RE: Contact number for SSA Central Office in Baltimore

[Guest guest]

You should call the COB contractor, , to see if they can

help.

You (not the pt) might call Claude Mone (pronounced " moon " ) in

Baltimore CMS at , don't know if he is still there, but he

works with ESRD coverage issues. Or he can direct you.

Fred L. Forsthoffer, MBA

Financial Analyst

Banner Good Samaritan Transplant Services

, , F-

Contact number for SSA Central Office

in Baltimore

I'm looking for the phone number for the SSA Central Office in

Baltimore, land.

I have a patient that is trying to clear up a conflict w/in Social

Security about when her ESRD Medicare ends. She needs a letter from

them for her EGHP to start paying primary again. She is aware of her

36 months and is trying to be pro-active for her providers and

billing hang-ups. In one systems computer,they show it should

terminate the end of January, 2006. In another one, they show it

ends the end of March, 2006. (Her ESRD Medicare effecitve date is

2/25/2003- should end 2/28/2006?)

Anyway- because there is a conflict within the SSA system, the gal at

her local office can't issue a letter- she actually understands that

it ends 36 months after the transplant. The patient wants to push it

by calling Baltimore herself and I can't find a phone number on the

website.

Thoughts and numbers are always appreciated!!!

Michele Snyders, MSW

[Guest guest]

It's actually 36 mos from the date the pt was DISCHARGED from the hospital following the tx, so if your pt was tx'd on 2/25, but not d/c until 3/2 for example, then yes, the termination date for the Medicare would be 3/31 under the ESRD rules.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of michelesnydersSent: Thursday, March 23, 2006 3:43 PMTo: TxFinancialCoordinators Subject: Contact number for SSA Central Office in Baltimore

I'm looking for the phone number for the SSA Central Office in Baltimore, land.I have a patient that is trying to clear up a conflict w/in Social Security about when her ESRD Medicare ends. She needs a letter from them for her EGHP to start paying primary again. She is aware of her 36 months and is trying to be pro-active for her providers and billing hang-ups. In one systems computer,they show it should terminate the end of January, 2006. In another one, they show it ends the end of March, 2006. (Her ESRD Medicare effecitve date is 2/25/2003- should end 2/28/2006?)Anyway- because there is a conflict within the SSA system, the gal at her local office can't issue a letter- she actually understands that it ends 36 months after the transplant. The patient wants to push it by calling Baltimore herself and I can't find a phone number on the website.Thoughts and numbers are always appreciated!!!Michele Snyders, MSW

[Guest guest]

Only if she meets regular disability criteria-having a pancreas tx is not an entitlement event for Medicare.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Delson, SheilaSent: Friday, March 24, 2006 10:36 AMTo: TxFinancialCoordinators Subject: RE: Contact number for SSA Central Office in Baltimore

I have another question just posed to me by a patient: Kidney t/p 4 years ago; medicare termed after 36 months. Pancreas t/p last week (after kidney) - is there any chance of her getting medicare for this?

[Guest guest]

My understanding is that Medicare does not participate with pancreas txp if its

done separate from kidney.

: I was

under the impression that Medicare participates in SPK?? I thought that is

what I recall someone mentioning or is it just commercial insurers??

K

Harper University Hospital, Detroit

RE:

Contact number for SSA Central Office in Baltimore

I have

another question just posed to me by a patient:

Kidney t/p 4 years ago;

medicare termed after 36 months.

Pancreas t/p last week (after

kidney) - is there any chance of her getting medicare for this?

[Guest guest]

Pancreas AFTER kidney, regardless of when the kidney was done, is covered as is KP, however, Pancreas Tx Alone (PTA aka Pancreas BEFORE kidney) isn't a Medicare covered tx. However, as I said, having a pancreas tx is not an entitlement event w/Medicare-in other words, someone won't get Medicare just because he/she had a pancreas tx the way pt's do for having kidney txs.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of , Sent: Friday, March 24, 2006 10:55 AMTo: TxFinancialCoordinators Subject: RE: Contact number for SSA Central Office in Baltimore

My understanding is that Medicare does not participate with pancreas txp if its done separate from kidney.

: I was under the impression that Medicare participates in SPK?? I thought that is what I recall someone mentioning or is it just commercial insurers??

K

Harper University Hospital, Detroit

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of LAguiar@...Sent: Friday, March 24, 2006 10:41 AMTo: TxFinancialCoordinators Subject: RE: Contact number for SSA Central Office in Baltimore

Only if she meets regular disability criteria-having a pancreas tx is not an entitlement event for Medicare.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Delson, SheilaSent: Friday, March 24, 2006 10:36 AMTo: TxFinancialCoordinators Subject: RE: Contact number for SSA Central Office in Baltimore

I have another question just posed to me by a patient: Kidney t/p 4 years ago; medicare termed after 36 months. Pancreas t/p last week (after kidney) - is there any chance of her getting medicare for this?

[Guest guest]

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of LAguiar@...

Sent: Friday, March 24, 2006 9:59

AM

To:

TxFinancialCoordinators

Subject: RE:

Contact number for SSA Central Office in Baltimore

Pancreas AFTER kidney, regardless of when the kidney was done, is

covered as is KP, however, Pancreas Tx Alone (PTA aka Pancreas BEFORE kidney)

isn't a Medicare covered tx. However, as I said, having a pancreas tx is

not an entitlement event w/Medicare-in other words, someone won't get Medicare

just because he/she had a pancreas tx the way pt's do for having kidney txs.

J. Aguiar

Beth Israel Deaconess, Boston

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of ,

Sent: Friday, March 24, 2006 10:55

AM

To:

TxFinancialCoordinators

Subject: RE:

Contact number for SSA Central Office in Baltimore

My understanding is that Medicare does

not participate with pancreas txp if its done separate from kidney.

: I was under the impression that

Medicare participates in SPK?? I thought that is what I recall

someone mentioning or is it just commercial insurers??

K

Harper University Hospital, Detroit

-----Original

Message-----

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of LAguiar@...

Sent: Friday, March 24, 2006 10:41

AM

To:

TxFinancialCoordinators

Subject: RE:

Contact number for SSA Central Office in Baltimore

Only if she meets regular disability

criteria-having a pancreas tx is not an entitlement event for Medicare.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Delson, Sheila

Sent: Friday, March 24, 2006 10:36

AM

To:

TxFinancialCoordinators

Subject: RE:

Contact number for SSA Central Office in Baltimore

I have another

question just posed to me by a patient:

Kidney t/p 4 years ago;

medicare termed after 36 months.

Pancreas t/p last week (after

kidney) - is there any chance of her getting medicare for this?

[Guest guest]

CMS issued a proposed Decision Memo for

Pancreas Transplants on 1/26/2006. CAG-00295R They are proposing to cover

pancreas transplant alone, PTA, for Type 1 diabetics who do not have ESRD. Hopefully

there will be a national coverage decision later this year, and PTA will be another

qualifying event for Medicare like kidney transplant is now.

Fred L. Forsthoffer, MBA

Financial Analyst

Banner Good Samaritan Transplant Services

,

, F-

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of LAguiar@...

Sent: Friday, March 24, 2006 8:59

AM

To: TxFinancialCoordinators

Subject: RE:

Contact number for SSA Central Office in Baltimore

Pancreas

AFTER kidney, regardless of when the kidney was done, is covered as is KP,

however, Pancreas Tx Alone (PTA aka Pancreas BEFORE kidney) isn't a Medicare

covered tx. However, as I said, having a pancreas tx is not an

entitlement event w/Medicare-in other words, someone won't get Medicare just

because he/she had a pancreas tx the way pt's do for having kidney txs.

J.

Aguiar

Beth Israel

Deaconess, Boston

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of ,

Sent: Friday, March 24, 2006 10:55

AM

To:

TxFinancialCoordinators

Subject: RE:

Contact number for SSA Central Office in Baltimore

My

understanding is that Medicare does not participate with pancreas txp if its

done separate from kidney.

: I was

under the impression that Medicare participates in SPK?? I thought

that is what I recall someone mentioning or is it just commercial insurers??

K

Harper

University Hospital, Detroit

RE:

Contact number for SSA Central Office in Baltimore

I have another question just posed to me by a patient:

Kidney t/p 4 years ago;

medicare termed after 36 months.

Pancreas t/p last week (after

kidney) - is there any chance of her getting medicare for this?

[Guest guest]

Thank you all

for responding and enlightening me regarding the pancreas txp and medicare. I

started this job in September and have quite a lot to learn. This website is

invaluable….

K

RE:

Contact number for SSA Central Office in Baltimore

I have another question just posed to me by a patient:

Kidney t/p 4 years ago;

medicare termed after 36 months.

Pancreas t/p last week (after

kidney) - is there any chance of her getting medicare for this?

[Guest guest]

wow! someone at your SSA office is seriously mixing up Disability and Renal Medicare program rules! or...do you think there might be some pts who went into kidney transplant on Disability Medicare and didn't fill out the paperwork for the Renal program? I don't think SSA automatically flips the switch so to speak if a specific app for Renal coverage isn't made...

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org

"The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little." FDR

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of BEVERLY A LARSONSent: Friday, March 24, 2006 11:16 AMTo: TxFinancialCoordinators Subject: RE: Contact number for SSA Central Office in BaltimoreOur experience has been that the patient's are being called in after 24 months by Social Security and Medicare is being discontinued. This is a real hardship for immunosuppressive drugs.>>> LAguiar@... 03/24/06 7:03 AM >>>

It's actually 36 mos from the date the pt was DISCHARGED from the hospital following the tx, so if your pt was tx'd on 2/25, but not d/c until 3/2 for example, then yes, the termination date for the Medicare would be 3/31 under the ESRD rules.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of michelesnydersSent: Thursday, March 23, 2006 3:43 PMTo: TxFinancialCoordinators Subject: Contact number for SSA Central Office in Baltimore

I'm looking for the phone number for the SSA Central Office in Baltimore, land.I have a patient that is trying to clear up a conflict w/in Social Security about when her ESRD Medicare ends. She needs a letter from them for her EGHP to start paying primary again. She is aware of her 36 months and is trying to be pro-active for her providers and billing hang-ups. In one systems computer,they show it should terminate the end of January, 2006. In another one, they show it ends the end of March, 2006. (Her ESRD Medicare effecitve date is 2/25/2003- should end 2/28/2006?)Anyway- because there is a conflict within the SSA system, the gal at her local office can't issue a letter- she actually understands that it ends 36 months after the transplant. The patient wants to push it by calling Baltimore herself and I can't find a phone number on the website.! Thoughts and numbers are always appreciated!!!Michele Snyders, MSW

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