Guest guest Posted January 12, 2001 Report Share Posted January 12, 2001 Hi everyone! I have a situation where the patient started dialysis when she was 14 years old, received a kidney transplant at age 28 in 1992. She did not resume dialysis until 11/2000. She claims that Social Security told her that since she started dialysis under the age of 18, she would have Medicare benefits indefinitely. The Medicare common working file still shows her eligible. Can anyone confirm this? Thanks so much in advance! L. Dodson Transplant Credit Analyst phone:(412)647-6307 fax:(412)647-6049 email:dodsonml@... ---------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 12, 2001 Report Share Posted January 12, 2001 , I would think that unless she was Medicare eligible due to another disability, she would have lost the Medicare covge 3 years after her transplant. Does she have other insurance coverage? I would think she would need to got thru the 30 month COB again, since it's been over 3 yrs since her tx. BUT, if she has no other coverage, then it's a different story.... her Medicare will remain primary.... each situation brings another set of questions.....! a -- In TxFinancialCoordinatorsegroups, " Dodson, " <DodsonML@M...> wrote: > Hi everyone! > > I have a situation where the patient started dialysis when she was 14 years > old, received a kidney transplant at age 28 in 1992. She did not resume > dialysis until 11/2000. She claims that Social Security told her that since > she started dialysis under the age of 18, she would have Medicare benefits > indefinitely. The Medicare common working file still shows her eligible. > Can anyone confirm this? > > Thanks so much in advance! > L. Dodson > Transplant Credit Analyst > phone:(412)647-6307 > fax:(412)647-6049 > email:dodsonml@m... > > > > ---------- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2002 Report Share Posted June 5, 2002 All donor charges should be put on you Medicare Cost Report except for anesthesia and the surgeon's fee for removal. These charges should be billed to the recipients' insurance. >>> haroldw@... 06/05/02 10:14AM >>> Good Morning, My name is Iris Vines I am Financial Counselor for Transplant Services of the Washington Hospital Center. I received your email from the TPA website. I'm inquiring information regarding transplant reciepients and donors. Here recently I've noticed that some insurance companies are requesting letters of denials from donors own healthcare coverage to be submitted along with the recipients claims for payment. I'm checking to see if this has been your experience as well. As far as I know before we just submitt the donors charges attached to the reciepients without denials from donor denied coverage from their own health coverage. What information could you share with me inregards to billing practices for reciepients and donor charges. Thank you for your time and attention regarding the above questinons. Iris Vines Financial Counselor Transplant Services Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2002 Report Share Posted June 5, 2002 Hi Iris, I explain to the donor that the recipient's plan will not cover donor unless it's been denied by donor's private ins. I need to contact their personal EGHP to get denial in writing and have pt sign a consent / release form. I try get in writing that pt's donation is not " deemed medically necessary " and/or " considered elective " by their private carrier and therefore the procedure is not authorized. With all of this, I assure the donor that there is still no out-of-pocket to them. Once the letter is obtained, I fax the letter to the recipient's ins carrier and get an actual preauth for the donation. Remember, the recipient may also be MCR eligible if not already and therefore will also cover all donor's cost. Good luck ! Sioson Renal TFC NY Presbyterian Harold Ward wrote: > Good Morning, > > My name is Iris Vines I am Financial Counselor for Transplant Services of > the Washington Hospital Center. > I received your email from the TPA website. I'm inquiring information > regarding transplant reciepients and > donors. Here recently I've noticed that some insurance companies are > requesting letters of denials from > donors own healthcare coverage to be submitted along with the recipients > claims for payment. I'm checking to > see if this has been your experience as well. As far as I know before we > just submitt the donors charges > attached to the reciepients without denials from donor denied coverage from > their own health coverage. What information could you share with me > inregards to billing practices for reciepients and donor charges. Thank > you for your time and attention regarding the above questinons. > > Iris Vines > Financial Counselor > Transplant Services > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2002 Report Share Posted June 5, 2002 These charges are to go on the Medicare Cost Report except for the Anesthesia and Surgeon fee which is billed to the recipient's insurance. >>> Cap7002@... 06/05/02 10:39AM >>> Hi Iris, I explain to the donor that the recipient's plan will not cover donor unless it's been denied by donor's private ins. I need to contact their personal EGHP to get denial in writing and have pt sign a consent / release form. I try get in writing that pt's donation is not " deemed medically necessary " and/or " considered elective " by their private carrier and therefore the procedure is not authorized. With all of this, I assure the donor that there is still no out-of-pocket to them. Once the letter is obtained, I fax the letter to the recipient's ins carrier and get an actual preauth for the donation. Remember, the recipient may also be MCR eligible if not already and therefore will also cover all donor's cost. Good luck ! Sioson Renal TFC NY Presbyterian Harold Ward wrote: > Good Morning, > > My name is Iris Vines I am Financial Counselor for Transplant Services of > the Washington Hospital Center. > I received your email from the TPA website. I'm inquiring information > regarding transplant reciepients and > donors. Here recently I've noticed that some insurance companies are > requesting letters of denials from > donors own healthcare coverage to be submitted along with the recipients > claims for payment. I'm checking to > see if this has been your experience as well. As far as I know before we > just submitt the donors charges > attached to the reciepients without denials from donor denied coverage from > their own health coverage. What information could you share with me > inregards to billing practices for reciepients and donor charges. Thank > you for your time and attention regarding the above questinons. > > Iris Vines > Financial Counselor > Transplant Services > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2005 Report Share Posted September 24, 2005 If you could have one thing that being overweight prevents you from having what would it be. self esteem- no fear of the unknown- the belief in myself that i could do anything. Suna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2005 Report Share Posted September 24, 2005 I would like to be able to go anywhere I wanted to go(theaters, restaurants, public transportation, etc.)without worrying about if I will be able to fit in theseat and if my family is embarrassed by me.Mona I so feel this same way. But the difference is its Me who feels this way. not my family. Even though they are all smaller sized people they couldn't care less what I look like. They have always been the ones to drag me out places even though I hate to go out in public. Cause its always been me who worries that people are staring or laughing behind my back. or worse even the ones who don't bother to try and hide the fact that they are disgusted by my size. I have been doing low carb since April and have lost 40 pounds. But its just the tip of the iceberg. I have at least another 150 go. but this time I feel like I am going to get there. I am taking back control over my own life. I came to this group because I loved that Steve had taken control over his own life. This is his way of dealing. I love reading the journal entries so I joined here to hear more supporting stories about his journey and others. I was disappointed to read all the bickering. It was the last thing I expected to read. I almost left the group the day after I joined. But I stayed hoping it would all stop. its disheartening to hear people talk like that to each other. It was the last thing I needed. since I struggle with compulsive eating. SO I started to delete the posts I knew where it was coming from. I hope its over now. I would really like to stay. I wish everyone well Peace be the Journey for Steve and April. Suna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2005 Report Share Posted September 24, 2005 How old was this guy? 12? It's bad enough when children say such things. I can't believe adults can be so juvenile!!! What a jerk! Well at least you and I only need to lose weight. He needs a personality makeover!! Don't let him discourage you from being friendly. You are the better person. Mona --- wvskywatcher wrote: > The peace of mind of not being the brunt of fat > comments. At work > yesterday in the hospital cafeteria, a male > co-worker was in line with > me. I smiled at him and said, " Nice to see you " . > He said, " Good to > see you too, like I could have missed you " . I then > looked at him and > said, " Don't be an ass " . and he then looked at my > behind and > said, " I'd talk about ass if I were you " . All this > came about just > because I was being friendly. Maybe I handled it > wrong, oh well. I > am just tired of the comments and the stares. I am > not a freak just > because I am large. > > > > If you could have one thing that being overweight > prevents you from > > having what would it be. > > > > __________________________________ Yahoo! Mail - PC Magazine Editors' Choice 2005 http://mail.yahoo.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 24, 2005 Report Share Posted September 24, 2005 what a nightmare! I just can't believe some people would go so far as to do such a horrible thing! I am sorry that happened to you! i do not know what i would have done in that situation. How dare she do that to you and her child. what an ignorant woman. Suna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 27, 2005 Report Share Posted September 27, 2005 ---Wow, what a really good question! I cannot think of anything off the top of my head. Have to really consider this/ In thefatmanwalking_group , " stevelillervaught " <vaught_1@m...> wrote: > If you could have one thing that being overweight prevents you from > having what would it be. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 27, 2005 Report Share Posted September 27, 2005 I would have turned around and smiled at the little girl, the told her gently I owuld NEVER hurt little children. But I am kind of confrontational that way. I have a friend who is very large due to serious health issues she has had her whole life. She tells me some really terrible stories about others who comment on her. The children do not bother her but adults really set her off. She really fixed some young men in a restaurant one time but I cannot tell the whole story, it is not mine to tell. Suffice it to say I doubt strongly they will ever publicly mock a large person again! Rofl-- In thefatmanwalking_group , " wvskywatcher " <wvskywatcher@h...> wrote: > I appreciate all the kind words regarding the fella who was making > rude comments to me. Why did he do it? HIS low self-esteem. YOu > see, he is 55ish, losing his hair, some of his teeth. Probably used > to be a sex pot !!! And prejudice against large people is learned > from unkind words and comments made around us as children. I think > it is a learned behaviour, just as prejudice against African- > Americans, Jewish, Indians, the list could go on and on. Several > years ago, I was in a mall in a large city with a friend. We were > in a store doing our thing and suddenly I heard a shrill womans > voice shreeking to her child to get out of the way, the fat lady > will sit on you and kill you. I discreetly turned and saw the woman > was looking at me. She then followed me around the store telling > her child I was evil because I was fat, that I would hurt her if I > sat on her. The woman was thin, dirty, stringy hair and with her > was a beautiful little girl looking at me with fear in her eyes. I > tried to get the manager to call security or something, but they > wouldn't. My friend and I left the store quickly and practically > ran to our car, she followed us to the door of the mall, continuing > the onslot. She was teaching her child prejudice. The incident > bothered me for awhile but I'm okay with it now, I just hope the > little girl grew up to not hate large people.... > > > > > > If you could have one thing that being overweight prevents you > > from > > > > having what would it be. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 27, 2005 Report Share Posted September 27, 2005 ok I thought about it....I want to climb trees again! lololol -- In thefatmanwalking_group , CraftyGardenerTN@a... wrote: > One thing is REALLY, REALLY, REALLY hard to choose. But I would have to say > it would be able to run and play and do activities with my husband and > daughter. > > Hugs, Quote Link to comment Share on other sites More sharing options...
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