RE: RE: Rx coverage

[Guest guest]

-

I now send follow-up letters to some patients after their transplant evaluation

advising them about their coverage and financial responsibility. I also advise

them to confirm these benefits with their insurance company. Sometimes I give

them an estimate of their out-of-pocket expenses for medications (the ones added

after txp). This is time consuming, but I am hoping it will help to avoid the

problem you are facing. It is very difficult when patients expect to be " taken

care of " and don't assume responsibility for their own finances.

Good luck!

Jan McIlvaine

Lankenau Hospital

Phila., PA

RE: Rx coverage

Good morning

We have had recent problems with patients following transplant not being able to

afford there copays for prescriptions. We had one case where pt has her rx thru

a major medical and informed us prior to discharge they could not afford the

cost and then turn into major medical.

Any suggestions would be appreciated, pt signs a form on transplant eval date

that they understand coverage and cost. Could this situation be elimanated???

Pt's have coverage but can not afford the initial payment or the monthly copays

for meds. How do other centers view this???????????

M1@...

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[Guest guest]

Can you give information on that kidney foundation one time grant-phone #,etc?

Thanks,

Joan

RE: Rx coverage

We have this occur at times in our program, actually twice over the last

month. We even had a patient refuse to leave the hospital until this

issue was resolved for him! Even though I explain about the cost of

copays it doesn't hit home until they go to the pharmacy. I encourage

patients to use the 3 month mail order option after a month or two, to

save on copays. This way they get 3 months worth of medicine for 2

months of copays, saving four months of copays over the course of the

year.

For kidney patients I ask them to apply to the national kidney

foundation for the one time grant to get them over the initial hump (and

shock) of copays.

I also believe that not only the financial coordinator but the

coordinators as well ,need to reinforce the expense of medications. I am

trying to get this done in our program, as patients tend to have

selective hearing about this issue.

Hope this helps.

>>> M1@... 12/11/02 11:18AM >>>

Good morning

We have had recent problems with patients following transplant not

being able to afford there copays for prescriptions. We had one case

where pt has her rx thru a major medical and informed us prior to

discharge they could not afford the cost and then turn into major

medical.

Any suggestions would be appreciated, pt signs a form on transplant

eval date

that they understand coverage and cost. Could this situation be

eliminated???

Pt's have coverage but can not afford the initial payment or the

monthly copays for meds. How do other centers view this???????????

M1@...

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

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intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the West Penn Allegheny Health System at and contact the

Information Security Department at telephone ext.1746.

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[Guest guest]

I would appreciate if you could send to me also, I spoke to our social worker

about this and she thought it took some time before it was processed and they

did not always have funds available. We have not tried this method and would

like to use this in future if needed.

Thanks for your response, it is very difficult to have patients keep us aware of

changes in ins coverage and now this rx cost piece is becoming more of a problem

as copay rise and coverage is reduced.

Any and all suggestions are appreciated

>>> Joan.Kersten@... 12/12/02 09:53AM >>>

Can you give information on that kidney foundation one time grant-phone #,etc?

Thanks,

Joan

RE: Rx coverage

We have this occur at times in our program, actually twice over the last

month. We even had a patient refuse to leave the hospital until this

issue was resolved for him! Even though I explain about the cost of

copays it doesn't hit home until they go to the pharmacy. I encourage

patients to use the 3 month mail order option after a month or two, to

save on copays. This way they get 3 months worth of medicine for 2

months of copays, saving four months of copays over the course of the

year.

For kidney patients I ask them to apply to the national kidney

foundation for the one time grant to get them over the initial hump (and

shock) of copays.

I also believe that not only the financial coordinator but the

coordinators as well ,need to reinforce the expense of medications. I am

trying to get this done in our program, as patients tend to have

selective hearing about this issue.

Hope this helps.

>>> M1@... 12/11/02 11:18AM >>>

Good morning

We have had recent problems with patients following transplant not

being able to afford there copays for prescriptions. We had one case

where pt has her rx thru a major medical and informed us prior to

discharge they could not afford the cost and then turn into major

medical.

Any suggestions would be appreciated, pt signs a form on transplant

eval date

that they understand coverage and cost. Could this situation be

eliminated???

Pt's have coverage but can not afford the initial payment or the

monthly copays for meds. How do other centers view this???????????

M1@...

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

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the West Penn Allegheny Health System at and contact the

Information Security Department at telephone ext.1746.

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

www.mimesweeper.com

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[Guest guest]

I believe the one time grant is administered through the National Kidney

Foundation. The application must be filed by a social worker. I believe

each state has there own chapter of the NKF. You can get state specific

information on the internet.

I will get more information when I speak with our social worker.

Hope this helps.

>>> M1@... 12/12/02 10:56AM >>>

I would appreciate if you could send to me also, I spoke to our social

worker about this and she thought it took some time before it was

processed and they did not always have funds available. We have not

tried this method and would like to use this in future if needed.

Thanks for your response, it is very difficult to have patients keep us

aware of changes in ins coverage and now this rx cost piece is becoming

more of a problem as copay rise and coverage is reduced.

Any and all suggestions are appreciated

>>> Joan.Kersten@... 12/12/02 09:53AM >>>

Can you give information on that kidney foundation one time grant-phone

#,etc?

Thanks,

Joan

RE: Rx coverage

We have this occur at times in our program, actually twice over the

last

month. We even had a patient refuse to leave the hospital until this

issue was resolved for him! Even though I explain about the cost of

copays it doesn't hit home until they go to the pharmacy. I encourage

patients to use the 3 month mail order option after a month or two, to

save on copays. This way they get 3 months worth of medicine for 2

months of copays, saving four months of copays over the course of the

year.

For kidney patients I ask them to apply to the national kidney

foundation for the one time grant to get them over the initial hump

(and

shock) of copays.

I also believe that not only the financial coordinator but the

coordinators as well ,need to reinforce the expense of medications. I

am

trying to get this done in our program, as patients tend to have

selective hearing about this issue.

Hope this helps.

>>> M1@... 12/11/02 11:18AM >>>

Good morning

We have had recent problems with patients following transplant not

being able to afford there copays for prescriptions. We had one case

where pt has her rx thru a major medical and informed us prior to

discharge they could not afford the cost and then turn into major

medical.

Any suggestions would be appreciated, pt signs a form on transplant

eval date

that they understand coverage and cost. Could this situation be

eliminated???

Pt's have coverage but can not afford the initial payment or the

monthly copays for meds. How do other centers view this???????????

M1@...

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

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the West Penn Allegheny Health System at and contact

the

Information Security Department at telephone ext.1746.

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

www.mimesweeper.com

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

[Guest guest]

Jan

I am reluctant to send anything in writing to patients as

coverage/contract language changes so frequently and it is impossible

to determine what new treatment/ medicine may be utilized when the

patient finally comes to transplant.

I do think giving them a list of medications they are likely to need

and having them call their pharmacy to find out their responsibility for

copays etc might bring home the estimated expense of the medications. I

may have our patients start doing this.

I believe patients need to do their own research to become informed

consumers.Transplant is an elective procedure for kidney patients. They

have a choice as to modalities for treatment. I tell them that nothing

is written in stone when it comes to medicines, but this is our protocol

at this time. I have found that patients agree to anything prior to the

transplant but many expect the program to take care of problems after

transplant.

>>> McIlvaineJ@... 12/12/02 08:41AM >>>

-

I now send follow-up letters to some patients after their transplant

evaluation advising them about their coverage and financial

responsibility. I also advise them to confirm these benefits with their

insurance company. Sometimes I give them an estimate of their

out-of-pocket expenses for medications (the ones added after txp). This

is time consuming, but I am hoping it will help to avoid the problem you

are facing. It is very difficult when patients expect to be " taken care

of " and don't assume responsibility for their own finances.

Good luck!

Jan McIlvaine

Lankenau Hospital

Phila., PA

RE: Rx coverage

Good morning

We have had recent problems with patients following transplant not

being able to afford there copays for prescriptions. We had one case

where pt has her rx thru a major medical and informed us prior to

discharge they could not afford the cost and then turn into major

medical.

Any suggestions would be appreciated, pt signs a form on transplant

eval date

that they understand coverage and cost. Could this situation be

elimanated???

Pt's have coverage but can not afford the initial payment or the

monthly copays for meds. How do other centers view this???????????

M1@...

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

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the West Penn Allegheny Health System at and contact the

Information Security Department at telephone ext.1746.

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

www.mimesweeper.com

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

[Guest guest]

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

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the West Penn Allegheny Health System at and contact the

Information Security Department at telephone ext.1746.

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

www.mimesweeper.com

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

[Guest guest]

Jan

I have already spoken to our clinical coordinators and social worker on you

idea. We like it--------------------------this sounds like a good solution.

I also agree am reluctant to put info obtained from ins co verbally in writing

to pts on benefits and coverage. This is up to them to obtain from ins co.

Thanks again

Mmartin1@...

>>> jbucche@... 12/13/02 09:45AM >>>

Jan

I am reluctant to send anything in writing to patients as

coverage/contract language changes so frequently and it is impossible

to determine what new treatment/ medicine may be utilized when the

patient finally comes to transplant.

I do think giving them a list of medications they are likely to need

and having them call their pharmacy to find out their responsibility for

copays etc might bring home the estimated expense of the medications. I

may have our patients start doing this.

I believe patients need to do their own research to become informed

consumers.Transplant is an elective procedure for kidney patients. They

have a choice as to modalities for treatment. I tell them that nothing

is written in stone when it comes to medicines, but this is our protocol

at this time. I have found that patients agree to anything prior to the

transplant but many expect the program to take care of problems after

transplant.

>>> McIlvaineJ@... 12/12/02 08:41AM >>>

-

I now send follow-up letters to some patients after their transplant

evaluation advising them about their coverage and financial

responsibility. I also advise them to confirm these benefits with their

insurance company. Sometimes I give them an estimate of their

out-of-pocket expenses for medications (the ones added after txp). This

is time consuming, but I am hoping it will help to avoid the problem you

are facing. It is very difficult when patients expect to be " taken care

of " and don't assume responsibility for their own finances.

Good luck!

Jan McIlvaine

Lankenau Hospital

Phila., PA

RE: Rx coverage

Good morning

We have had recent problems with patients following transplant not

being able to afford there copays for prescriptions. We had one case

where pt has her rx thru a major medical and informed us prior to

discharge they could not afford the cost and then turn into major

medical.

Any suggestions would be appreciated, pt signs a form on transplant

eval date

that they understand coverage and cost. Could this situation be

elimanated???

Pt's have coverage but can not afford the initial payment or the

monthly copays for meds. How do other centers view this???????????

M1@...

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

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the West Penn Allegheny Health System at and contact the

Information Security Department at telephone ext.1746.

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

www.mimesweeper.com

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

[Guest guest]

jan,

i work at emory university hospital atl, ga lung transplant

when a patient is thinking about having a transplant i send out to them a

package that includes all of the transplant information. this is sent out before

they come in for the evaluation.

1. 2- booklet on lung transplant (one of these was created for our area and

gives cost of medication and transplant cost) i also inform them that these cost

are not in stone. the other booklet is from unos.

2. a transplant plan-this is a form that requires the patient to tell how they

will pay for any drugs, who will be their support, travel and lodging

arrangement. will they be going back to work, will they be willing to get help

from ga transplant foundation with fundraising and getting back on track to

getting a job after transplant if they are able to do so

3. i also include with this a letter advising them check the benefits for the

transplant and the drugs and to have this information when they come in for the

evaluation. when they arrive i meet with them and go over the benefits they

receive vs the benefits i receive from the insurance co. and then we go over

everything else. i have a check list and i have the patient sign this and give

them a copy so they can not say that they were not aware of cost and anything

transplant related. when a patient makes that call to the insurance co they

understand better than me telling them about the benefits . they also get to

talk sometimes with the case manager and this can be helpful.

wendy dawson

mckelvey lung transplant center

internal medicine

emory university hospital

office

fax #

>>> jbucche@... 12/13/02 09:45AM >>>

Jan

I am reluctant to send anything in writing to patients as

coverage/contract language changes so frequently and it is impossible

to determine what new treatment/ medicine may be utilized when the

patient finally comes to transplant.

I do think giving them a list of medications they are likely to need

and having them call their pharmacy to find out their responsibility for

copays etc might bring home the estimated expense of the medications. I

may have our patients start doing this.

I believe patients need to do their own research to become informed

consumers.Transplant is an elective procedure for kidney patients. They

have a choice as to modalities for treatment. I tell them that nothing

is written in stone when it comes to medicines, but this is our protocol

at this time. I have found that patients agree to anything prior to the

transplant but many expect the program to take care of problems after

transplant.

>>> McIlvaineJ@... 12/12/02 08:41AM >>>

-

I now send follow-up letters to some patients after their transplant

evaluation advising them about their coverage and financial

responsibility. I also advise them to confirm these benefits with their

insurance company. Sometimes I give them an estimate of their

out-of-pocket expenses for medications (the ones added after txp). This

is time consuming, but I am hoping it will help to avoid the problem you

are facing. It is very difficult when patients expect to be " taken care

of " and don't assume responsibility for their own finances.

Good luck!

Jan McIlvaine

Lankenau Hospital

Phila., PA

RE: Rx coverage

Good morning

We have had recent problems with patients following transplant not

being able to afford there copays for prescriptions. We had one case

where pt has her rx thru a major medical and informed us prior to

discharge they could not afford the cost and then turn into major

medical.

Any suggestions would be appreciated, pt signs a form on transplant

eval date

that they understand coverage and cost. Could this situation be

elimanated???

Pt's have coverage but can not afford the initial payment or the

monthly copays for meds. How do other centers view this???????????

M1@...

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

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the West Penn Allegheny Health System at and contact the

Information Security Department at telephone ext.1746.

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

www.mimesweeper.com

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

[Guest guest]

Thanks everyone -

Your comments are most useful.

, I like your idea - We do send a medical questionnaire now so we could

just add the other components. It will be interesting to see how many comply.

Have a great holiday season.

Jan

RE: Rx coverage

Good morning

We have had recent problems with patients following transplant not

being able to afford there copays for prescriptions. We had one case

where pt has her rx thru a major medical and informed us prior to

discharge they could not afford the cost and then turn into major

medical.

Any suggestions would be appreciated, pt signs a form on transplant

eval date

that they understand coverage and cost. Could this situation be

elimanated???

Pt's have coverage but can not afford the initial payment or the

monthly copays for meds. How do other centers view this???????????

M1@...

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

This email and any files transmitted with it are confidential and

intended solely for the use of the individual or entity to whom they

are addressed. If you have received this email in error please notify

the West Penn Allegheny Health System at and contact the

Information Security Department at telephone ext.1746.

This footnote also confirms that this email message has been swept by

MIMEsweeper for the presence of computer viruses.

www.mimesweeper.com

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