RE: POST TRANSPLANT DONOR COMPLICATIONS

[Guest guest]

HI,

Please, someone explain to me how an appendectomy (which I thought was

normally only done in the case of an emergency) is a complication of or

related to a Live Kidney Donation. I don't have a problem with the

incisional hernia repair, but I do not understand the appendectomy.

Thanks,

Bill

P.S. Yes, if there is a complication due to live donor kidney donation, the

transplant center where the donation occurred is responsible for all

facility services.

POST TRANSPLANT DONOR COMPLICATIONS

A kidney transplant donor (5 years out) recently had surgery repairing

incisional hernia and incidental appendectomy related to the transplant from

5 years back.

From what I know............. we (the facility) are on the hook for his

facility charges related to his surgery.

And.........the recipients primary insurance at the time of the Transplant

(Medicare) should be billed for the Professional Fees related to the donor's

complications.

However...........who should pick up what Medicare does not cover?

The recipient had Medicaid (2nd to Medicare) at the time of Transplant.

However, he does not have Medicaid now.

Thanks,

Todd Seiger

[Guest guest]

I think we have had cases where, while the doctor is in there, he does

something not really transplant-related-cholecystectomy, etc, I can't

remember others now. But we have made them get a separate auth for

these other services. And we do not pay any part of them.

Fred L. Forsthoffer, MBA

Financial Analyst

Banner Samaritan Transplant Services

, , F-

POST TRANSPLANT DONOR COMPLICATIONS

A kidney transplant donor (5 years out) recently had surgery repairing

incisional hernia and incidental appendectomy related to the transplant

from

5 years back.

From what I know............. we (the facility) are on the hook for his

facility charges related to his surgery.

And.........the recipients primary insurance at the time of the

Transplant

(Medicare) should be billed for the Professional Fees related to the

donor's

complications.

However...........who should pick up what Medicare does not cover?

The recipient had Medicaid (2nd to Medicare) at the time of Transplant.

However, he does not have Medicaid now.

Thanks,

Todd Seiger

[Guest guest]

Thanks Bill,

The appendectomy was incidental to the incisional hernia repair. Not

related .

As far as the payment to providers...........apparently my question was not

clear.

I know our transplant facility is responsible for all facility services.

MY QUESTION WAS.............. After the recipients Medicare is billed for

the pro. fees related to the donor complications, who should pick up what

Medicare does not cover? Or does Medicare pick it up at 100% allowed?

todd

POST TRANSPLANT DONOR COMPLICATIONS

A kidney transplant donor (5 years out) recently had surgery repairing

incisional hernia and incidental appendectomy related to the transplant from

5 years back.

From what I know............. we (the facility) are on the hook for his

facility charges related to his surgery.

And.........the recipients primary insurance at the time of the Transplant

(Medicare) should be billed for the Professional Fees related to the donor's

complications.

However...........who should pick up what Medicare does not cover?

The recipient had Medicaid (2nd to Medicare) at the time of Transplant.

However, he does not have Medicaid now.

Thanks,

Todd Seiger

[Guest guest]

an added incidental question-

Does Medicare cover donor complications for liver transplants and if so do they

continue coverage for the donor(should any complications occur)if the recipient

expires?

Thank you,

Joan

POST TRANSPLANT DONOR COMPLICATIONS

A kidney transplant donor (5 years out) recently had surgery repairing

incisional hernia and incidental appendectomy related to the transplant from

5 years back.

From what I know............. we (the facility) are on the hook for his

facility charges related to his surgery.

And.........the recipients primary insurance at the time of the Transplant

(Medicare) should be billed for the Professional Fees related to the donor's

complications.

However...........who should pick up what Medicare does not cover?

The recipient had Medicaid (2nd to Medicare) at the time of Transplant.

However, he does not have Medicaid now.

Thanks,

Todd Seiger

[Guest guest]

Additionally, what about aborted liver transplants? Are they handled

like kidneys depending on who is the primary payer?

Fred L. Forsthoffer, MBA

Financial Analyst

Banner Samaritan Transplant Services

, , F-

POST TRANSPLANT DONOR COMPLICATIONS

A kidney transplant donor (5 years out) recently had surgery repairing

incisional hernia and incidental appendectomy related to the transplant

from

5 years back.

From what I know............. we (the facility) are on the hook for his

facility charges related to his surgery.

And.........the recipients primary insurance at the time of the

Transplant

(Medicare) should be billed for the Professional Fees related to the

donor's

complications.

However...........who should pick up what Medicare does not cover?

The recipient had Medicaid (2nd to Medicare) at the time of Transplant.

However, he does not have Medicaid now.

Thanks,

Todd Seiger

[Guest guest]

HI Todd,

Medicare, if Medicare is the payer, pays at 100% of Participating and that

is to be considered as " payment in full " the balance of the professional

fees are to be written off.

A follow up to the appendectomy, none of the fees we are discussing are

related to the appendectomy then?

Hope this helps,

Thanks

Bill

POST TRANSPLANT DONOR COMPLICATIONS

A kidney transplant donor (5 years out) recently had surgery repairing

incisional hernia and incidental appendectomy related to the transplant from

5 years back.

From what I know............. we (the facility) are on the hook for his

facility charges related to his surgery.

And.........the recipients primary insurance at the time of the Transplant

(Medicare) should be billed for the Professional Fees related to the donor's

complications.

However...........who should pick up what Medicare does not cover?

The recipient had Medicaid (2nd to Medicare) at the time of Transplant.

However, he does not have Medicaid now.

Thanks,

Todd Seiger

[Guest guest]

We typically receive a denial initially & then get it paid, clarifying that the charges are for living donor.

POST TRANSPLANT DONOR COMPLICATIONSA kidney transplant donor (5 years out) recently had surgery repairingincisional hernia and incidental appendectomy related to the transplant from5 years back.From what I know............. we (the facility) are on the hook for hisfacility charges related to his surgery.And.........the recipients primary insurance at the time of the Transplant(Medicare) should be billed for the Professional Fees related to the donor'scomplications.However...........who should pick up what Medicare does not cover?The recipient had Medicaid (2nd to Medicare) at the time of Transplant.However, he does not have Medicaid now.Thanks,Todd Seiger

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[Guest guest]

Is it possible the hernia was discovered when they went in to do the

appendectomy? In this case, wouldn't the hernia be the secondary procedure

and not the responsibility of the transplant center ?

Kreci

Transplant Financial Coordinator

Southwest Regional Florida Medical Center

Fort Myers, FL

POST TRANSPLANT DONOR COMPLICATIONS

A kidney transplant donor (5 years out) recently had surgery repairing

incisional hernia and incidental appendectomy related to the transplant from

5 years back.

From what I know............. we (the facility) are on the hook for his

facility charges related to his surgery.

And.........the recipients primary insurance at the time of the Transplant

(Medicare) should be billed for the Professional Fees related to the donor's

complications.

However...........who should pick up what Medicare does not cover?

The recipient had Medicaid (2nd to Medicare) at the time of Transplant.

However, he does not have Medicaid now.

Thanks,

Todd Seiger