Re: Anthem Transplant Unit Issues

[Guest guest]

It takes weeks for Anthem to even give us a call back not to mention benefits or a transplant approval. They are the absolute worst. Rodney A. HollinshedTransplant Financial CoordinatorUniversity of Kansas Medical Center3901 Rainbow Blvd.Kansas City, KS 66160Mail stop 5001 phone fax>>> "Steve Aulgur" 1/28/2011 11:10 AM >>> All, We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems. FYI - We will be speaking with them today about this and I would appreciate your feedback. Steve R. Aulgur, BSBA, MBABusiness Manager, Transplant ServicesMailstop: 90-31-691-Jewish Hospital216 S. Kingshighway Blvd.St. Louis, Mo. 63110 Phone Fax Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents.

[Guest guest]

We've had the same problem and have registered our concern with Anthem

Management. Besides the issues you mention, we've had several cases disappear in

their queue, so a Transplant auth request never went to an actual nurse for

review.

Goldstein

Stanford BMT

On Jan 28, 2011, at 12:11 PM, " Steve Aulgur "

> wrote:

All,

We have been experiencing problems with receiving transplant benefits/approvals

from the Anthem Transplant Unit in a timely manner. I was wondering if this

issue is unique to us only or have other centers had the same problems.

FYI - We will be speaking with them today about this and I would appreciate your

feedback.

Steve

R. Aulgur, BSBA, MBA

Business Manager, Transplant Services

Mailstop: 90-31-691

-Jewish Hospital

216 S. Kingshighway Blvd.

St. Louis, Mo. 63110

Phone

Fax

Confidentially Statement: This email and any attached documents are confidential

and legally privileged. This information is intended only for the use of the

individuals or entities listed above. If you are not the intended recipient, you

are hereby notified that any disclosure, copying, distribution or action taken

in reliance on the contents of these documents is strictly prohibited. If you

have received this information in error, please notify the sender immediately

and destroy these documents.

[Guest guest]

Join the crowd! It's a battle each and every time. I have registered complaints but it has had absolutely no effect at all. Our local BCBS case mgr has suggested pursuing this through the association, but who has time for that? She hears of the complaints about Anthem a lot as well. I was advised in the last couple of weeks they have "changed their process" and I got a referral form that can be faxed for benefits. Too soon to tell if it has helped, but I'm thinking it hasn't so far. Can email you that if you don't already have it.

Good luck!

CraycraftSolid Organ Transplant Financial CoordinatorUniversity of Kansas Medical Center Fax lcraycraft@...>>> "Steve Aulgur" 01/28/2011 11:10 AM >>>

All,

We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems.

FYI - We will be speaking with them today about this and I would appreciate your feedback.

Steve

R. Aulgur, BSBA, MBABusiness Manager, Transplant ServicesMailstop: 90-31-691-Jewish Hospital216 S. Kingshighway Blvd.St. Louis, Mo. 63110 Phone

Fax

Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents.

[Guest guest]

yep - had that happen too!

CraycraftSolid Organ Transplant Financial CoordinatorUniversity of Kansas Medical Center Fax lcraycraft@...>>> "Goldstein, " 01/28/2011 11:18 AM >>>

We've had the same problem and have registered our concern with Anthem Management. Besides the issues you mention, we've had several cases disappear in their queue, so a Transplant auth request never went to an actual nurse for review. Goldstein Stanford BMT On Jan 28, 2011, at 12:11 PM, "Steve Aulgur" > wrote: All, We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems. FYI - We will be speaking with them today about this and I would appreciate your feedback. Steve R. Aulgur, BSBA, MBA Business Manager, Transplant Services Mailstop: 90-31-691 -Jewish Hospital 216 S. Kingshighway Blvd. St. Louis, Mo. 63110 Phone Fax Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents.

[Guest guest]

I am having  this problems as well. I have 2 patients I have been waiting for over 3 weeks for, always get placed into a voicemail with no response, or even a return call to advise we received your referral request. Dana L. GesslerTransplant Credit Analyst, Transplant Fiscal Credit Department2 Hot Metal St | Quantum One Bldg | W403 | Pittsburgh, PA 15203Phone  412. 258.1898 |Fax  | Email  gesslerdl@...Pager Long Range Short Range 11350 " Confidential UPMC Information. Any unauthorized or improper disclosure, copying, distribution, or use of the contents of this e-mail or attached documents is prohibited. The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If you have received this communication in error, please notify the sender immediately by e-mail and delete the original message. " From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Goldstein, Sent: Friday, January 28, 2011 12:18 PMTo: TxFinancialCoordinators Cc: TxFinancialCoordinators Subject: Re: Anthem Transplant Unit Issues We've had the same problem and have registered our concern with Anthem Management. Besides the issues you mention, we've had several cases disappear in their queue, so a Transplant auth request never went to an actual nurse for review. GoldsteinStanford BMTOn Jan 28, 2011, at 12:11 PM, " Steve Aulgur " > wrote:All,We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems.FYI - We will be speaking with them today about this and I would appreciate your feedback.Steve R. Aulgur, BSBA, MBABusiness Manager, Transplant ServicesMailstop: 90-31-691-Jewish Hospital216 S. Kingshighway Blvd.St. Louis, Mo. 63110Phone Fax Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents.

[Guest guest]

No This is an ongoing problem since they reorganized,  we havementioned it several times to our contracting team, as well as Anthem’s uppermanagement.  Unfortunately it seems to be getting worse.  I am wondering ifthere is something we can do together.  We are having a very difficult timeespecially if we are dealing with an urgent issue and need a Transplant CaseManager  ASAP, there is absolutely no way to get a hold of a live person in theTransplant Unit.   This is unacceptable,  especially in a crisis.  which isalmost a daily occurrence. M. FinanceSupervisorCedars-SinaiMedical CenterComprehensiveTransplant Center 8635 W 3rdStreet, Suite 590 WLos Angeles, CA90048(310)423-3170-office(310)248-8160-fax From:TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Goldstein,Sent: Friday, January 28, 2011 9:18 AMTo: TxFinancialCoordinators Cc: TxFinancialCoordinators Subject: Re: Anthem Transplant Unit Issues We've had the same problem and have registeredour concern with Anthem Management. Besides the issues you mention, we've hadseveral cases disappear in their queue, so a Transplant auth request never wentto an actual nurse for review. Goldstein Stanford BMT On Jan 28, 2011, at 12:11 PM, " Steve Aulgur " > wrote: All, We have been experiencing problems with receiving transplant benefits/approvalsfrom the Anthem Transplant Unit in a timely manner. I was wondering if thisissue is unique to us only or have other centers had the same problems. FYI - We will be speaking with them today about this and I would appreciateyour feedback. Steve R. Aulgur, BSBA, MBA Business Manager, Transplant Services Mailstop: 90-31-691 -Jewish Hospital 216 S. Kingshighway Blvd. St. Louis, Mo. 63110 Phone Fax Confidentially Statement: This email and any attached documents areconfidential and legally privileged. This information is intended only for theuse of the individuals or entities listed above. If you are not the intendedrecipient, you are hereby notified that any disclosure, copying, distributionor action taken in reliance on the contents of these documents is strictlyprohibited. If you have received this information in error, please notify thesender immediately and destroy these documents. IMPORTANT WARNING: This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed byapplicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED.If you have received this message in error, please notify us immediatelyby calling and destroy the related message. Thank You for your cooperation.

[Guest guest]

I have a number for the BCBS Association, but no particular person to contact. I started down that road a while back, then just didn't get to go through with it. No sure what it might accomplish?

Here is the referral form I "drug" out of someone in the last couple of weeks. I don't know if it will help or not but I did add the fax number to it.

CraycraftSolid Organ Transplant Financial CoordinatorUniversity of Kansas Medical Center Fax lcraycraft@...>>> ", " <.@CSHSOrg> 01/28/2011 11:42 AM >>>

No This is an ongoing problem since they reorganized, we have mentioned it several times to our contracting team, as well as Anthem's upper management. Unfortunately it seems to be getting worse. I am wondering if there is something we can do together. We are having a very difficult time especially if we are dealing with an urgent issue and need a Transplant Case Manager ASAP, there is absolutely no way to get a hold of a live person in the Transplant Unit. This is unacceptable, especially in a crisis. which is almost a daily occurrence.

M.

Finance Supervisor

Cedars-Sinai Medical Center

Comprehensive Transplant Center

8635 W 3rd Street, Suite 590 W

Los Angeles, CA 90048

-office

-fax

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Goldstein, Sent: Friday, January 28, 2011 9:18 AMTo: TxFinancialCoordinators Cc: TxFinancialCoordinators Subject: Re: Anthem Transplant Unit Issues

We've had the same problem and have registered our concern with Anthem Management. Besides the issues you mention, we've had several cases disappear in their queue, so a Transplant auth request never went to an actual nurse for review. Goldstein Stanford BMT On Jan 28, 2011, at 12:11 PM, "Steve Aulgur" > wrote: All, We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems. FYI - We will be speaking with them today about this and I would appreciate your feedback. Steve R. Aulgur, BSBA, MBA Business Manager, Transplant Services Mailstop: 90-31-691 -Jewish Hospital 216 S. Kingshighway Blvd. St. Louis, Mo. 63110 Phone Fax Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents.

IMPORTANT WARNING: This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed byapplicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED.If you have received this message in error, please notify us immediatelyby calling and destroy the related message. Thank You for your cooperation.

1 of 1 File(s)

BENEFIT REQUEST FORM -ANTHEM BCBS 1-2011.doc

[Guest guest]

Is this in Connecticut? >>> ", " 1/28/2011 12:42 PM >>> No This is an ongoing problem since they reorganized, we have mentioned it several times to our contracting team, as well as Anthem’s upper management. Unfortunately it seems to be getting worse. I am wondering if there is something we can do together. We are having a very difficult time especially if we are dealing with an urgent issue and need a Transplant Case Manager ASAP, there is absolutely no way to get a hold of a live person in the Transplant Unit. This is unacceptable, especially in a crisis. which is almost a daily occurrence. M. Finance SupervisorCedars-Sinai Medical CenterComprehensive Transplant Center8635 W 3rd Street, Suite 590 WLos Angeles, CA 90048-office-faxFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Goldstein, Sent: Friday, January 28, 2011 9:18 AMTo: TxFinancialCoordinators Cc: TxFinancialCoordinators Subject: Re: Anthem Transplant Unit Issues We've had the same problem and have registered our concern with Anthem Management. Besides the issues you mention, we've had several cases disappear in their queue, so a Transplant auth request never went to an actual nurse for review. Goldstein Stanford BMT On Jan 28, 2011, at 12:11 PM, "Steve Aulgur" > wrote: All, We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems. FYI - We will be speaking with them today about this and I would appreciate your feedback. Steve R. Aulgur, BSBA, MBA Business Manager, Transplant Services Mailstop: 90-31-691 -Jewish Hospital 216 S. Kingshighway Blvd. St. Louis, Mo. 63110 Phone Fax Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents. IMPORTANT WARNING: This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed byapplicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED.If you have received this message in error, please notify us immediatelyby calling and destroy the related message. Thank You for your cooperation.

[Guest guest]

Did your contracting team get a response from Anthem?

Beverly Rasberry Transplant Financial Coordinator University of Illinois Medical Center Division of Transplantation Phone Fax

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of , Sent: Friday, January 28, 2011 11:42 AMTo: TxFinancialCoordinators Subject: RE: Anthem Transplant Unit Issues

No This is an ongoing problem since they reorganized, we have mentioned it several times to our contracting team, as well as Anthem’s upper management. Unfortunately it seems to be getting worse. I am wondering if there is something we can do together. We are having a very difficult time especially if we are dealing with an urgent issue and need a Transplant Case Manager ASAP, there is absolutely no way to get a hold of a live person in the Transplant Unit. This is unacceptable, especially in a crisis. which is almost a daily occurrence.

M.

Finance Supervisor

Cedars-Sinai Medical Center

Comprehensive Transplant Center

8635 W 3rd Street, Suite 590 W

Los Angeles, CA 90048

-office

-fax

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Goldstein, Sent: Friday, January 28, 2011 9:18 AMTo: TxFinancialCoordinators Cc: TxFinancialCoordinators Subject: Re: Anthem Transplant Unit Issues

We've had the same problem and have registered our concern with Anthem Management. Besides the issues you mention, we've had several cases disappear in their queue, so a Transplant auth request never went to an actual nurse for review. Goldstein Stanford BMT On Jan 28, 2011, at 12:11 PM, "Steve Aulgur" > wrote: All, We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems. FYI - We will be speaking with them today about this and I would appreciate your feedback. Steve R. Aulgur, BSBA, MBA Business Manager, Transplant Services Mailstop: 90-31-691 -Jewish Hospital 216 S. Kingshighway Blvd. St. Louis, Mo. 63110 Phone Fax Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents.

IMPORTANT WARNING: This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed byapplicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED.If you have received this message in error, please notify us immediatelyby calling and destroy the related message. Thank You for your cooperation.

*********************EMAIL DISCLAIMER*********************

This email and any files transmitted with it may be confidential and are

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

addressed. If you are not the intended recipient or the individual

responsible for delivering the e-mail to the intended recipient, any

disclosure, copying, distribution or any action taken or omitted to be

taken in reliance on it, is strictly prohibited. If you have received this

e-mail in error, please delete it and notify the sender or contact Health

Information Management .

[Guest guest]

I have experienced the same delay in getting benefits from Anthem. Turn around time has been 7-10 business days, and I usually end up placing multiple phone calls to the benefit specialist before they are returned.

Delashmit, TFC

Cannon Blood & Marrow Transplant Program

Centennial Medical Center

Nashville, TN. All, We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems. FYI - We will be

speaking with them today about this and I would appreciate your feedback. Steve R. Aulgur, BSBA, MBA Business Manager, Transplant Services Mailstop: 90-31-691 -Jewish Hospital 216 S. Kingshighway Blvd. St. Louis, Mo. 63110 Phone Fax Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents.

IMPORTANT WARNING: This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed byapplicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED.If you have received this message in error, please notify us immediatelyby calling and destroy the related message. Thank You for your cooperation. *********************EMAIL DISCLAIMER*********************This email and any files transmitted with it may be confidential and areintended solely for the use of the individual or entity to whom they areaddressed. If you are not the intended recipient or the individualresponsible for delivering the e-mail to the intended recipient, any disclosure, copying, distribution or any action taken or omitted to be taken in reliance on it, is strictly prohibited. If you have received thise-mail in error, please delete it and notify the sender or contact Health Information Management .

[Guest guest]

Same here, even after repeatedly asking and being told their turnaroundtime is 24-48 hours for benefits. I have to make repeat phone calls to getanyone to call me back…THEN…I’m told it’s not been received. I can’t standdealing with Anthem at all. Financial Counselor/Data CoordinatorUniversity of Kentucky Transplant CenterPhone: Fax: Pager: E-Mail: adhern2@... STATEMENT OF CONFIDENTIALITY The contents of this email message and any attachments are confidential and areintended solely for the addressee. The information may also be legallyprivileged. This transmission is sent in trust, for the sole purpose ofdelivery to the intended recipient. If you have received thistransmission in error, any use, reproduction or dissemination of thistransmission is strictly prohibited. If you are not the intendedrecipient, please immediately notify the sender by reply email or at and delete this message and its attachments, if any. From:TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of DelashmitSent: Friday, January 28, 2011 1:58 PMTo: TxFinancialCoordinators Subject: RE: Anthem Transplant Unit Issues I have experienced the same delay in getting benefits fromAnthem. Turn around time has been 7-10 business days, and I usually end upplacing multiple phone calls to the benefit specialist before they arereturned. Delashmit, TFC Cannon Blood & Marrow Transplant ProgramCentennial Medical CenterNashville, TN. All, We have been experiencing problems with receiving transplantbenefits/approvals from the Anthem Transplant Unit in a timely manner. I waswondering if this issue is unique to us only or have other centers had thesame problems. FYI - We will be speaking with them today about this and I would appreciateyour feedback. Steve R. Aulgur, BSBA, MBA Business Manager, Transplant Services Mailstop: 90-31-691 -Jewish Hospital 216 S. Kingshighway Blvd. St. Louis, Mo. 63110 Phone Fax Confidentially Statement: This email and any attached documents areconfidential and legally privileged. This information is intended only forthe use of the individuals or entities listed above. If you are not theintended recipient, you are hereby notified that any disclosure, copying,distribution or action taken in reliance on the contents of these documentsis strictly prohibited. If you have received this information in error,please notify the sender immediately and destroy these documents. IMPORTANT WARNING: This message is intended for the use ofthe person or entity to which it is addressed and may contain informationthat is privileged and confidential, the disclosure of which is governed byapplicable law. If the reader of this message is not the intended recipient,or the employee or agent responsible for delivering it to the intendedrecipient, you are hereby notified that any dissemination, distribution orcopying of this information is STRICTLY PROHIBITED.If you have received this message in error, please notify us immediatelyby calling and destroy the related message. Thank You for yourcooperation. *********************EMAIL DISCLAIMER*********************This email and any files transmitted with it may be confidential and areintended solely for the use of the individual or entity to whom they areaddressed. If you are not the intended recipient or the individualresponsible for delivering the e-mail to the intended recipient, any disclosure, copying, distribution or any action taken or omitted to be taken in reliance on it, is strictly prohibited. If you have receivedthise-mail in error, please delete it and notify the sender or contact Health Information Management .

[Guest guest]

I am ready to tear my hair out over this. I've got one request that I submitted

on Jan 5 that I can't get resolved, even though 4 people (including a team lead)

promised to built a case!

>

>

>

> All,

>

> We have been experiencing problems with receiving transplant

benefits/approvals from the Anthem Transplant Unit in a timely manner. I was

wondering if this issue is unique to us only or have other centers had the same

problems.

>

> FYI - We will be speaking with them today about this and I would appreciate

your feedback.

>

> Steve

>

>

> R. Aulgur, BSBA, MBA

> Business Manager, Transplant Services

> Mailstop: 90-31-691

> -Jewish Hospital

> 216 S. Kingshighway Blvd.

> St. Louis, Mo. 63110

> Phone

> Fax

>

> Confidentially Statement: This email and any attached documents are

confidential and legally privileged. This information is intended only for the

use of the individuals or entities listed above. If you are not the intended

recipient, you are hereby notified that any disclosure, copying, distribution or

action taken in reliance on the contents of these documents is strictly

prohibited. If you have received this information in error, please notify the

sender immediately and destroy these documents.

>

[Guest guest]

I have two patients that I am waiting for authorization on as well. This is the

first time I have had problems with Anthem responding.

Yalanda

Inova Fairfax Transplant

>

> All,

>

> We have been experiencing problems with receiving transplant

benefits/approvals from the Anthem Transplant Unit in a timely manner. I was

wondering if this issue is unique to us only or have other centers had the same

problems.

>

> FYI - We will be speaking with them today about this and I would appreciate

your feedback.

>

> Steve

>

>

> R. Aulgur, BSBA, MBA

> Business Manager, Transplant Services

> Mailstop: 90-31-691

> -Jewish Hospital

> 216 S. Kingshighway Blvd.

> St. Louis, Mo. 63110

> Phone

> Fax

>

> Confidentially Statement: This email and any attached documents are

confidential and legally privileged. This information is intended only for the

use of the individuals or entities listed above. If you are not the intended

recipient, you are hereby notified that any disclosure, copying, distribution or

action taken in reliance on the contents of these documents is strictly

prohibited. If you have received this information in error, please notify the

sender immediately and destroy these documents.

>

[Guest guest]

We have had alot of trouble. Mostly with Anthem in VA.I might have a direct number to get a hold of Batrub. I will check tomorrow and send you that information.BarbaraTo: TxFinancialCoordinators Sent: Tue, February 1, 2011 8:18:47 AMSubject: Re: Anthem Transplant Unit Issues

I have two patients that I am waiting for authorization on as well. This is the first time I have had problems with Anthem responding.

Yalanda

Inova Fairfax Transplant

>

> All,

>

> We have been experiencing problems with receiving transplant benefits/approvals from the Anthem Transplant Unit in a timely manner. I was wondering if this issue is unique to us only or have other centers had the same problems.

>

> FYI - We will be speaking with them today about this and I would appreciate your feedback.

>

> Steve

>

>

> R. Aulgur, BSBA, MBA

> Business Manager, Transplant Services

> Mailstop: 90-31-691

> -Jewish Hospital

> 216 S. Kingshighway Blvd.

> St. Louis, Mo. 63110

> Phone

> Fax

>

> Confidentially Statement: This email and any attached documents are confidential and legally privileged. This information is intended only for the use of the individuals or entities listed above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and destroy these documents.

>

[Guest guest]

I finally had to " get tough " to get any kind of results. Customer Service kept

telling me " 5 business days " . I told them I didn't believe it and that I wanted

responses ASAP. I finally got call backs on three of my cases. For my fourth

case they directed me to the wrong office. Amazing!

> >

> > All,

> >

> > We have been experiencing problems with receiving transplant

benefits/approvals

> >from the Anthem Transplant Unit in a timely manner. I was wondering if this

> >issue is unique to us only or have other centers had the same problems.

> >

> > FYI - We will be speaking with them today about this and I would appreciate

> >your feedback.

> >

> > Steve

> >

> >

> > R. Aulgur, BSBA, MBA

> > Business Manager, Transplant Services

> > Mailstop: 90-31-691

> > -Jewish Hospital

> > 216 S. Kingshighway Blvd.

> > St. Louis, Mo. 63110

> > Phone

> > Fax

> >

> > Confidentially Statement: This email and any attached documents are

> >confidential and legally privileged. This information is intended only for

the

> >use of the individuals or entities listed above. If you are not the intended

> >recipient, you are hereby notified that any disclosure, copying, distribution

or

> >action taken in reliance on the contents of these documents is strictly

> >prohibited. If you have received this information in error, please notify the

> >sender immediately and destroy these documents.

> >

>

[Guest guest]

We struggle with even getting anyone on the phone with BCBS of Michigan and BCBS

of Illinois. We call one number and get referred to another and only get

recorded messages. And call backs hopefully with answers about network or

preauthorizing a transplant after much much follow up. What is the secret to

get through to at least Case Management departments?

Lois Winningham

Transplant Financial Coordinator

University of KS Hospital

phone

fax

" Advanced Care For The Next Century "

[Guest guest]

BC of Michigan – I use this number to their Human Organ Transplant it takes a day or two for them to call back.   Hope this helps! Dana L. GesslerTransplant Credit Analyst, Transplant Fiscal Credit Department2 Hot Metal St | Quantum One Bldg | W403 | Pittsburgh, PA 15203Phone  412. 258.1898 |Fax  | Email  gesslerdl@...Pager Long Range Short Range 11350 " Confidential UPMC Information. Any unauthorized or improper disclosure, copying, distribution, or use of the contents of this e-mail or attached documents is prohibited. The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If you have received this communication in error, please notify the sender immediately by e-mail and delete the original message. " From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Lois WinninghamSent: Thursday, February 03, 2011 8:32 AMTo: TxFinancialCoordinators Subject: Re: Anthem Transplant Unit Issues We struggle with even getting anyone on the phone with BCBS of Michigan and BCBS of Illinois. We call one number and get referred to another and only get recorded messages. And call backs hopefully with answers about network or preauthorizing a transplant after much much follow up. What is the secret to get through to at least Case Management departments?Lois WinninghamTransplant Financial CoordinatorUniversity of KS Hospitalphone fax " Advanced Care For The Next Century "

[Guest guest]

A couple of weeks ago after this discussion, I received a response (below) from . This is the person I was told to contact by BCBS Association contracting. Not sure if she is really the appropriate person to approach, but FYI - here was her response. Now we all have "a" number to call if we do not see any improvement!

, thank you for your outreach and raising your concerns. We strive to be responsive to our Provider and member inquiries and I am sorry to hear that we have fallen short of that goal. I will share your concerns with the management team of our UM/CM department and I will ask that someone reach out to you.

Please do not hesitate to contact me if your experience does not improve and I would like to hear back from you with your feedback in a few weeks.

Pat

RN, BSN/Director Specialty Network Management/ Telephone / patricia.martin@...

CraycraftSolid Organ Transplant Financial CoordinatorUniversity of Kansas Medical Center Fax lcraycraft@...>>> "jrichetts" 02/02/2011 1:56 PM >>>

I finally had to "get tough" to get any kind of results. Customer Service kept telling me "5 business days". I told them I didn't believe it and that I wanted responses ASAP. I finally got call backs on three of my cases. For my fourth case they directed me to the wrong office. Amazing!> >> > All,> > > > We have been experiencing problems with receiving transplant benefits/approvals > >from the Anthem Transplant Unit in a timely manner. I was wondering if this > >issue is unique to us only or have other centers had the same problems.> > > > FYI - We will be speaking with them today about this and I would appreciate > >your feedback.> > > > Steve> > > > > > R. Aulgur, BSBA, MBA> > Business Manager, Transplant Services> > Mailstop: 90-31-691> > -Jewish Hospital> > 216 S. Kingshighway Blvd.> > St. Louis, Mo. 63110 > > Phone > > Fax > > > > Confidentially Statement: This email and any attached documents are > >confidential and legally privileged. This information is intended only for the > >use of the individuals or entities listed above. If you are not the intended > >recipient, you are hereby notified that any disclosure, copying, distribution or > >action taken in reliance on the contents of these documents is strictly > >prohibited. If you have received this information in error, please notify the > >sender immediately and destroy these documents.> >>

[Guest guest]

, Thank you so much for sharing this

and pursuing an avenue we can take.

M Hogan

Transplant

Financial Coordinator

Lahey

Clinic

41 Mall Rd

Burlington, MA 01805

Phone:

Fax:

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Craycraft

Sent: Thursday, February 03, 2011

10:11 AM

To: TxFinancialCoordinators

Subject:

Re: Anthem Transplant Unit Issues

A couple of weeks

ago after this discussion, I received a response (below) from .

This is the person I was told to contact by BCBS Association contracting. Not

sure if she is really the appropriate person to approach, but FYI - here was

her response. Now we all have " a " number to call if we do not

see any improvement!

, thank you for your outreach and

raising your concerns. We strive to be responsive to our Provider and member

inquiries and I am sorry to hear that we have fallen short of that goal. I will

share your concerns with the management team of our UM/CM department and I will

ask that someone reach out to you.

Please do not hesitate to contact me if

your experience does not improve and I would like to hear back from you with

your feedback in a few weeks.

Pat

RN, BSN/Director Specialty Network

Management/ Telephone / patricia.martin@...

Craycraft

Solid Organ Transplant Financial Coordinator

University of Kansas

Medical Center

Fax

lcraycraft@...

>>> " jrichetts " 02/02/2011 1:56 PM

>>>

I finally had to " get

tough " to get any kind of results. Customer Service kept telling me

" 5 business days " . I told them I didn't believe it and that I wanted

responses ASAP. I finally got call backs on three of my cases. For my fourth

case they directed me to the wrong office. Amazing!

> >

> > All,

> >

> > We have been experiencing problems with receiving transplant

benefits/approvals

> >from the Anthem Transplant Unit in a timely manner. I was wondering if

this

> >issue is unique to us only or have other centers had the same

problems.

> >

> > FYI - We will be speaking with them today about this and I would

appreciate

> >your feedback.

> >

> > Steve

> >

> >

> > R. Aulgur, BSBA, MBA

> > Business Manager, Transplant Services

> > Mailstop: 90-31-691

> > -Jewish

Hospital

> > 216 S. Kingshighway

Blvd.

> > St. Louis, Mo. 63110

> > Phone

> > Fax

> >

> > Confidentially Statement: This email and any attached documents are

> >confidential and legally privileged. This information is intended only

for the

> >use of the individuals or entities listed above. If you are not the

intended

> >recipient, you are hereby notified that any disclosure, copying,

distribution or

> >action taken in reliance on the contents of these documents is

strictly

> >prohibited. If you have received this information in error, please

notify the

> >sender immediately and destroy these documents.

> >

>

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