Out of State Medicaid and Liver transplants -HELP!!!!

[Guest guest]

Ok, here is the scenario:

We had a patient referred to CMC (NC) for liver transplant who has WV Medicaid-

WV does not have a liver transplant program. We were told they usually send

patients to Pittsburgh, however that center is 7 hours away for pt and CMC is

only 3, plus he has family in town here to stay w/. Before we started the

evaluation, we were told we were in network w/ WV (per provider services at

MCD)so we proceeded. Today, I find out we are actually out of network and needed

to have approval for all testing that has already been completed. What I need is

some type of documentation from WV MCD in regards to organ transplant. I have

looked online, but couldnt find exactly what I'm looking for. If anyone has any

info about what they pay for organ transplants or if anyone else has had a

similar situation w/ out of stated MCD I would appreciate it greatly. I'm

starting to think that we should never have agreeed to evaluate this pt!

Thanks so much for any help you can give!

Leah Knowles

TFC

CMC

Charlotte NC

[Guest guest]

Craft RN opt.4 is the case manager for WV M'caid. She might be able to help you out.

H

H.E. Snoddy Transplant Financial Coordinator UVA Transplant Center

Voice: Fax: Email: snoddy@...

"Aut inveniam viam aut faciam"-Either I shall find a way or make one; Hannibal Si hoc legere scis nimium eruditionis habes (If you can read this you have too much education)

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of lmk_276Sent: Tuesday, June 15, 2010 3:37 PMTo: TxFinancialCoordinators Subject: Out of State Medicaid and Liver transplants -HELP!!!!

Ok, here is the scenario:We had a patient referred to CMC (NC) for liver transplant who has WV Medicaid- WV does not have a liver transplant program. We were told they usually send patients to Pittsburgh, however that center is 7 hours away for pt and CMC is only 3, plus he has family in town here to stay w/. Before we started the evaluation, we were told we were in network w/ WV (per provider services at MCD)so we proceeded. Today, I find out we are actually out of network and needed to have approval for all testing that has already been completed. What I need is some type of documentation from WV MCD in regards to organ transplant. I have looked online, but couldnt find exactly what I'm looking for. If anyone has any info about what they pay for organ transplants or if anyone else has had a similar situation w/ out of stated MCD I would appreciate it greatly. I'm starting to think that we should never have agreeed to evaluate this pt! Thanks so much for any help you can give!Leah KnowlesTFC CMCCharlotte NC