Guest guest Posted June 10, 2004 Report Share Posted June 10, 2004 In cases like this, I collect insurance information from the donor. I explain to them that this is the insurance company's rule, not ours. If the donor's insurance says they will not pay, I try to get it in writing. If they say they will pay, I still get authorization from the recipient's insurance for any copays and/or deductibles. I don't like this, but haven't figured out a way around it. Good luck! Janet M. Lovely Lankenau Hospital Phila., PA Kidney Donors How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2004 Report Share Posted June 10, 2004 We have run into a couple of instances where the recipient's insurance required a denial from the donor's insurance before processing the claim - a MADDENING stall tactic. It means billing the donor's insurance first and then submitting the denied claim to the recipient's. When the donor workup is done outside of our own facility, it's a lengthy and frustrating process for the other facility's biller - and they must be cajoled into sticking w/it rather than giving up and billing the donor directly. I've heard of some programs that require the donor to get a letter from their insurance stating that there is no benefit, and I'll be giving that a try the next time this crops up. Meanwhile our program is exploring the practice of billing all donor evals straight to the KACC and just bypassing the commercial payers. Is anyone else doing this and how is it working out? -----Original Message-----From: ELIZONDO, FELICIA Sent: Thursday, June 10, 2004 12:55 PMTo: TxFinancialCoordinators Subject: Kidney DonorsHow do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2004 Report Share Posted June 10, 2004 Yes that is how we do it: Everything for the donor and recipient is done through the KACC; when transplant occurs the organ requisition charges are all bundled under one revenue code and added to the UB for the recipient. Have never had any problems, bills are getting paid for both types of transplants. Kreci Transplant Financial Coordinator Southwest Regional Florida Medical Center Fort Myers, FL -----Original Message-----From: on, :LPH Trnsplnt Sent: Thursday, June 10, 2004 4:05 PMTo: TxFinancialCoordinators Subject: RE: Kidney Donors We have run into a couple of instances where the recipient's insurance required a denial from the donor's insurance before processing the claim - a MADDENING stall tactic. It means billing the donor's insurance first and then submitting the denied claim to the recipient's. When the donor workup is done outside of our own facility, it's a lengthy and frustrating process for the other facility's biller - and they must be cajoled into sticking w/it rather than giving up and billing the donor directly. I've heard of some programs that require the donor to get a letter from their insurance stating that there is no benefit, and I'll be giving that a try the next time this crops up. Meanwhile our program is exploring the practice of billing all donor evals straight to the KACC and just bypassing the commercial payers. Is anyone else doing this and how is it working out? -----Original Message-----From: ELIZONDO, FELICIA Sent: Thursday, June 10, 2004 12:55 PMTo: TxFinancialCoordinators Subject: Kidney DonorsHow do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 We do the same as 's hospital. I used to get the donor insurance info, but stopped after our accounting dept decided we didn't want to get into trouble for double dipping with Medicare and insurance, since the donor's bill gets tacked onto the recipients'... Kidney Donors How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 All pre-transplant services for donor (as well as recips) svcs go thru our KACC. It's the Part B services (anesthesia, doc, etc.) associated w/the hospital service when the transplant is performed that is the problem. I just contacted the anesthesia service that sent a bill to one of our donors as the recips BCBS policy would not pick up the 20% coins after Mcare stating they need a denial from the donor's insurance. We are still trying to work it out. Sherri Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 Dear Sherri, Medicare should pay 100% for the anesthesia services for the donor. Janet M. Lovely Lankenau Hospital Phila., PA Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 That's what I thought but the billing ofc said 'no'...I will look at my Mcare regs & give them a call back...Thanks! Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 It is written in ESRD Medicare booklet for patients. Also, there is a specific billing code which must be used. (Maybe Q32?) - Does anyone out there know for sure. Good luck. Jan Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 I thinks it's Q3. Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 Our unit puts all cost for donors in the kidney acquisition cost center. We treat every renal patient as if they have Medicare. Bev>>> lmorriso@... 06/10/04 04:05PM >>> We have run into a couple of instances where the recipient's insurance required a denial from the donor's insurance before processing the claim - a MADDENING stall tactic. It means billing the donor's insurance first and then submitting the denied claim to the recipient's. When the donor workup is done outside of our own facility, it's a lengthy and frustrating process for the other facility's biller - and they must be cajoled into sticking w/it rather than giving up and billing the donor directly. I've heard of some programs that require the donor to get a letter from their insurance stating that there is no benefit, and I'll be giving that a try the next time this crops up. Meanwhile our program is exploring the practice of billing all donor evals straight to the KACC and just bypassing the commercial payers. Is anyone else doing this and how is it working out? -----Original Message-----From: ELIZONDO, FELICIA Sent: Thursday, June 10, 2004 12:55 PMTo: TxFinancialCoordinators Subject: Kidney DonorsHow do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 We have ALL charges sent to us: anes, hosp, surgeon etc we run through the KACC. Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 We put all donor work-up expenses in the KACC. It has not been a problem. -----Original Message-----From: BEVERLY A. LARSON Sent: Friday, June 11, 2004 11:25 AMTo: TxFinancialCoordinators Subject: RE: Kidney DonorsOur unit puts all cost for donors in the kidney acquisition cost center. We treat every renal patient as if they have Medicare. Bev>>> lmorriso@... 06/10/04 04:05PM >>> We have run into a couple of instances where the recipient's insurance required a denial from the donor's insurance before processing the claim - a MADDENING stall tactic. It means billing the donor's insurance first and then submitting the denied claim to the recipient's. When the donor workup is done outside of our own facility, it's a lengthy and frustrating process for the other facility's biller - and they must be cajoled into sticking w/it rather than giving up and billing the donor directly. I've heard of some programs that require the donor to get a letter from their insurance stating that there is no benefit, and I'll be giving that a try the next time this crops up. Meanwhile our program is exploring the practice of billing all donor evals straight to the KACC and just bypassing the commercial payers. Is anyone else doing this and how is it working out? -----Original Message-----From: ELIZONDO, FELICIA Sent: Thursday, June 10, 2004 12:55 PMTo: TxFinancialCoordinators Subject: Kidney DonorsHow do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 Yes a you are right. Q3 and dx code V59.4 see--cms website " Medicare coverage Database " -- view article titled, " Article for Claims Processing Procedure Change for Kidney Donor Service " (A11468) McIver Renal Services Financial Counselor Summa Health System Akron, OH Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 We also have the donor bills sent to us to pay and then put all donor expenses to KACC - - here at Baptist in Little Rock. We have also started having an increase in recipient insurances wanting donor insurance info - and I do not give it to them. I notify the donor, get their insurance and send them a letter asking them to deny benefits and to send me the letter, then I forward to recipient's case manager. After that, we don't usually hear from them. Kim Kim Bentley, BBAOffice Manager - Kidney Transplant ProgramBaptist Health Medical Center - Little RockMedical Towers 2, Suite 800Little Rock, Arkansas 72205phone: fax: email: kabentle@... IMPORTANT NOTICE - The information (both of the message and any attachments) contained in this message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or an agent responsible for delivering it to an intended recipient, or has received this message in error, you are hereby notified that we do not consent to any reading, dissemination, distribution or copying of this message and any such actions are strictly prohibited. If you have received this message in error, please notify the sender immediately and destroy the transmitted information. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 Thanks...now I can fax it to the anesthesia practice! Happy Friday everyone! Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 HI All, Kidney, Medicare Regulations indicate the following with respect to a Live Kidney Donor: 1. The transplant center MUST pay for all pre donation evaluation costs, physician and hospital, and place those costs in the KACC. 2. At the time of the inpatient stay the transplant center MUST pay for the inpatient stay for the donation. 3. At the time of the inpatient stay, the physicians fees for the Live Donor MUST be billed to the recipients primary payer. If the payer is Medicare, Medicare is to pay those fees at 100% of participating, with NO deductable and/of coinsurance. Yes there is a billing code modifier and I am sorry to say that I do not know what it is. 4. The transplant center MUST pay for all facility fees for post donation complications, regardless of who or where the facility is. The physicians that treat the Live Donor for post donation complications MUST bill the recipients primary payer just in number 3. 5. If the Transplant center pays for physician fees for the live donor for services rendered during the donation or for post donation complications, the transplant center MAY NOT claim those costs as KACC costs because they are not allowable. 6. The charge for the Live Donor kidney that is placed on the patients bill is NOT a summation of all of the live donor evaluation charges and the charges for the inpatient stay for the donation, it is a Standard Acquisition Charge that is set by the transplant center and the same amount is placed on the recipients bill for a live donor transplant regardless of who the payer is. 7. It has almost become a standard of practice for the recipients insurance to require that there be a denial from the donors insurance before they will pay for the transplant or for the organ acquisition portion of the transplant. We recommend that you obtain the donors insurance in the transplant office only and with the written permission of the donor call the donors insurance and tell them that in accordance with the Social Security Act, they do not have to pay for donation related expenses and to please send you a denial. If they do now wish to cooperate, either the donor will need to get a denial or we need to question whether or not the donor should donate because of potential long term problems. Additionally, if the donor says that you can not contact their insurance, you should probably not utilize them as a donor. 8. The transplant center has to make a decision, do they want to be out of compliance with Medicare Regulations or a Blue Cross contract. Remember, national law and regulations come before contract provisions. Especially when the recipient is Medicare Entitled. LIVER, 1. There is NO NATIONAL COVERAGE POLICY that requires Medicare TO PAY FOR A LIVER TRANSPLANT WHEN THE LIVER COMES FROM A LIVE DONOR. If the transplant center does not have a Local Medical Medical Determination from the local intermediary (and carrier if the doctors want to get paid), they can deny payment for the transplant. Likewise, there is NO MEDICARE REGULATION that requires the transplant center to pay for Live Donor related services of any kind. You also need a Local Medical Determination for that from the Intermediary (and from the carrier if the physicians want to get paid). Please check out your updated resource manual, it has most of the regulatory " stuff " necessary to support this. Hope this helps, Thanks, Bill At 11:10 AM 6/11/2004, you wrote: I thinks it's Q3. Re: Kidney Donors We now collect donor information. The physicians office gets the denials, as they bill for the services. >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> How do you deal with insurance companies who require a denial from the donor's insurance before they will pay for svcs? Example: Most BCBS policies state that the recipient has donor coverage if the donor is on the policy or if the donor's insurance does not cover. We do not collect donor insurance information. Does anyone run across this problem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 Thank you a and , Bill At 12:44 PM 6/11/2004, you wrote: >Yes a you are right. > >Q3 and dx code V59.4 > >see--cms website " Medicare coverage Database " -- view article titled, > " Article for Claims Processing Procedure Change for Kidney Donor >Service " (A11468) > > > McIver >Renal Services Financial Counselor >Summa Health System >Akron, OH > > > Re: Kidney Donors > > > > > > > > > > > >We now collect donor information. The physicians office gets the > > > >denials, as they bill for the services. > > > > > > > > > > > > > > > > >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> > > > >How do you deal with insurance companies who require a denial from the > > > >donor's insurance before they will pay for svcs? Example: Most BCBS > > > >policies state that the recipient has donor coverage if the donor is on > > > >the policy or if the donor's insurance does not cover. We do not > > > >collect donor insurance information. Does anyone run across this > > > >problem and if so how do you handle it? > > > > > > > >Felicia > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 Does anyone know the procedure code for IVIG therapy? Re: Kidney Donors > > > > > > > > > > > >We now collect donor information. The physicians office gets the > > > >denials, as they bill for the services. > > > > > > > > > > > > > > > > >>> Felicia.Elizondo@... 06/10/04 03:54PM >>> > > > >How do you deal with insurance companies who require a denial from the > > > >donor's insurance before they will pay for svcs? Example: Most BCBS > > > >policies state that the recipient has donor coverage if the donor is on > > > >the policy or if the donor's insurance does not cover. We do not > > > >collect donor insurance information. Does anyone run across this > > > >problem and if so how do you handle it? > > > > > > > >Felicia > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 14, 2004 Report Share Posted June 14, 2004 I was hoping I can get the feedback of some of you guys. I have a patient with a living related donor. The recipients insurance will cover all donor charges as long as they get a denial from the donors insurance. Normally I would get written permission from the donor saying that we can contact their insurance for this purpose. I usually ger a letter of denial once I explain that according to Social Security act they do not have to pay for donation related bills. My problem is that the donors insurance is Medicaid. Are there different regulations because it is Mediicaid or do I follow the same guideline. No one seems to understand and they keep giving me the run around. I know we can't directly bill Medicaid. Thanks Celenia ManeFinancial CoordinatorSt.Lukes Roosevelt Transplant Program>>> Vaughan@... 06/11/04 01:04PM >>>HI All,Kidney,Medicare Regulations indicate the following with respect to a Live Kidney Donor:1. The transplant center MUST pay for all pre donation evaluation costs, physician and hospital, and place those costs in the KACC.2. At the time of the inpatient stay the transplant center MUST pay for the inpatient stay for the donation. 3. At the time of the inpatient stay, the physicians fees for the Live Donor MUST be billed to the recipients primary payer. If the payer is Medicare, Medicare is to pay those fees at 100% of participating, with NO deductable and/of coinsurance. Yes there is a billing code modifier and I am sorry to say that I do not know what it is.4. The transplant center MUST pay for all facility fees for post donation complications, regardless of who or where the facility is. The physicians that treat the Live Donor for post donation complications MUST bill the recipients primary payer just in number 3.5. If the Transplant center pays for physician fees for the live donor for services rendered during the donation or for post donation complications, the transplant center MAY NOT claim those costs as KACC costs because they are not allowable.6. The charge for the Live Donor kidney that is placed on the patients bill is NOT a summation of all of the live donor evaluation charges and the charges for the inpatient stay for the donation, it is a Standard Acquisition Charge that is set by the transplant center and the same amount is placed on the recipients bill for a live donor transplant regardless of who the payer is.7. It has almost become a standard of practice for the recipients insurance to require that there be a denial from the donors insurance before they will pay for the transplant or for the organ acquisition portion of the transplant. We recommend that you obtain the donors insurance in the transplant office only and with the written permission of the donor call the donors insurance and tell them that in accordance with the Social Security Act, they do not have to pay for donation related expenses and to please send you a denial. If they do now wish to cooperate, either the donor will need to get a denial or we need to question whether or not the donor should donate because of potential long term problems. Additionally, if the donor says that you can not contact their insurance, you should probably not utilize them as a donor.8. The transplant center has to make a decision, do they want to be out of compliance with Medicare Regulations or a Blue Cross contract. Remember, national law and regulations come before contract provisions. Especially when the recipient is Medicare Entitled.LIVER,1. There is NO NATIONAL COVERAGE POLICY that requires Medicare TO PAY FOR A LIVER TRANSPLANT WHEN THE LIVER COMES FROM A LIVE DONOR. If the transplant center does not have a Local Medical Medical Determination from the local intermediary (and carrier if the doctors want to get paid), they can deny payment for the transplant. Likewise, there is NO MEDICARE REGULATION that requires the transplant center to pay for Live Donor related services of any kind. You also need a Local Medical Determination for that from the Intermediary (and from the carrier if the physicians want to get paid).Please check out your updated resource manual, it has most of the regulatory "stuff" necessary to support this.Hope this helps,Thanks,BillAt 11:10 AM 6/11/2004, you wrote: I thinks it's Q3.-----Original Message-----From: Lovely, Janet M. Sent: Friday, June 11, 2004 11:03 AMTo: TxFinancialCoordinators Subject: RE: Kidney DonorsIt is written in ESRD Medicare booklet for patients. Also, there is aspecific billing code which must be used. (Maybe Q32?) - Does anyone outthere know for sure.Good luck.Jan-----Original Message-----From: Sbalbi, Sherri Sent: Friday, June 11, 2004 10:01 AMTo: TxFinancialCoordinators Subject: RE: Kidney DonorsThat's what I thought but the billing ofc said 'no'...I will look at myMcare regs & give them a call back...Thanks!-----Original Message-----From: Lovely, Janet M. Sent: Friday, June 11, 2004 9:55 AMTo: TxFinancialCoordinators Subject: RE: Kidney DonorsDear Sherri,Medicare should pay 100% for the anesthesia services for the donor.Janet M. LovelyLankenau HospitalPhila., PA-----Original Message-----From: Sbalbi, Sherri Sent: Friday, June 11, 2004 9:10 AMTo: TxFinancialCoordinators Subject: RE: Kidney DonorsAll pre-transplant services for donor (as well as recips) svcs go thruour KACC. It's the Part B services (anesthesia, doc, etc.) associatedw/the hospital service when the transplant is performed that is theproblem. I just contacted the anesthesia service that sent a bill toone of our donors as the recips BCBS policy would not pick up the 20%coins after Mcare stating they need a denial from the donor's insurance.We are still trying to work it out.Sherri-----Original Message-----From: anne Buccheri Sent: Friday, June 11, 2004 8:16 AMTo: TxFinancialCoordinators Subject: Re: Kidney DonorsWe now collect donor information. The physicians office gets thedenials, as they bill for the services.>>> Felicia.Elizondo@... 06/10/04 03:54PM >>>How do you deal with insurance companies who require a denial from thedonor's insurance before they will pay for svcs? Example: Most BCBSpolicies state that the recipient has donor coverage if the donor is onthe policy or if the donor's insurance does not cover. We do notcollect donor insurance information. Does anyone run across thisproblem and if so how do you handle it? Felicia Quote Link to comment Share on other sites More sharing options...
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