Guest guest Posted March 21, 2006 Report Share Posted March 21, 2006 No, whatever tests the OPO does, regardless of whether donation occurs, are the responsibility of the OPO. You need to send the inpt bill to NEOB so the on-site coordinator can review the charges & identify those he/she ordered as part of the donation process, which they will then pay-everything else is presumed 'medical care' & is the responsibility of the pt's health ins carrier. J. Aguiar Beth Israel Deaconess, Boston From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Brown, Bonnie R.Sent: Tuesday, March 21, 2006 2:29 PMTo: TxFinancialCoordinators Subject: Organ donor question Hello all, Any thoughts on the scenario below would be very helpful. Organ donor brain dead patient is kept alive on life support in order to evaluate organs to be procured for transplant. Results of testing rule out patient as potential organ donor/organs not viable. If our OPO took the organs, we would bill them for services rendered from the point the patient was deemed brain dead. Since the tests rule the patient out, are these services reimbursed via the Medicare Cost Report? Thanks, Bonnie Bonnie R Brown Patient Financial Services Liaison Lahey Clinic Telephone: Fax: 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 21, 2006 Report Share Posted March 21, 2006 I have a question. Any pre-kidney transplant patient that comes in for an kidney evaluation and does not have MEDICARE at that time, but qualifies for MEDICARE. Do you bill there evaluation to KIDNEY ACQUISITION? I was only billing patients that had MEDICARE at the time of there evaluation. KennedySenior Financial Coordinator/Assistant to Transplant Administrator Transplant & Surgery DepartmentPhone: (202)444-7267Fax: (202)444-7304 (202)444-2969 CONFIDENTIAL: The information in this transmission is confidential and is intended only for the individual or entity named above. The information contained in this transmission may be protected under federal law or other applicable law. If you are not the intended recipient of this transmission, you are hereby notified that any distribution, dissemination or duplication of this communication is strictly prohibited. If you have received this communication in error please return this transmission to us an notify us immediately by return e-mail THANK YOU.>>> LAguiar@... 03/21/06 02:31PM >>> No, whatever tests the OPO does, regardless of whether donation occurs, are the responsibility of the OPO. You need to send the inpt bill to NEOB so the on-site coordinator can review the charges & identify those he/she ordered as part of the donation process, which they will then pay-everything else is presumed 'medical care' & is the responsibility of the pt's health ins carrier. J. Aguiar Beth Israel Deaconess, Boston From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Brown, Bonnie R.Sent: Tuesday, March 21, 2006 2:29 PMTo: TxFinancialCoordinators Subject: Organ donor question Hello all, Any thoughts on the scenario below would be very helpful. Organ donor brain dead patient is kept alive on life support in order to evaluate organs to be procured for transplant. Results of testing rule out patient as potential organ donor/organs not viable. If our OPO took the organs, we would bill them for services rendered from the point the patient was deemed brain dead. Since the tests rule the patient out, are these services reimbursed via the Medicare Cost Report? Thanks, Bonnie Bonnie R Brown Patient Financial Services Liaison Lahey Clinic Telephone: Fax: 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 22, 2006 Report Share Posted March 22, 2006 Hi All, Medicare Cost Reporting instructions and CMS intent is that the transplant center log ALL pre-transplant evaluation hospital ancillary services for all potential recipients and potential live donors regardless of organ type for proper inclusion in the Cost Report regardless of Medicare involvement or regardless of whether or not the payer for the patient is billed. If you do not include those charges on the Cost Report, your are NOT in compliance with the Medicare Cost Reporting instructions. If you bill the payer for the evaluation you may not bill the potential recipient for deductibles and coinsurance for ESRD patients and Pancreas patients and Medicare Only other non renal patients. In all cases, if Medicare ultimately pays for the transplant, any money collected for pre-transplant evaluation services MUST be offset on line 58 of the Medicare Cost Report or Medicare will consider the transplant center as having been paid twice for the evaluation services. We recommend that you NOT bill any ESRD potential recipient or potential pancreas recipient for evaluation services and that you write them all off and log them for inclusion in the KACC on the Cost Report because of the potential of double payment. If the transplant center decides to bill third party payers during the COB period, at the time of the cost report, every time Medicare is the Primary Payer, you MUST review to see who paid for the evaluation and when non Medicare primary payers paid for the evaluations, you MUST offset the amount collected by the transplant center for each patient, on the Medicare Cost Report. Hope this helps, Thanks, Bill From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Kennedy Sent: Tuesday, March 21, 2006 4:19 PM To: TxFinancialCoordinators Subject: RE: Organ donor question I have a question. Any pre-kidney transplant patient that comes in for an kidney evaluation and does not have MEDICARE at that time, but qualifies for MEDICARE. Do you bill there evaluation to KIDNEY ACQUISITION? I was only billing patients that had MEDICARE at the time of there evaluation. Kennedy Senior Financial Coordinator/ Assistant to Transplant Administrator Transplant & Surgery Department Phone: (202)444-7267 Fax: (202)444-7304 (202)444-2969 CONFIDENTIAL: The information in this transmission is confidential and is intended only for the individual or entity named above. The information contained in this transmission may be protected under federal law or other applicable law. If you are not the intended recipient of this transmission, you are hereby notified that any distribution, dissemination or duplication of this communication is strictly prohibited. If you have received this communication in error please return this transmission to us an notify us immediately by return e-mail THANK YOU. >>> LAguiar@... 03/21/06 02:31PM >>> No, whatever tests the OPO does, regardless of whether donation occurs, are the responsibility of the OPO. You need to send the inpt bill to NEOB so the on-site coordinator can review the charges & identify those he/she ordered as part of the donation process, which they will then pay-everything else is presumed 'medical care' & is the responsibility of the pt's health ins carrier. J. Aguiar Beth Israel Deaconess, Boston From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Brown, Bonnie R. Sent: Tuesday, March 21, 2006 2:29 PM To: TxFinancialCoordinators Subject: Organ donor question Hello all, Any thoughts on the scenario below would be very helpful. Organ donor brain dead patient is kept alive on life support in order to evaluate organs to be procured for transplant. Results of testing rule out patient as potential organ donor/organs not viable. If our OPO took the organs, we would bill them for services rendered from the point the patient was deemed brain dead. Since the tests rule the patient out, are these services reimbursed via the Medicare Cost Report? Thanks, Bonnie Bonnie R Brown Patient Financial Services Liaison Lahey Clinic Telephone: (781) 744-5822 Fax: 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 22, 2006 Report Share Posted March 22, 2006 We treat all of our pre-renal transplant patients as if they have Medicare. Bev>>> CHEEKR@... 03/21/06 4:19 PM >>> I have a question. Any pre-kidney transplant patient that comes in for an kidney evaluation and does not have MEDICARE at that time, but qualifies for MEDICARE. Do you bill there evaluation to KIDNEY ACQUISITION? I was only billing patients that had MEDICARE at the time of there evaluation. KennedySenior Financial Coordinator/Assistant to Transplant Administrator Transplant & Surgery DepartmentPhone: (202)444-7267Fax: (202)444-7304 (202)444-2969 CONFIDENTIAL: The information in this transmission is confidential and is intended only for the individual or entity named above. The information contained in this transmission may be protected under federal law or other applicable law. If you are not the intended recipient of this transmission, you are hereby notified that any distribution, dissemination or duplication of this communication is strictly prohibited. If you have received this communication in error please return this transmission to us an notify us immediately by return e-mail THANK YOU.>>> LAguiar@... 03/21/06 02:31PM >>> No, whatever tests the OPO does, regardless of whether donation occurs, are the responsibility of the OPO. You need to send the inpt bill to NEOB so the on-site coordinator can review the charges & identify those he/she ordered as part of the donation process, which they will then pay-everything else is presumed 'medical care' & is the responsibility of the pt's health ins carrier. J. Aguiar Beth Israel Deaconess, Boston From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Brown, Bonnie R.Sent: Tuesday, March 21, 2006 2:29 PMTo: TxFinancialCoordinators Subject: Organ donor question Hello all, Any thoughts on the scenario below would be very helpful. Organ donor brain dead patient is kept alive on life support in order to evaluate organs to be procured for transplant. Results of testing rule out patient as potential organ donor/organs not viable. If our OPO took the organs, we would bill them for services rendered from the point the patient was deemed brain dead. Since the tests rule the patient out, are these services reimbursed via the Medicare Cost Report? Thanks, Bonnie Bonnie R Brown Patient Financial Services Liaison Lahey Clinic Telephone: Fax: 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 22, 2006 Report Share Posted March 22, 2006 Just more info.... From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of VaughanSent: Wednesday, March 22, 2006 7:24 AMTo: TxFinancialCoordinators Subject: RE: Organ donor question Hi All, Medicare Cost Reporting instructions and CMS intent is that the transplant center log ALL pre-transplant evaluation hospital ancillary services for all potential recipients and potential live donors regardless of organ type for proper inclusion in the Cost Report regardless of Medicare involvement or regardless of whether or not the payer for the patient is billed. If you do not include those charges on the Cost Report, your are NOT in compliance with the Medicare Cost Reporting instructions. If you bill the payer for the evaluation you may not bill the potential recipient for deductibles and coinsurance for ESRD patients and Pancreas patients and Medicare Only other non renal patients. In all cases, if Medicare ultimately pays for the transplant, any money collected for pre-transplant evaluation services MUST be offset on line 58 of the Medicare Cost Report or Medicare will consider the transplant center as having been paid twice for the evaluation services. We recommend that you NOT bill any ESRD potential recipient or potential pancreas recipient for evaluation services and that you write them all off and log them for inclusion in the KACC on the Cost Report because of the potential of double payment. If the transplant center decides to bill third party payers during the COB period, at the time of the cost report, every time Medicare is the Primary Payer, you MUST review to see who paid for the evaluation and when non Medicare primary payers paid for the evaluations, you MUST offset the amount collected by the transplant center for each patient, on the Medicare Cost Report. Hope this helps, Thanks, Bill From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of KennedySent: Tuesday, March 21, 2006 4:19 PMTo: TxFinancialCoordinators Subject: RE: Organ donor question I have a question. Any pre-kidney transplant patient that comes in for an kidney evaluation and does not have MEDICARE at that time, but qualifies for MEDICARE. Do you bill there evaluation to KIDNEY ACQUISITION? I was only billing patients that had MEDICARE at the time of there evaluation. KennedySenior Financial Coordinator/Assistant to Transplant Administrator Transplant & Surgery DepartmentPhone: (202)444-7267Fax: (202)444-7304 (202)444-2969 CONFIDENTIAL: The information in this transmission is confidential and is intended only for the individual or entity named above. The information contained in this transmission may be protected under federal law or other applicable law. If you are not the intended recipient of this transmission, you are hereby notified that any distribution, dissemination or duplication of this communication is strictly prohibited. If you have received this communication in error please return this transmission to us an notify us immediately by return e-mail THANK YOU.>>> LAguiar@... 03/21/06 02:31PM >>> No, whatever tests the OPO does, regardless of whether donation occurs, are the responsibility of the OPO. You need to send the inpt bill to NEOB so the on-site coordinator can review the charges & identify those he/she ordered as part of the donation process, which they will then pay-everything else is presumed 'medical care' & is the responsibility of the pt's health ins carrier. J. Aguiar Beth Israel Deaconess, Boston From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Brown, Bonnie R.Sent: Tuesday, March 21, 2006 2:29 PMTo: TxFinancialCoordinators Subject: Organ donor question Hello all, Any thoughts on the scenario below would be very helpful. Organ donor brain dead patient is kept alive on life support in order to evaluate organs to be procured for transplant. Results of testing rule out patient as potential organ donor/organs not viable. If our OPO took the organs, we would bill them for services rendered from the point the patient was deemed brain dead. Since the tests rule the patient out, are these services reimbursed via the Medicare Cost Report? Thanks, Bonnie Bonnie R Brown Patient Financial Services Liaison Lahey Clinic Telephone: Fax: 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. Quote Link to comment Share on other sites More sharing options...
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