Fund-raising Questionnaire

[Guest guest]

1. Does your facility require transplant

patients to fund-raise? If so, during what phase of transplant care

are they notified of their fund-raising goal (evaluation) (listing)?

2. If your facility does not require

transplant patients to fund-raise what type of assistance does your facility

offer patients that have financial concerns...ie. medication cost, travel

and lodging cost...etc?

3. What types of services/things do

transplant patients at your facility fund-raise for and what time frames

do you give them to reach their goals...ie. medications (1 year post transplant)

(2 years post transplant), travel and lodging (6 months-1 year)?

4. If your facility require transplant

patients to fund-raise do you have different fund-raising goals by transplant

type?

5. How often do you follow up with the

transplant patient that is required to fund-raise to determine if they

are making progress toward reaching their fund-raising goal?

6. Do you have different fund-raising

goals by insurance type...ie. Medicare, Medicaid, Commercial Insurance?

Do you follow specific guidelines by payor? If so, please share

the guidelines.

7. Do you require Medicare A & B only

transplant patients to enroll in a Part D, Part C or Medicare supplement

plan?

8. Do you partner with drug companies

or lodging facilities to assist with medications and travel and lodging

accommodations for your transplant patients?

Thank you for your assistance,

F. McCray, MPA

Manager, Transplant Financial Services

Patient Revenue Management Organization of

Duke University Health System and Private Diagnostic Clinic

(phone)

(fax)

Email: vincent.mccray@...