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RE: DCD Donors

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There should be no impact on payment, a donor is a donor. There is no reason you would share this information.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, DeborahSent: Tuesday, March 21, 2006 3:28 PMTo: TxFinancialCoordinators Subject: DCD Donors

Can you let me know if any of your facilities have experience with DCD (Donor after Cardiac Death) donors?

If so, what experience have you seen? We are looking more into this and are concerned if this had had any impact on contracting or health plans in general.

Any feedback you can give would be very helpful.

Thanks

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

***********************************************************************This electronic transmission contains information from Methodist Health System and should be considered confidential and privileged. The information contained in the above messages is intended only for the use of the individual(s) and entity(ies) named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution, or use of this information is prohibited. If you receive this transmission in error, please notify the sender immediately by return e-mail. Methodist Health System, its subsidiaries and affiliates hereby claim all applicable privileges related to the transmission of this communication.

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You probably will see an increased LOS due to a higher incidence of ATN or DGF, though. However, since you have no way of knowing who will get a DCD organ @ the time of contracting, it's just one of those things you may have to live with ultimately.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, DeborahSent: Tuesday, March 21, 2006 3:28 PMTo: TxFinancialCoordinators Subject: DCD Donors

Can you let me know if any of your facilities have experience with DCD (Donor after Cardiac Death) donors?

If so, what experience have you seen? We are looking more into this and are concerned if this had had any impact on contracting or health plans in general.

Any feedback you can give would be very helpful.

Thanks

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

***********************************************************************This electronic transmission contains information from Methodist Health System and should be considered confidential and privileged. The information contained in the above messages is intended only for the use of the individual(s) and entity(ies) named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution, or use of this information is prohibited. If you receive this transmission in error, please notify the sender immediately by return e-mail. Methodist Health System, its subsidiaries and affiliates hereby claim all applicable privileges related to the transmission of this communication.

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Thanks!

I think more the issue is those doors that

are not used after we have brought the patients in, anesthetized them, and gone

out for “possible” procurement.

From what I understand, there are about

50%+ of these donors that are then not donors so this could potentially run up the

costs dramatically. Sorry, I was not so clear the first time.

Thanks

Debbie Mast

Supervisor, Senior

Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung,

Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of LAguiar@...

Sent: Tuesday, March 21, 2006

12:50 PM

To: TxFinancialCoordinators

Subject: RE:

DCD Donors

You probably

will see an increased LOS due to a higher incidence of ATN or DGF,

though. However, since you have no way of knowing who will get a DCD

organ @ the time of contracting, it's just one of those things you may have to

live with ultimately.

J.

Aguiar

Beth Israel

Deaconess, Boston

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Mast, Deborah

Sent: Tuesday, March 21, 2006 3:28

PM

To: TxFinancialCoordinators

Subject:

DCD Donors

Can you let me know if any of your

facilities have experience with DCD (Donor after Cardiac Death) donors?

If so, what experience have you

seen? We are looking more into this and are concerned if this had had any

impact on contracting or health plans in general.

Any feedback you can give would be very

helpful.

Thanks

Debbie Mast

Supervisor, Senior

Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung,

Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

***********************************************************************

This electronic transmission contains information from Methodist Health

System and should be considered confidential and privileged. The

information contained in the above messages is intended only for the

use of the individual(s) and entity(ies) named above. If you are not

the intended recipient, be aware that any disclosure, copying,

distribution, or use of this information is prohibited. If you receive

this transmission in error, please notify the sender immediately by

return e-mail. Methodist Health System, its subsidiaries and

affiliates hereby claim all applicable privileges related to the

transmission of this communication.

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But if the recipient goes home w/o going to the OR & having the actual tx, the costs from the 'dry run' should still be going to the KACC, I believe-Bill, can you chime in on this? I know this question has been asked & answered before, but I want to make sure I've gotten it right.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, DeborahSent: Tuesday, March 21, 2006 5:14 PMTo: TxFinancialCoordinators Subject: RE: DCD Donors

Thanks!

I think more the issue is those doors that are not used after we have brought the patients in, anesthetized them, and gone out for “possible” procurement.

From what I understand, there are about 50%+ of these donors that are then not donors so this could potentially run up the costs dramatically. Sorry, I was not so clear the first time.

Thanks

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

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Guest guest

Hi all,

Lets talk about the steps in the

process. If we bring a recipient in, do all of the pre-op stuff, run up hospital

charges and H & P’s and the recipient winds up going home, all of the

charges for the services go to OACC regardless of whether the donor is a live

donor, a “normal” deceased donor, an “extended donor”

or the “non-heart beating donor”. Yes, the potential is there

for higher overall program costs,

Additionally, the potential for higher

program costs also exists even if the transplant center does not accept the “extended

donor” or “non-heart beating donor” organs if the OPO that

services the center procures those types of organs. The reason in that the

OPO costs will probably go up because of them taking only kidneys and having

very high donor hospital bills and having the donor hospital bill spread over

only two organs and not over 4 or more.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of LAguiar@...

Sent: Wednesday, March 22, 2006

6:46 AM

To: TxFinancialCoordinators

Subject: RE:

DCD Donors

But if the

recipient goes home w/o going to the OR & having the actual tx, the costs

from the 'dry run' should still be going to the KACC, I believe-Bill, can you

chime in on this? I know this question has been asked & answered before,

but I want to make sure I've gotten it right.

J.

Aguiar

Beth Israel

Deaconess, Boston

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Mast, Deborah

Sent: Tuesday, March 21, 2006 5:14

PM

To: TxFinancialCoordinators

Subject: RE:

DCD Donors

Thanks!

I think more the issue is those doors that

are not used after we have brought the patients in, anesthetized them, and gone

out for “possible” procurement.

From what I understand, there are about

50%+ of these donors that are then not donors so this could potentially run up

the costs dramatically. Sorry, I was not so clear the first time.

Thanks

Debbie Mast

Supervisor, Senior

Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung,

Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

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We, as an industry, have “hurt”

our selves in kidney transplant by in many cases contracting differently for

Live Donor vs Deceased donor transplant. To add questions about non-heart

beating donors to the mix could hurt even more.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of , Stoops

Sent: Tuesday, March 21, 2006 3:36

PM

To: TxFinancialCoordinators

Subject: RE:

DCD Donors

There should be no impact on payment, a

donor is a donor. There is no reason you would share this information.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Mast, Deborah

Sent: Tuesday, March 21, 2006 3:28

PM

To: TxFinancialCoordinators

Subject:

DCD Donors

Can you let me know if any of your

facilities have experience with DCD (Donor after Cardiac Death) donors?

If so, what experience have you

seen? We are looking more into this and are concerned if this had had any

impact on contracting or health plans in general.

Any feedback you can give would be very

helpful.

Thanks

Debbie Mast

Supervisor, Senior

Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver,

Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

***********************************************************************

This electronic transmission contains information from Methodist Health

System and should be considered confidential and privileged. The

information contained in the above messages is intended only for the

use of the individual(s) and entity(ies) named above. If you are not

the intended recipient, be aware that any disclosure, copying,

distribution, or use of this information is prohibited. If you receive

this transmission in error, please notify the sender immediately by

return e-mail. Methodist Health System, its subsidiaries and

affiliates hereby claim all applicable privileges related to the

transmission of this communication.

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It is my understanding that any cost associated with the possible donation of organs is charged to the the procuring organization. They do not go to the family of the deceased donor even if the organs are not used. Bev>>> DMast@... 03/21/06 5:14 PM >>>

Thanks!

I think more the issue is those doors that are not used after we have brought the patients in, anesthetized them, and gone out for “possible” procurement.

From what I understand, there are about 50%+ of these donors that are then not donors so this could potentially run up the costs dramatically. Sorry, I was not so clear the first time.

Thanks

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of LAguiar@...Sent: Tuesday, March 21, 2006 12:50 PMTo: TxFinancialCoordinators Subject: RE: DCD Donors

You probably will see an increased LOS due to a higher incidence of ATN or DGF, though. However, since you have no way of knowing who will get a DCD organ @ the time of contracting, it's just one of those things you may have to live with ultimately.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, DeborahSent: Tuesday, March 21, 2006 3:28 PMTo: TxFinancialCoordinators Subject: DCD Donors

Can you let me know if any of your facilities have experience with DCD (Donor after Cardiac Death) donors?

If so, what experience have you seen? We are looking more into this and are concerned if this had had any impact on contracting or health plans in general.

Any feedback you can give would be very helpful.

Thanks

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

***********************************************************************This electronic transmission contains information from Methodist Health System and should be considered confidential and privileged. The information contained in the above messages is intended only for the use of the individual(s) and entity(ies) named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution, or use of this information is prohibited. If you receive this transmission in error, please notify the sender immediately by return e-mail. Methodist Health System, its subsidiaries and affiliates hereby claim all applicable privileges related to the transmission of this communication.

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Guest guest

In my experience, what Beverly said is correct. Once the patient is "pronounced" the patient is technically discharged, any charges after that are to be billed to the OPO. As well as the harvesting.

Kreci Transplant Financial Coordinator Southwest Florida Regional Medical Center 2727 Winkler Ave Fort Myers, FL 33910

This email may contain CONFIDENTIAL PATIENT INFORMATION, which may also be legally PRIVILEGED, and which is intended to be read and or used only by the individual entity named above. If the reader of this e-mail is NOT the intended recipient, you are hereby notified that you are in possession of confidential and privileged information. Any disclosure, dissemination, distribution, copying or the taking of any action in reliance of the contents of this information is strictly prohibited.

If you have received this e-mail in error, please immediately notify the sender by telephone, and return the original. Redisclosure of this information is prohibited without the written authorization of the patient to whom it pertains.

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of BEVERLY A LARSONSent: Wednesday, March 22, 2006 8:34 AMTo: TxFinancialCoordinators Subject: RE: DCD DonorsIt is my understanding that any cost associated with the possible donation of organs is charged to the the procuring organization. They do not go to the family of the deceased donor even if the organs are not used. Bev>>> DMast@... 03/21/06 5:14 PM >>>

Thanks!

I think more the issue is those doors that are not used after we have brought the patients in, anesthetized them, and gone out for “possible” procurement.

From what I understand, there are about 50%+ of these donors that are then not donors so this could potentially run up the costs dramatically. Sorry, I was not so clear the first time.

Thanks

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of LAguiar@...Sent: Tuesday, March 21, 2006 12:50 PMTo: TxFinancialCoordinators Subject: RE: DCD Donors

You probably will see an increased LOS due to a higher incidence of ATN or DGF, though. However, since you have no way of knowing who will get a DCD organ @ the time of contracting, it's just one of those things you may have to live with ultimately.

J. Aguiar

Beth Israel Deaconess, Boston

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, DeborahSent: Tuesday, March 21, 2006 3:28 PMTo: TxFinancialCoordinators Subject: DCD Donors

Can you let me know if any of your facilities have experience with DCD (Donor after Cardiac Death) donors?

If so, what experience have you seen? We are looking more into this and are concerned if this had had any impact on contracting or health plans in general.

Any feedback you can give would be very helpful.

Thanks

Debbie Mast

Supervisor, Senior Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

***********************************************************************This electronic transmission contains information from Methodist Health System and should be considered confidential and privileged. The information contained in the above messages is intended only for the use of the individual(s) and entity(ies) named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution, or use of this information is prohibited. If you receive this transmission in error, please notify the sender immediately by return e-mail. Methodist Health System, its subsidiaries and affiliates hereby claim all applicable privileges related to the transmission of this communication.

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Guest guest

Thanks to everyone for answering my

question!

Also, this would actually encompass all

organs…so, basically we just have to run the higher costs if we choose to

do the DCD donors!

Debbie Mast

Supervisor, Senior

Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung,

Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Vaughan

Sent: Wednesday, March 22, 2006

4:15 AM

To: TxFinancialCoordinators

Subject: RE:

DCD Donors

Hi all,

Lets talk about the steps in the

process. If we bring a recipient in, do all of the pre-op stuff, run up

hospital charges and H & P’s and the recipient winds up going home, all

of the charges for the services go to OACC regardless of whether the donor is a

live donor, a “normal” deceased donor, an “extended

donor” or the “non-heart beating donor”. Yes, the

potential is there for higher overall program costs,

Additionally, the potential for higher

program costs also exists even if the transplant center does not accept the

“extended donor” or “non-heart beating donor” organs if

the OPO that services the center procures those types of organs. The

reason in that the OPO costs will probably go up because of them taking only

kidneys and having very high donor hospital bills and having the donor hospital

bill spread over only two organs and not over 4 or more.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of LAguiar@...

Sent: Wednesday, March 22, 2006

6:46 AM

To: TxFinancialCoordinators

Subject: RE:

DCD Donors

But if the

recipient goes home w/o going to the OR & having the actual tx, the costs

from the 'dry run' should still be going to the KACC, I believe-Bill, can you

chime in on this? I know this question has been asked & answered

before, but I want to make sure I've gotten it right.

J.

Aguiar

Beth Israel

Deaconess, Boston

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ]

On Behalf Of Mast, Deborah

Sent: Tuesday, March 21, 2006 5:14

PM

To: TxFinancialCoordinators

Subject: RE:

DCD Donors

Thanks!

I think more the issue is those doors that

are not used after we have brought the patients in, anesthetized them, and gone

out for “possible” procurement.

From what I understand, there are about

50%+ of these donors that are then not donors so this could potentially run up

the costs dramatically. Sorry, I was not so clear the first time.

Thanks

Debbie Mast

Supervisor, Senior

Transplant Financial Coordinator

Member, TFCA

Heart Failure, Heart, Lung, Heart/Lung,

Liver, Kidney, Pancreas, Intestinal Transplant Programs

Phone: Fax:

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