Guest guest Posted May 20, 2010 Report Share Posted May 20, 2010 We discourage them. They dont keep up with the COB period and we cant get state help for their Part D since it is all rolled into one A<B<D Whitney Folsom, TFC ETMC Transplant Program 1100 E Lake St ste 340 Tyler, TX 75701 phone fax wlfolsom@... >>> " R. Simon (Transplant Admin) " 5/20/2010 9:18 AM >>> While I know Medicare Advantage Plans are anything but advantageous to patients, I'm wondering if transplant programs have policies that either will or will not accept these patients for active listing for transplant? Besides the patient problems, it is my understanding these transplants are reimbursed on the DRG and additional payment for the actually organ charge does not occur as I'm told these are not considered Medicare organs for the cost report. I'm wondering if centers have had success contracting with specific advantage plans to enhance reimbursement or have other information about these policies? Thanks, Simon, MSW Manager, Transplant Financial Operations Froedtert Memorial Lutheran Hospital 9200 W. Wisconsin Avenue Milwaukee, WI 53226 =========================================================== This message is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law. If you are not the intended recipient(s), you are notified that the dissemination, distribution or copying of this message is strictly prohibited. If you received this message in error, or are not the named recipient(s), please notify the sender and delete this e-mail from your computer. ETMC has implemented secure messaging for certain types of messages. For more information about our secure messaging system, go to: http://www.etmc.org/mail/ Thank you. =========================================================== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2010 Report Share Posted May 20, 2010 We currently take them on a case by case basis..We sometimes already contract with the health plan and use that guideline for payment..If we don't contract with the health plan we do a letter of agreement for the pre-evaluation,actual transplant and post transplant care...this includes the organ..Most of our patient's will and can qualify for our state program as a secondary...for those who do not we make sure they are in the right advantage plan for them..ie,co-pays, ded,and rx plan..to assure the patient can afford all expenses.. Cruz Transplant Financial Coordinator UCSD Medical Center elcruz@... To: TxFinancialCoordinators Sent: Thu, May 20, 2010 7:18:52 AMSubject: Medicare Advantage Plans While I know Medicare Advantage Plans are anything but advantageous to patients, I'm wondering if transplant programs have policies that either will or will not accept these patients for active listing for transplant? Besides the patient problems, it is my understanding these transplants are reimbursed on the DRG and additional payment for the actually organ charge does not occur as I'm told these are not considered Medicare organs for the cost report. I'm wondering if centers have had success contracting with specific advantage plans to enhance reimbursement or have other information about these policies? Thanks, Simon, MSW Manager, Transplant Financial Operations Froedtert Memorial Lutheran Hospital 9200 W. Wisconsin Avenue Milwaukee, WI 53226 Quote Link to comment Share on other sites More sharing options...
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