Guest guest Posted January 9, 2009 Report Share Posted January 9, 2009 Hello everyone, I’m having a brain freeze and need a little help. A patient had a kidney transplant in 2000 and of course Medicare benefits terminated 3 years later. Meanwhile patient re-started dialysis and Medicare became effective on 5-1-08, so my question is does the coordination of period start over? A new 30 months or is Medicare primary because of re-entitlement? Thanks Shores Children's Memorial Hospital Chicago, IL From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Vaughan Sent: Friday, January 02, 2009 7:44 AM To: TxFinancialCoordinators Subject: RE: dumb question from the liver tfc re: esrd! Entitlement begins the first of the month from the beginning of in-center Hemo Dialysis after the 90 day waiting period. It begins the first of the month if the patient has home dialysis training first. If the patient has insurance there is effectively a 33 month coordination of benefits period including the 90 day waiting period if the patient does in-center hemo, there is a 30 month coordination of benefits period if the patient does home dialysis. If the patient does not have other insurance, Medicare becomes primary after 90 days for the in-center patient and the first of the month that they began home dialysis training. The " anniversary " date is always the first of the month. Hope this helps, Thanks, Bill dumb question from the liver tfc re: esrd! Thirty months if straight hemo. Bev If patient did home dialysis then they get Medicare from day 1 and they do not have the 90 day wait before their Medicare is effective. Bev Beverly A. Larson, Transplant Financial Coord. Sentara Norfolk Gen. Hosp. Transplant Department Phone: Fax: email: balarson@ sentara.com >>> " Gray, Meredith M " <Meredith_GrayURMC (DOT) Rochester.edu> 12/31/2008 >>> 3:12 PM >>> Humor me. I don’t do renal & our renal queen is out of the office. What is the rule about medicare & dialysis… Pt began dialysis 3/9/07. How long before medicare is prime? Meredith Gray Liver Transplant Financial Coordinator University of Rochester Strong Memorial Hospital 601 Elmwood Avenue Box 602 Rochester, NY 14642 (fax) (pager) P Think Green before printing this e-mail. This message contains information which may be confidential and privileged. Unless you are the addressee (or authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in the message (including attachments). If you have received the message in error, please advise sender by reply email and delete the message. Thank you! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2009 Report Share Posted January 9, 2009 yes, new COB -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Shores, Sent: Friday, January 09, 2009 9:14 AMTo: TxFinancialCoordinators Subject: RE: dumb question Hello everyone, I’m having a brain freeze and need a little help. A patient had a kidney transplant in 2000 and of course Medicare benefits terminated 3 years later. Meanwhile patient re-started dialysis and Medicare became effective on 5-1-08, so my question is does the coordination of period start over? A new 30 months or is Medicare primary because of re-entitlement? Thanks Shores Children's Memorial Hospital Chicago, IL From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of VaughanSent: Friday, January 02, 2009 7:44 AMTo: TxFinancialCoordinators Subject: RE: dumb question from the liver tfc re: esrd! Entitlement begins the first of the month from the beginning of in-center Hemo Dialysis after the 90 day waiting period. It begins the first of the month if the patient has home dialysis training first.If the patient has insurance there is effectively a 33 month coordination of benefits period including the 90 day waiting period if the patient does in-center hemo, there is a 30 month coordination of benefits period if the patient does home dialysis.If the patient does not have other insurance, Medicare becomes primary after 90 days for the in-center patient and the first of the month that they began home dialysis training. The "anniversary" date is always the first of the month.Hope this helps,Thanks,Bill-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY A LARSONSent: Friday, January 02, 2009 8:29 AMTo: TxFinancialCoordinators Subject: dumb question from the liver tfc re: esrd!Thirty months if straight hemo. Bev If patient did home dialysis then they get Medicare from day 1 and they do not have the 90 day wait before their Medicare is effective. BevBeverly A. Larson,Transplant Financial Coord.Sentara Norfolk Gen. Hosp.Transplant DepartmentPhone: Fax: email: balarson@ sentara.com>>> "Gray, Meredith M" <Meredith_GrayURMC (DOT) Rochester.edu> 12/31/2008 >>> 3:12 PM >>>Humor me. I don’t do renal & our renal queen is out of the office. What is the rule about medicare & dialysis… Pt began dialysis 3/9/07. How long before medicare is prime? Meredith GrayLiver Transplant Financial CoordinatorUniversity of Rochester Strong Memorial Hospital601 Elmwood Avenue Box 602Rochester, NY 14642 (fax) (pager)P Think Green before printing this e-mail.This message contains information which may be confidential and privileged. Unless you are the addressee (or authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in the message (including attachments). If you have received the message in error, please advise sender by reply email and delete the message. Thank you! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2009 Report Share Posted January 9, 2009 He would not have a 3-month waiting period for the Medicare coverage AND he would have another ESRD 30-month coordination period that would start with the new ESRD effective date. Tyler Transplant Financial Coordinator Providence Sacred Heart Medical Center and Children's Hospital Spokane, WA linda.tyler@... From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Shores, Sent: Friday, January 09, 2009 9:14 AMTo: TxFinancialCoordinators Subject: RE: dumb question Hello everyone, I’m having a brain freeze and need a little help. A patient had a kidney transplant in 2000 and of course Medicare benefits terminated 3 years later. Meanwhile patient re-started dialysis and Medicare became effective on 5-1-08, so my question is does the coordination of period start over? A new 30 months or is Medicare primary because of re-entitlement? Thanks Shores Children's Memorial Hospital Chicago, IL From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of VaughanSent: Friday, January 02, 2009 7:44 AMTo: TxFinancialCoordinators Subject: RE: dumb question from the liver tfc re: esrd! Entitlement begins the first of the month from the beginning of in-center Hemo Dialysis after the 90 day waiting period. It begins the first of the month if the patient has home dialysis training first.If the patient has insurance there is effectively a 33 month coordination of benefits period including the 90 day waiting period if the patient does in-center hemo, there is a 30 month coordination of benefits period if the patient does home dialysis.If the patient does not have other insurance, Medicare becomes primary after 90 days for the in-center patient and the first of the month that they began home dialysis training. The "anniversary" date is always the first of the month.Hope this helps,Thanks,Bill-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY A LARSONSent: Friday, January 02, 2009 8:29 AMTo: TxFinancialCoordinators Subject: dumb question from the liver tfc re: esrd!Thirty months if straight hemo. Bev If patient did home dialysis then they get Medicare from day 1 and they do not have the 90 day wait before their Medicare is effective. BevBeverly A. Larson,Transplant Financial Coord.Sentara Norfolk Gen. Hosp.Transplant DepartmentPhone: Fax: email: balarson@ sentara.com>>> "Gray, Meredith M" <Meredith_GrayURMC (DOT) Rochester.edu> 12/31/2008 >>> 3:12 PM >>>Humor me. I don’t do renal & our renal queen is out of the office. What is the rule about medicare & dialysis… Pt began dialysis 3/9/07. How long before medicare is prime? Meredith GrayLiver Transplant Financial CoordinatorUniversity of Rochester Strong Memorial Hospital601 Elmwood Avenue Box 602Rochester, NY 14642 (fax) (pager)P Think Green before printing this e-mail.This message contains information which may be confidential and privileged. Unless you are the addressee (or authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in the message (including attachments). If you have received the message in error, please advise sender by reply email and delete the message. Thank you! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2009 Report Share Posted January 9, 2009 Thank you. That is what I thought however the insurance company insist Medicare in primary. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Tyler, A. Sent: Friday, January 09, 2009 11:20 AM To: TxFinancialCoordinators Subject: RE: dumb question He would not have a 3-month waiting period for the Medicare coverage AND he would have another ESRD 30-month coordination period that would start with the new ESRD effective date. Tyler Transplant Financial Coordinator Providence Sacred Heart Medical Center and Children's Hospital Spokane, WA linda.tylerprovidence (DOT) org From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Shores, Sent: Friday, January 09, 2009 9:14 AM To: TxFinancialCoordinators Subject: RE: dumb question Hello everyone, I’m having a brain freeze and need a little help. A patient had a kidney transplant in 2000 and of course Medicare benefits terminated 3 years later. Meanwhile patient re-started dialysis and Medicare became effective on 5-1-08, so my question is does the coordination of period start over? A new 30 months or is Medicare primary because of re-entitlement? Thanks Shores Children's Memorial Hospital Chicago, IL size=2 width="100%" align=center tabIndex=-1> From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Vaughan Sent: Friday, January 02, 2009 7:44 AM To: TxFinancialCoordinators Subject: RE: dumb question from the liver tfc re: esrd! Entitlement begins the first of the month from the beginning of in-center Hemo Dialysis after the 90 day waiting period. It begins the first of the month if the patient has home dialysis training first. If the patient has insurance there is effectively a 33 month coordination of benefits period including the 90 day waiting period if the patient does in-center hemo, there is a 30 month coordination of benefits period if the patient does home dialysis. If the patient does not have other insurance, Medicare becomes primary after 90 days for the in-center patient and the first of the month that they began home dialysis training. The " anniversary " date is always the first of the month. Hope this helps, Thanks, Bill dumb question from the liver tfc re: esrd! Thirty months if straight hemo. Bev If patient did home dialysis then they get Medicare from day 1 and they do not have the 90 day wait before their Medicare is effective. Bev Beverly A. Larson, Transplant Financial Coord. Sentara Norfolk Gen. Hosp. Transplant Department Phone: Fax: email: balarson@ sentara.com >>> " Gray, Meredith M " <Meredith_GrayURMC (DOT) Rochester.edu> 12/31/2008 >>> 3:12 PM >>> Humor me. I don’t do renal & our renal queen is out of the office. What is the rule about medicare & dialysis… Pt began dialysis 3/9/07. How long before medicare is prime? Meredith Gray Liver Transplant Financial Coordinator University of Rochester Strong Memorial Hospital 601 Elmwood Avenue Box 602 Rochester, NY 14642 (fax) (pager) P Think Green before printing this e-mail. This message contains information which may be confidential and privileged. Unless you are the addressee (or authorized to receive for the addressee), you may not use, copy or disclose to anyone the message or any information contained in the message (including attachments). If you have received the message in error, please advise sender by reply email and delete the message. Thank you! Quote Link to comment Share on other sites More sharing options...
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