where

> they only pay 80% of the immunos and the patient is responsible for

20%.

>

>

>

> Daryl Battin, LICSW

>

> Financial Coordinator/Social Worker

>

> Lahey Clinic Kidney Transplant

>

> 41 Mall Road, Burlington, MA 01805

>

> Ph: /FAX:

>

>

>

> ________________________________

>

> From: TxFinancialCoordinators

> [mailto:TxFinancialCoordinators ]

On Behalf Of Kreci,

>

> Sent: Tuesday, June 24, 2008 12:12 PM

> To: TxFinancialCoordinators

> Subject: RE: Managed Care Medicare/

Medicare

> Advantage Plans

>

>

>

> Yes, those plans follow all Medicare guidelines.

>

> Pat Kreci

>

> Transplant Financial Coordinator

>

> Southwest Fl Regional

Medical Center

>

> Ft Myers, FL

>

>

>

> ________________________________

>

> From: TxFinancialCoordinators

> [mailto:TxFinancialCoordinators ]

On Behalf Of

> sclarkleach

> Sent: Tuesday, June 24, 2008 11:01 AM

> To: TxFinancialCoordinators

> Subject: Managed Care Medicare/ Medicare

> Advantage Plans

>

>

>

> Can someone tell me whether or not we have to follow the same

billing

> guidelines for Medicare Advantage and/ or Medicare Managed Care

plans

> as we do Medicare. For example, if a patient has Physician's Health

> Choice, should we not bill them (PHC) directly for evaluation

testing?

>

> Thanks Much,

>

> Sarita

> Seton Heart Transplant

> Austin Texas

>

>

>

>

>

> See our web page at http://www.lahey.org

for a full directory of

Lahey sites, staff, services and career opportunities.

>

> THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS

ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED,

CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you

are not the intended recipient, your use of this message for any

purpose is strictly prohibited. If you have received this

communication in error, please delete the message and notify the

sender so that we may correct our records.

>

[Guest guest]

They are still billed to Medicare Cost Report.>>> "sclarkleach" 6/25/2008 11:40 AM >>>So do we bill the Medicare Advantage Plans directly for the eval testing or not? Does anyone have a definitive answer?Thanks Again.>> * At one point I heard that patients with Medicare Advantage Plans> could not be counted as Medicare patients for the Medicare Cost report?> > > > > > * Also, as an aside, need to read fine print of Medicare Advantage> Plans. For example, we have one that people ending signing up for where> they only pay 80% of the immunos and the patient is responsible for 20%.> > > > Daryl Battin, LICSW> > Financial Coordinator/Social Worker> > Lahey Clinic Kidney Transplant > > 41 Mall Road, Burlington, MA 01805> > Ph: /FAX: > > > > ________________________________> > From: TxFinancialCoordinators > [mailto:TxFinancialCoordinators ] On Behalf Of Kreci,> > Sent: Tuesday, June 24, 2008 12:12 PM> To: TxFinancialCoordinators > Subject: RE: Managed Care Medicare/ Medicare> Advantage Plans> > > > Yes, those plans follow all Medicare guidelines.> > Pat Kreci> > Transplant Financial Coordinator> > Southwest Fl Regional Medical Center> > Ft Myers, FL> > > > ________________________________> > From: TxFinancialCoordinators > [mailto:TxFinancialCoordinators ] On Behalf Of> sclarkleach> Sent: Tuesday, June 24, 2008 11:01 AM> To: TxFinancialCoordinators > Subject: Managed Care Medicare/ Medicare> Advantage Plans> > > > Can someone tell me whether or not we have to follow the same billing > guidelines for Medicare Advantage and/ or Medicare Managed Care plans > as we do Medicare. For example, if a patient has Physician's Health > Choice, should we not bill them (PHC) directly for evaluation testing?> > Thanks Much,> > Sarita> Seton Heart Transplant > Austin Texas> > > > > > See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.> > THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.>