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RE: Medicare Entitlement

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I am not very sure

of what you are asking but if the pt is entitled to Medicare than it does

become effective the 1 day of the month that he got transplanted. If he is not

entitled to Medicare then you can not bill Medicare for the evaluation. If you

guys did an evaluation prior to any ins. coverage I think the pt is responsible

for the charges.

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoi@...

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of ,

Sent: Friday, March 14, 2008 9:36

AM

To:

TxFinancialCoordinators

Subject:

Medicare Entitlement

Good Morning All

I have a patient who did not qualify for

Medicare in November 2007.Patient lived in India. They came in initially

as an International (SELF-PAY)

Transplant Patient. I month to transplant

the patient presents and insurance policy. We hustle and get an authorization

for the transplant

but they will not pay for evaluations that

took place before Coverage began. I am not clear because now the patient

believes that he is entitled to the

Medicare retro back to the Day 1 of the

month if transplant because a social worker told them that... They do not have

enough working quarters in this country to qualify.Spouse doesn't work..... am

I missing something ?

Transplant

Finance Coordinator

Brigham

and Women's Hospital

Division

of Transplant Surgery

75 Francis Street, PBB 215

Boston, Ma 02115

Phone:

617 525-7415

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What is the entitlement event? 65, dialysis or transplant? How long were they in the country before the entitlement event?

If the patient is over 65 they can pay to enroll in Medicare even if they don't have enough work credits.

Becca Jerominski Financial Coordinator Transplant Program Christiana Health Care Services Phone (302)623-7088 Fax

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The patient was in the country for 4 months... with no US work history.

They gave a deposit for Self pay Transplant b/c they had no Insurance.

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Jerominski, Sent: Friday, March 14, 2008 3:43 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

What is the entitlement event? 65, dialysis or transplant? How long were they in the country before the entitlement event?

If the patient is over 65 they can pay to enroll in Medicare even if they don't have enough work credits.

Becca Jerominski Financial Coordinator Transplant Program Christiana Health Care Services Phone (302)623-7088 Fax

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He will not be entitled

to Medicare. He will have to pay for the evaluation. Did his ins. pay for the

transplant or did he not have a pre-exist clause.

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoi@...

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of ,

Sent: Friday, March 14, 2008 2:48

PM

To:

TxFinancialCoordinators

Subject: RE:

Medicare Entitlement

The patient was in the country for 4

months... with no US

work history.

They gave a deposit for Self pay

Transplant b/c they had no Insurance.

RE:

Medicare Entitlement

What is the entitlement event? 65,

dialysis or transplant? How long were they in the country before the

entitlement event?

If the patient is over 65 they can pay

to enroll in Medicare even if they don't have enough work credits.

Becca

Jerominski

Financial Coordinator

Transplant Program

Christiana Health Care

Services

Phone (302)623-7088

Fax

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The insurance paid for the transplant... I was surprised

they will not pay for the evaluations

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Antoine, Beverly A.Sent: Friday, March 14, 2008 3:53 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

He will not be entitled to Medicare. He will have to pay for the evaluation. Did his ins. pay for the transplant or did he not have a pre-exist clause.

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoilsuhsc (DOT) edu

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of , Sent: Friday, March 14, 2008 2:48 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

The patient was in the country for 4 months... with no US work history.

They gave a deposit for Self pay Transplant b/c they had no Insurance.

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Jerominski, Sent: Friday, March 14, 2008 3:43 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

What is the entitlement event? 65, dialysis or transplant? How long were they in the country before the entitlement event?

If the patient is over 65 they can pay to enroll in Medicare even if they don't have enough work credits.

Becca Jerominski Financial Coordinator Transplant Program Christiana Health Care Services Phone (302)623-7088 Fax

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The insurance paid for the transplant... I was surprised

they will not pay for the evaluations [Aguiar, J.] That's because, unlike Medicare, there is no 'pre-entitlement' clause on a commercial ins policy. Services are covered only when the policy is active (subject to all kinds of exclusions, exceptions, & assorted fine print, of course!), but not before or after.

Keep in mind, the pre-entitlement coverage under Medicare is only applicable in the case of a kidney tx. For someone needing a heart or a liver, for example, there is no coverage under Medicare until the effective date listed on the card.

J. Aguiar

Mayo Clinic Arizona

..

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Yes that is a

surprise that they paid for the transplant. They will not pay because at the

time you guys did the evaluation he did not have insurance therefore, they are

not responsible to cover the eval however, you still have the patient deposit.

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoi@...

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of ,

Sent: Friday, March 14, 2008 2:55

PM

To:

TxFinancialCoordinators

Subject: RE:

Medicare Entitlement

The insurance paid for the transplant...

I was surprised

they will not pay for the

evaluations

RE:

Medicare Entitlement

What is the entitlement event? 65, dialysis or transplant? How

long were they in the country before the entitlement event?

If the patient is over 65 they can pay to enroll in Medicare

even if they don't have enough work credits.

Becca

Jerominski

Financial Coordinator

Transplant Program

Christiana Health Care

Services

Phone (302)623-7088

Fax

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From what I understand the deposit was returned when we flipped the registration from self-pay to Commercial.

this was a very involved case ...

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Antoine, Beverly A.Sent: Friday, March 14, 2008 4:06 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

Yes that is a surprise that they paid for the transplant. They will not pay because at the time you guys did the evaluation he did not have insurance therefore, they are not responsible to cover the eval however, you still have the patient deposit.

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoilsuhsc (DOT) edu

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of , Sent: Friday, March 14, 2008 2:55 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

The insurance paid for the transplant... I was surprised

they will not pay for the evaluations

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Antoine, Beverly A.Sent: Friday, March 14, 2008 3:53 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

He will not be entitled to Medicare. He will have to pay for the evaluation. Did his ins. pay for the transplant or did he not have a pre-exist clause.

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoilsuhsc (DOT) edu

size=2 width="100%" align=center tabIndex=-1>

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of , Sent: Friday, March 14, 2008 2:48 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

The patient was in the country for 4 months... with no US work history.

They gave a deposit for Self pay Transplant b/c they had no Insurance.

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Jerominski, Sent: Friday, March 14, 2008 3:43 PMTo: TxFinancialCoordinators Subject: RE: Medicare Entitlement

What is the entitlement event? 65, dialysis or transplant? How long were they in the country before the entitlement event?

If the patient is over 65 they can pay to enroll in Medicare even if they don't have enough work credits.

Becca Jerominski Financial Coordinator Transplant Program Christiana Health Care Services Phone (302)623-7088 Fax

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Guest guest

The billing department

will just have to send the patient the bill for the evaluation or the center

will have to eat the charges.

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoi@...

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of ,

Sent: Friday, March 14, 2008 3:09

PM

To:

TxFinancialCoordinators

Subject: RE:

Medicare Entitlement

From what I understand the deposit was

returned when we flipped the registration from self-pay to Commercial.

this was a very involved case ...

RE:

Medicare Entitlement

What is the entitlement event? 65, dialysis or transplant? How

long were they in the country before the entitlement event?

If the patient is over 65 they can pay to enroll in Medicare

even if they don't have enough work credits.

Becca

Jerominski

Financial Coordinator

Transplant Program

Christiana Health Care

Services

Phone (302)623-7088

Fax

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