COB Question -- a new wrinkle ....

[Guest guest]

On the phone with Aetna (actually Hewit which administers

the Lucente benefits for the spouse who has the plan) – pt’s spouse

has Aetna through her Lucente retirement.

Patient is age 55.

Patient has Medicare A due to ESRD 6/1/08 – her benefit

says that since he now has Medicare then Medicare will become primary for him and

Lucente has put him on a United Healthcare plan secondary.

Can Aetna/Lucente truly do that with ESRD Medicare and COB

information (dialysis 3/08, transplant 10/08)?

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41

Mall Road, Burlington,

MA 01805

Ph: /FAX:

Page:

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 don’t believe so, it appears they

are using the disability/ age based Medicare COB guidelines. They may need to

be directed to the Medicare ESRD publication to understand the difference.

Sher

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

Sent: Wednesday, January 07, 2009

10:33 AM

To: TxFinancialCoordinators

Subject:

COB Question -- a new wrinkle ....

On the phone with Aetna (actually Hewit which administers

the Lucente benefits for the spouse who has the plan) – pt’s spouse

has Aetna through her Lucente

retirement. Patient is age 55.

Patient has Medicare A due to ESRD 6/1/08 – her

benefit says that since he now has Medicare then Medicare will become primary

for him and Lucente has put him on a United Healthcare plan secondary.

Can Aetna/Lucente truly do that with ESRD Medicare and COB

information (dialysis 3/08, transplant 10/08)?

Daryl Battin, LICSW

Financial Coordinator/Social

Worker

Lahey Clinic Kidney

Transplant

41 Mall Road,

Burlington, MA

01805

Ph: /FAX:

Page:

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 the spouse benefits with Lucente is

thru a retirement plan that will make Mcare primary. Only active

employment benefits are primary to Mcare.

Mila

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Stirling-Burgin, Sherry

Sent: Wednesday, January 07, 2009

9:34 AM

To: TxFinancialCoordinators

Subject: RE:

COB Question -- a new wrinkle ....

I don’t believe so, it appears they are using the disability/

age based Medicare COB guidelines. They may need to be directed to the Medicare

ESRD publication to understand the difference.

Sher

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, January 07, 2009

10:33 AM

To: TxFinancialCoordinators

Subject:

COB Question -- a new wrinkle ....

On the phone

with Aetna (actually Hewit which administers the Lucente benefits for the

spouse who has the plan) – pt’s spouse has Aetna through her Lucente retirement. Patient

is age 55.

Patient has

Medicare A due to ESRD 6/1/08 – her benefit says that since he now has

Medicare then Medicare will become primary for him and Lucente has put him on a

United Healthcare plan secondary.

Can

Aetna/Lucente truly do that with ESRD Medicare and COB information (dialysis

3/08, transplant 10/08)?

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road,

Burlington, MA 01805

Ph: /FAX:

Page:

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]

Spouse is age 54 – she is not on

Medicare.

Daryl Battin,

LICSW

Financial Coordinator/Social

Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

Page:

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Kirkpatrick Mila

Sent: Wednesday, January 07, 2009

10:52 AM

To: TxFinancialCoordinators

Subject: RE:

COB Question -- a new wrinkle ....

If the spouse benefits with Lucente is thru a retirement plan that

will make Mcare primary. Only active employment benefits are primary to

Mcare.

Mila

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Stirling-Burgin, Sherry

Sent: Wednesday, January 07, 2009

9:34 AM

To: TxFinancialCoordinators

Subject: RE:

COB Question -- a new wrinkle ....

I don’t believe so, it appears they are using the disability/

age based Medicare COB guidelines. They may need to be directed to the Medicare

ESRD publication to understand the difference.

Sher

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, January 07, 2009

10:33 AM

To: TxFinancialCoordinators

Subject:

COB Question -- a new wrinkle ....

On the phone

with Aetna (actually Hewit which administers the Lucente benefits for the

spouse who has the plan) – pt’s spouse has Aetna through her Lucente retirement.

Patient is age 55.

Patient has

Medicare A due to ESRD 6/1/08 – her benefit says that since he now has

Medicare then Medicare will become primary for him and Lucente has put him on a

United Healthcare plan secondary.

Can

Aetna/Lucente truly do that with ESRD Medicare and COB information (dialysis

3/08, transplant 10/08)?

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road,

Burlington, MA 01805

Ph: /FAX:

Page:

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]

Current status – I gently “pushed”

the issue with the line staff re why the Federal laws from CMS for ESRD

Medicare was being handle differently. Ended up with a specialist who

agreed that Aetna should remain primary

through the COB.

Apparently the question about if the

patient had Medicare did not ask the reason for the Medicare eligibility which

Hewit now has.

Daryl Battin,

LICSW

Financial Coordinator/Social

Worker

Lahey Clinic

Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

Page:

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Stirling-Burgin,

Sherry

Sent: Wednesday, January 07, 2009

10:34 AM

To:

TxFinancialCoordinators

Subject: RE:

COB Question -- a new wrinkle ....

I don’t believe so, it appears they are using the disability/

age based Medicare COB guidelines. They may need to be directed to the Medicare

ESRD publication to understand the difference.

Sher

From: TxFinancialCoordinators

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

Sent: Wednesday, January 07, 2009

10:33 AM

To: TxFinancialCoordinators

Subject:

COB Question -- a new wrinkle ....

On the phone

with Aetna (actually Hewit which administers the Lucente benefits for the

spouse who has the plan) – pt’s spouse has Aetna through her Lucente retirement. Patient

is age 55.

Patient has

Medicare A due to ESRD 6/1/08 – her benefit says that since he now has

Medicare then Medicare will become primary for him and Lucente has put him on a

United Healthcare plan secondary.

Can

Aetna/Lucente truly do that with ESRD Medicare and COB information (dialysis

3/08, transplant 10/08)?

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road,

Burlington, MA 01805

Ph: /FAX:

Page:

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]

Excellent.

What a tangled web we have wovenJ

Sher Stirling-Burgin, RN-BC, CCM

Transplant Financial Coordinator

Liver/Multivisceral Programs

Clarian Transplant

550 N.University Blvd., Rm. 4601

Indpls., IN 46202-5250

Desk:

FAX:

sstirlingburgin@...

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

Sent: Wednesday, January 07, 2009

10:56 AM

To: TxFinancialCoordinators

Subject: RE:

COB Question -- a new wrinkle ....

Current status – I gently

“pushed” the issue with the line staff re why the Federal laws from

CMS for ESRD Medicare was being handle differently. Ended up with a

specialist who agreed that Aetna

should remain primary through the COB.

Apparently the question about if the

patient had Medicare did not ask the reason for the Medicare eligibility which

Hewit now has.

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney Transplant

41 Mall Road, Burlington,

MA 01805

Ph: /FAX:

Page:

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Stirling-Burgin,

Sherry

Sent: Wednesday, January 07, 2009

10:34 AM

To: TxFinancialCoordinators

Subject: RE:

COB Question -- a new wrinkle ....

I don’t believe so, it appears they

are using the disability/ age based Medicare COB guidelines. They may need to

be directed to the Medicare ESRD publication to understand the difference.

Sher

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Battin, Daryl J.

Sent: Wednesday, January 07, 2009

10:33 AM

To: TxFinancialCoordinators

Subject:

COB Question -- a new wrinkle ....

On the phone with Aetna (actually Hewit which administers

the Lucente benefits for the spouse who has the plan) – pt’s spouse

has Aetna

through her Lucente retirement. Patient is age 55.

Patient has Medicare A due to ESRD 6/1/08 – her

benefit says that since he now has Medicare then Medicare will become primary

for him and Lucente has put him on a United Healthcare plan secondary.

Can Aetna/Lucente truly do that with ESRD Medicare and COB

information (dialysis 3/08, transplant 10/08)?

Daryl Battin, LICSW

Financial Coordinator/Social

Worker

Lahey Clinic Kidney

Transplant

41 Mall Road,

Burlington, MA 01805

Ph: /FAX:

Page:

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]

Yes they can and they will send a letter that they will not pay without a Medicare EOB. CIGNA does this and so does TRICARE. BEv Beverly A. Larson,Transplant Financial Coord.Sentara Norfolk Gen. Hosp.Transplant DepartmentPhone: Fax: email: balarson@ sentara.com>>> "Battin, Daryl J." 1/7/2009 10:33 AM >>>On the phone with Aetna (actually Hewit which administers the Lucente benefits for the spouse who has the plan) – pt’s spouse has Aetna through her Lucente retirement. Patient is age 55. Patient has Medicare A due to ESRD 6/1/08 – her benefit says that since he now has Medicare then Medicare will become primary for him and Lucente has put him on a United Healthcare plan secondary.Can Aetna/Lucente truly do that with ESRD Medicare and COB information (dialysis 3/08, transplant 10/08)? Daryl Battin, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney Transplant 41 Mall Road, Burlington, MA 01805Ph: /FAX: Page: 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.