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Try:

Hospital Manual

ESRD Appendix-Coverage of Services

Section E218.3

http://www.hcfa.gov/pubforms/10%5Fhospital/hoe200.htm

and Social Security Act Section 1881 8(d) (falls on page 7 of 9 page print

out)

http://www.ssa.gov/OP_Home/ssact/title18/1881.htm

Lori Bond

Financial Counselor in Transplant

Legacy Good Samaritan Hospital and Medical Center

medicare

Can anyone confirm how long is the post-op follow-up for kidney/liver

donors ?

Or if someone can give me a direct website to go to.

Any information will be greatly appreciated !

Thanks-

Sioson

Renal TFC

NY Presby

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HI,Out here in California the donor post-op follow up is 3 months. Can

go longer if complication develop within that time frame. Includes Meds

for post op pain or infection.

Ann Reilly UCSF Pre-Kidney Tx F/C

(415)353-8779

>

>Reply-To: TxFinancialCoordinators

>To: " TxFinancialCoordinators "

><TxFinancialCoordinators >

>Subject: medicare

>Date: Fri, 09 Aug 2002 15:07:44 -0400

>

>Can anyone confirm how long is the post-op follow-up for kidney/liver

>donors ?

>

>Or if someone can give me a direct website to go to.

>

>Any information will be greatly appreciated !

>

>Thanks-

> Sioson

>Renal TFC

>NY Presby

>

_________________________________________________________________

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  • 5 months later...

Hold the bill -- better to bill once Medicare is up on line (usually 6 to 8

weeks from application), then refund commercial insurance later. Entitlement

goes back date ESRD eligibility (dialysis) whether or not the patient signed

up at point of dialysis or point of transplant.

-Lori

Medicare

We have a kidney transplant patient who just received a cadaveric

kidney. She started CAPD 6/00. She has commercial insurance. so she did

not sign up for Medicare until Dec 2002 when Medicare would become

prime. Medicare lost her paperwork, so she has no card or number. Even

though she is not in the system, once she is, Medicare will be prime.

Will the effective date go back to 6/00 when she started CAPDdialysis?

If we bill her commercial they will deny it based on COB dates.Payment

for hospital and MD's. will be delayed until she becomes active with

Medicare.

Any advice?

Thanks again for your help.

Hartford Hospital Transplant Program

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We had a case like this and the Medicare entitlement date was after the

Coordination of Benefits period ended (in this case 12/02). It caused a lot of

confusion with billing, because Medicare had trouble computing that the COB was

over at the date of entitlement. However, in the end, they paid.

Jan McIlvaine

Lankenau Hospital

Phila., PA

Medicare

We have a kidney transplant patient who just received a cadaveric

kidney. She started CAPD 6/00. She has commercial insurance. so she did

not sign up for Medicare until Dec 2002 when Medicare would become

prime. Medicare lost her paperwork, so she has no card or number. Even

though she is not in the system, once she is, Medicare will be prime.

Will the effective date go back to 6/00 when she started CAPDdialysis?

If we bill her commercial they will deny it based on COB dates.Payment

for hospital and MD's. will be delayed until she becomes active with

Medicare.

Any advice?

Thanks again for your help.

Hartford Hospital Transplant Program

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  • 4 weeks later...

Now that her Medicare is primary and no part B, her BC/bS policy will pickup

for any out patient treatment. She'll be liable for any co-pays, deductibles

and out of pockets. So yes she'll incure more out of pocket now that BC/BS

will be like the part B side.Deb Wade

Medicare

> Good morning-

> I have a patient that has BCBS primary and Medicare 2ndary due to esrd.

She

> just completed her 30 m cob period. She did not opt for Part B as her BCBS

> covered everything but a $5 copay. Now that BCBS is 2ndary, can she be

> penalized for not opting for the Part B by her BCBS?

>

> This is for a kidney transplant, so she would not have been eligible for

> Medicare for any other reason.

>

> I would appreciate any input.

>

> Donovan

> Transplant Financial Coordinator

> SUNY Upstate Medical University

> 750 East Street

> Syracuse, New York 13210

> PH:

> FAX:

> Donovanl@...

>

>

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BCBS can they say she is liable for more then her $5 copay due to no Part B?

(as a penalty?)

Donovan

Transplant Financial Coordinator

SUNY Upstate Medical University

750 East Street

Syracuse, New York 13210

PH:

FAX:

Donovanl@...

>>> DWade@... 02/17/03 10:11AM >>>

Now that her Medicare is primary and no part B, her BC/bS policy will

pickup

for any out patient treatment. She'll be liable for any co-pays,

deductibles

and out of pockets. So yes she'll incure more out of pocket now that BC/BS

will be like the part B side.Deb Wade

Medicare

> Good morning-

> I have a patient that has BCBS primary and Medicare 2ndary due to esrd.

She

> just completed her 30 m cob period. She did not opt for Part B as her

BCBS

> covered everything but a $5 copay. Now that BCBS is 2ndary, can she be

> penalized for not opting for the Part B by her BCBS?

>

> This is for a kidney transplant, so she would not have been eligible for

> Medicare for any other reason.

>

> I would appreciate any input.

>

> Donovan

> Transplant Financial Coordinator

> SUNY Upstate Medical University

> 750 East Street

> Syracuse, New York 13210

> PH:

> FAX:

> Donovanl@...

>

>

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Yes, DW

Medicare

>

>

> > Good morning-

> > I have a patient that has BCBS primary and Medicare 2ndary due to esrd.

> She

> > just completed her 30 m cob period. She did not opt for Part B as her

> BCBS

> > covered everything but a $5 copay. Now that BCBS is 2ndary, can she be

> > penalized for not opting for the Part B by her BCBS?

> >

> > This is for a kidney transplant, so she would not have been eligible for

> > Medicare for any other reason.

> >

> > I would appreciate any input.

> >

> > Donovan

> > Transplant Financial Coordinator

> > SUNY Upstate Medical University

> > 750 East Street

> > Syracuse, New York 13210

> > PH:

> > FAX:

> > Donovanl@...

> >

> >

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Verify with the plan. Some plans have a clause of no coverage if eligible for

government or other insurance & it was declined. She may be able to sign up for

part B now without a penalty due to other coverage or as it is now time for

open enrollment....

Re: Medicare

BCBS can they say she is liable for more then her $5 copay due to no Part B?

(as a penalty?)

Donovan

Transplant Financial Coordinator

SUNY Upstate Medical University

750 East Street

Syracuse, New York 13210

PH:

FAX:

Donovanl@...

>>> DWade@... 02/17/03 10:11AM >>>

Now that her Medicare is primary and no part B, her BC/bS policy will

pickup

for any out patient treatment. She'll be liable for any co-pays,

deductibles

and out of pockets. So yes she'll incure more out of pocket now that BC/BS

will be like the part B side.Deb Wade

Medicare

> Good morning-

> I have a patient that has BCBS primary and Medicare 2ndary due to esrd.

She

> just completed her 30 m cob period. She did not opt for Part B as her

BCBS

> covered everything but a $5 copay. Now that BCBS is 2ndary, can she be

> penalized for not opting for the Part B by her BCBS?

>

> This is for a kidney transplant, so she would not have been eligible for

> Medicare for any other reason.

>

> I would appreciate any input.

>

> Donovan

> Transplant Financial Coordinator

> SUNY Upstate Medical University

> 750 East Street

> Syracuse, New York 13210

> PH:

> FAX:

> Donovanl@...

>

>

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but why would she have to do that and pay $60 more per month for coverage

that she would have not needed, due to adequate BCBS coverage? She would be

paying double for the same coverage? Does not make sense....

Donovan

Transplant Financial Coordinator

SUNY Upstate Medical University

750 East Street

Syracuse, New York 13210

PH:

FAX:

Donovanl@...

>>> Joan.Kersten@... 02/17/03 02:01PM >>>

Verify with the plan. Some plans have a clause of no coverage if eligible

for government or other insurance & it was declined. She may be able to

sign up for part B now without a penalty due to other coverage or as it is

now time for open enrollment....

Re: Medicare

BCBS can they say she is liable for more then her $5 copay due to no Part

B?

(as a penalty?)

Donovan

Transplant Financial Coordinator

SUNY Upstate Medical University

750 East Street

Syracuse, New York 13210

PH:

FAX:

Donovanl@...

>>> DWade@... 02/17/03 10:11AM >>>

Now that her Medicare is primary and no part B, her BC/bS policy will

pickup

for any out patient treatment. She'll be liable for any co-pays,

deductibles

and out of pockets. So yes she'll incure more out of pocket now that BC/BS

will be like the part B side.Deb Wade

Medicare

> Good morning-

> I have a patient that has BCBS primary and Medicare 2ndary due to esrd.

She

> just completed her 30 m cob period. She did not opt for Part B as her

BCBS

> covered everything but a $5 copay. Now that BCBS is 2ndary, can she be

> penalized for not opting for the Part B by her BCBS?

>

> This is for a kidney transplant, so she would not have been eligible for

> Medicare for any other reason.

>

> I would appreciate any input.

>

> Donovan

> Transplant Financial Coordinator

> SUNY Upstate Medical University

> 750 East Street

> Syracuse, New York 13210

> PH:

> FAX:

> Donovanl@...

>

>

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When I meet with patients for financial counseling I explain this to them and explain their options. I have been told by patients that dialysis centers tell them to take Part A because it is " free " . I tell patients that if they are not going to enroll in Part B then do not enroll in Part A because this can hurt them for several reasons. We have a patient who transferred from another transplant center due to an insurance change and he only had Part A. We had to place him on hold until Medicare Part B becomes active in July! He had completed his 30 month COB period. He only took Part A because he had an HMO. He did this to save a few bucks but it hurt him in the long run. We have had a few patients who contacted SS and were able to get the Part B reinstated, since they had applied for it then did not continue to pay the premium, by back paying the premium. Perhaps you could look into this. Good Luck.

Porter

University Hospitals of Cleveland

Re: Medicare

BCBS can they say she is liable for more then her $5 copay due to no Part B?

(as a penalty?)

Donovan

Transplant Financial Coordinator

SUNY Upstate Medical University

750 East Street

Syracuse, New York 13210

PH:

FAX:

Donovanl@...

>>> DWade@... 02/17/03 10:11AM >>>

Now that her Medicare is primary and no part B, her BC/bS policy will pickup

for any out patient treatment. She'll be liable for any co-pays, deductibles

and out of pockets. So yes she'll incure more out of pocket now that BC/BS

will be like the part B side.Deb Wade

Medicare

> Good morning-

> I have a patient that has BCBS primary and Medicare 2ndary due to

> esrd.

She

> just completed her 30 m cob period. She did not opt for Part B as her

BCBS

> covered everything but a $5 copay. Now that BCBS is 2ndary, can she be

> penalized for not opting for the Part B by her BCBS?

>

> This is for a kidney transplant, so she would not have been eligible

> for Medicare for any other reason.

>

> I would appreciate any input.

>

> Donovan

> Transplant Financial Coordinator

> SUNY Upstate Medical University

> 750 East Street

> Syracuse, New York 13210

> PH:

> FAX:

> Donovanl@...

>

>

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We counsel all of our kidney patients to decide

if and when they want to enroll in ESRD Medicare as it relates to their current

insurance situation, i.e. plan ahead.

And if they decide to enroll, to get both Parts. We always counsel

against getting just Part A and declining Part B. We want them to see it

as an “all or nothing” situation. For the reasons you

mention.

Re:

Medicare

BCBS can they say she is liable for more then her $5

copay due to no Part B?

(as a penalty?)

Donovan

Transplant Financial Coordinator

SUNY Upstate Medical University

750 East Street

Syracuse, New York 13210

PH:

FAX:

Donovanl@...

>>> DWade@... 02/17/03 10:11AM

>>>

Now that her Medicare is primary

and no part B, her BC/bS policy will pickup

for any out patient treatment.

She'll be liable for any co-pays, deductibles

and out of pockets. So yes she'll

incure more out of pocket now that BC/BS

will be like the part B side.Deb

Wade

Medicare

> Good morning-

> I have a patient that has BCBS

primary and Medicare 2ndary due to

> esrd.

She

> just completed her 30 m cob

period. She did not opt for Part B as her

BCBS

> covered everything but a $5 copay.

Now that BCBS is 2ndary, can she be

> penalized for not opting for

the Part B by her BCBS?

>

> This is for a kidney

transplant, so she would not have been eligible

> for Medicare for any other

reason.

>

> I would appreciate any input.

>

> Donovan

> Transplant Financial

Coordinator

> SUNY Upstate Medical

University

> 750 East Street

> Syracuse, New York 13210

> PH:

> FAX:

> Donovanl@...

>

>

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