Re: Post-Transplant Donor Complication

[Guest guest]

I would think that it would go on the Medicare Cost report

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Silvia Alfaro

Sent: Wednesday, March 02, 2011 5:58 PM

To: 'TxFinancialCoordinators '

Subject: Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of

transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states

they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service.

They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

[Guest guest]

I agree with you Phyllis. AyabarrenoFinancial CoordinatorHartford Hospital Transplant Program80 Seymour Street - Suite 321Hartford, CT 06102Email: Mayabar@...Tele# Fax# >>> Phyllis Lang 3/3/2011 8:05 AM >>> I would think that it would go on the Medicare Cost reportFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Silvia AlfaroSent: Wednesday, March 02, 2011 5:58 PMTo: 'TxFinancialCoordinators 'Subject: Post-Transplant Donor Complication Hello,I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?Thank you, your help is appreciated.Silvia AlfaroFinancial CoordinatorSharp Memorial HospitalKidney/Pancreas Transplant Center

Attachment: vcard [not shown]

[Guest guest]

Hi All,We suggest the following billing order, some of which has been completed.  We also suggest a phone call to the carrier that makes the decision on who is primary and who is secondary, there are time that they can compel Medicare to pay.Initially we suggest billing the donor physician fees to the current payer for the Recipient.  Any technical, non physician services are the responsibility of the KACC.  If/when the current payer denies payment, the Medicare should be billed with all of the appropriate modifiers, if/when Medicare denies, then we believe that the recipient is responsible.  Remember discussions of what happens if the recipient does not have Part B, how they could become responsible for care of the donor.  We don’t  think that this is different.There is nothing in regulation that clearly speaks to this.  However it is clear in the intent that the Donor is not responsible.The absolutely last resort is for the hospital to pay for the fees, but the fees are NOT allowable on the KACC.Hope this helps,Thanks,Bill From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of AyabarrenoSent: Thursday, March 03, 2011 8:26 AMTo: TxFinancialCoordinators Subject: RE: Post-Transplant Donor ComplicationImportance: Low I agree with you Phyllis. AyabarrenoFinancial CoordinatorHartford Hospital Transplant Program80 Seymour Street - Suite 321Hartford, CT 06102Email: Mayabar@...Tele# Fax# >>> Phyllis Lang 3/3/2011 8:05 AM >>> I would think that it would go on the Medicare Cost reportFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Silvia AlfaroSent: Wednesday, March 02, 2011 5:58 PMTo: 'TxFinancialCoordinators 'Subject: Post-Transplant Donor Complication Hello,I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?Thank you, your help is appreciated.Silvia AlfaroFinancial CoordinatorSharp Memorial HospitalKidney/Pancreas Transplant Center

[Guest guest]

Thank you Bill. This is consistent with

how our hospital was approaching coverage for donors when no Part B existed any

longer on the recipient.

Sheila Kantor

Manager, Patient Access Services Department

Sharp Metropolitan Medical Campus

(fax)

(pgr)

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of jbvaughan

Sent: Thursday, March 03, 2011

5:41 AM

To:

TxFinancialCoordinators

Subject: RE:

RE: Post-Transplant Donor Complication

Hi All,

We suggest the following billing order, some of which has been

completed. We also suggest a phone call to the carrier that makes the

decision on who is primary and who is secondary, there are time that they can

compel Medicare to pay.

Initially we suggest billing the donor physician fees to the

current payer for the Recipient. Any technical, non physician services

are the responsibility of the KACC. If/when the current payer denies

payment, the Medicare should be billed with all of the appropriate modifiers,

if/when Medicare denies, then we believe that the recipient is

responsible.

Remember discussions of what happens if the recipient does not

have Part B, how they could become responsible for care of the donor. We

don’t think that this is different.

There is nothing in regulation that clearly speaks to

this. However it is clear in the intent that the Donor is not responsible.

The absolutely last resort is for the hospital to pay for the

fees, but the fees are NOT allowable on the KACC.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Ayabarreno

Sent: Thursday, March 03, 2011

8:26 AM

To:

TxFinancialCoordinators

Subject:

RE: Post-Transplant Donor Complication

Importance: Low

I agree with you

Phyllis.

Ayabarreno

Financial Coordinator

Hartford Hospital

Transplant Program

80 Seymour Street

- Suite 321

Hartford, CT

06102

Email: Mayabar@...

Tele#

Fax#

>>> Phyllis Lang 3/3/2011 8:05 AM

>>>

I would think that it would go on the Medicare Cost report

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Silvia Alfaro

Sent: Wednesday, March 02, 2011

5:58 PM

To:

'TxFinancialCoordinators '

Subject:

Post-Transplant Donor Complication

Hello,

I have a donor

that donated his Kidney in 2005 and now is having some complications. The

recipient at the time of transplant had Medicare A/B, however, it termed three

years after transplant, in 2008. The donor had an ultrasound done in

September 2010 at out hospital, but now he is being billed for the professional

fees from a different provider. That provider states they have billed

Mcare a few times with the recipient’s info and donor’s info, they made sure it

stated that this was related to a complication from the Kidney donation, but

Mcare has denied the claim stating that recipient was not eligible at time of

service. They have billed the donor and are threatening him to send him

to collections. Does anybody have any advice on this situation?

What else can our Center do to help the donor?

Thank you, your

help is appreciated.

Silvia

Alfaro

Financial

Coordinator

Sharp Memorial Hospital

Kidney/Pancreas

Transplant Center

[Guest guest]

So a recipient could potentially be financially obligated to fully pay out of pocket for a donor complication if Part B has dropped after the 3-year period?

I was not aware of that.

Sara Danner

| Transplant Financial Coordinator | Memorial Medical Center | Springfield, IL

Phone: | Fax: | E-mail:

danner.sara@...

CHOOSE GREAT.

CHOOSE MEMORIAL.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Sheila Kantor

Sent: Thursday, March 03, 2011 11:12 AM

To: 'TxFinancialCoordinators '

Subject: RE: RE: Post-Transplant Donor Complication

Thank you Bill. This is consistent with how our hospital was approaching coverage for donors when no

Part B existed any longer on the recipient.

Sheila Kantor

Manager, Patient Access Services Department

Sharp Metropolitan Medical Campus

(fax)

(pgr)

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of jbvaughan

Sent: Thursday, March 03, 2011 5:41 AM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor Complication

Hi All,

We suggest the following billing order, some of which has been completed. We also suggest a phone call to the carrier that makes the

decision on who is primary and who is secondary, there are time that they can compel Medicare to pay.

Initially we suggest billing the donor physician fees to the current payer for the Recipient. Any technical, non physician services

are the responsibility of the KACC. If/when the current payer denies payment, the Medicare should be billed with all of the appropriate modifiers, if/when Medicare denies, then we believe that the recipient is responsible.

Remember discussions of what happens if the recipient does not have Part B, how they could become responsible for care of the donor.

We don’t think that this is different.

There is nothing in regulation that clearly speaks to this. However it is clear in the intent that the Donor is not responsible.

The absolutely last resort is for the hospital to pay for the fees, but the fees are NOT allowable on the KACC.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Ayabarreno

Sent: Thursday, March 03, 2011 8:26 AM

To: TxFinancialCoordinators

Subject: RE: Post-Transplant Donor Complication

Importance: Low

I agree with you Phyllis.

Ayabarreno

Financial Coordinator

Hartford Hospital

Transplant Program

80 Seymour Street - Suite 321

Hartford, CT 06102

Email: Mayabar@...

Tele#

Fax#

>>> Phyllis Lang 3/3/2011 8:05 AM >>>

I would think that it would go on the Medicare Cost report

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Silvia Alfaro

Sent: Wednesday, March 02, 2011 5:58 PM

To: 'TxFinancialCoordinators '

Subject: Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however,

it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with

the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are

threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message.

Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

In a webinar last September, I understood Mark Horney from CMS to say that Part B coverage for donor complications remains available beyond the recipient's active entitlement, if Medicare deems that the problem is a true complication of donation. Is this crazy talk, Bill?

on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@...

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

That was my understanding as well.

Sara Danner

| Transplant Financial Coordinator | Memorial Medical Center | Springfield, IL

Phone: | Fax: | E-mail:

danner.sara@...

CHOOSE GREAT.

CHOOSE MEMORIAL.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Thursday, March 03, 2011 12:37 PM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor Complication

In a webinar last September, I understood Mark Horney from CMS to say that Part B coverage for donor complications remains available beyond the recipient's active entitlement,

if Medicare deems that the problem is a true complication of donation. Is this crazy talk, Bill?

on

Transplant Financial Coordinator

Legacy Good Samaritan Hospital

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however,

it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with

the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are

threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not

the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message.

Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

Hi , I missed that Webinar, unfortunately. It is entirely possible that he made that comment and if so it would be wonderful. Please be a hero, and email him and ask him. Please give him the situation as you understand it. If he agrees, ask him how to bill and to whom the Intermediary/r should direct their questions. This would be a major help to all of us. Thanks,Bill From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Thursday, March 03, 2011 1:37 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant Donor Complication In a webinar last September, I understood Mark Horney from CMS to say that Part B coverage for donor complications remains available beyond the recipient's active entitlement, if Medicare deems that the problem is a true complication of donation. Is this crazy talk, Bill? on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... Post-Transplant Donor Complication Hello,I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?Thank you, your help is appreciated.Silvia AlfaroFinancial CoordinatorSharp Memorial HospitalKidney/Pancreas Transplant Center This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

Maybe a joint emailJ From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Danner, SaraSent: Thursday, March 03, 2011 1:39 PMTo: 'TxFinancialCoordinators 'Subject: RE: RE: Post-Transplant Donor Complication That was my understanding as well. Sara Danner | Transplant Financial Coordinator | Memorial Medical Center | Springfield, ILPhone: | Fax: | E-mail: danner.sara@... CHOOSE GREAT. CHOOSE MEMORIAL. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Thursday, March 03, 2011 12:37 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant Donor Complication In a webinar last September, I understood Mark Horney from CMS to say that Part B coverage for donor complications remains available beyond the recipient's active entitlement, if Medicare deems that the problem is a true complication of donation. Is this crazy talk, Bill? on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... Post-Transplant Donor Complication Hello,I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?Thank you, your help is appreciated.Silvia AlfaroFinancial CoordinatorSharp Memorial HospitalKidney/Pancreas Transplant Center This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

happy to, do you have his email Bill?

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

Somehow I knew that question was coming. I would have to look it up on the CMS/Medicare website. Would you mind doing it or look back at the webinar materials and perhaps his contact information is there. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Thursday, March 03, 2011 1:55 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant Donor Complication happy to, do you have his email Bill? Post-Transplant Donor Complication Hello,I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?Thank you, your help is appreciated.Silvia AlfaroFinancial CoordinatorSharp Memorial HospitalKidney/Pancreas Transplant CenterThis message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

Isa, was this the August webinar on paired donation? Mark

was on that call with us….

I don’t recall another webinar either.

Debbie Mast

Database Administrator/Financial Manager

Solid Organ Transplant/VAD Program

Stanford Hospital and Clinics

750 Welch Road, Suite 220

Palo Alto, CA 94304

Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal

Transplant Programs

Trustee, TFCA

Phone: Fax:

www.donateLIFEcalifornia.org/stanfordmed

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of jbvaughan

Sent: Thursday, March 03, 2011 10:53 AM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor

Complication

Hi ,

I missed that Webinar,

unfortunately. It is entirely possible that he made that comment and if

so it would be wonderful.

Please be a hero, and email him and ask

him. Please give him the situation as you understand it. If he

agrees, ask him how to bill and to whom the Intermediary/r should direct

their questions.

This would be a major help to all of us.

Thanks,

Bill

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on,

:LPH Trnsplnt

Sent: Thursday, March 03, 2011 1:37 PM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor

Complication

In a webinar last

September, I understood Mark Horney from CMS to say that Part B

coverage for donor complications remains available beyond the recipient's

active entitlement, if Medicare deems that the problem is a true

complication of donation. Is this crazy talk, Bill?

on

Transplant Financial

Coordinator

Legacy Good Samaritan

Hospital

Legacy Transplant

Services

1040 NW 22nd Ave

Ste 480

Portland OR 97210

direct

main office

toll-free

fax

lmorriso@...

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now

is having some complications. The recipient at the time of transplant had

Medicare A/B, however, it termed three years after transplant, in 2008.

The donor had an ultrasound done in September 2010 at out hospital, but now he

is being billed for the professional fees from a different provider. That

provider states they have billed Mcare a few times with the recipient’s

info and donor’s info, they made sure it stated that this was related to

a complication from the Kidney donation, but Mcare has denied the claim stating

that recipient was not eligible at time of service. They have billed the

donor and are threatening him to send him to collections. Does anybody

have any advice on this situation? What else can our Center do to help

the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments)

contains confidential information intended for a specific individual and

purpose, and is protected by law. If you are not the intended recipient, you

should delete this message. Any disclosure, copying, or distribution of this

message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

MHorneycms (DOT) hhs.gov

Sara Danner

| Transplant Financial Coordinator | Memorial Medical Center | Springfield, IL

Phone: | Fax: | E-mail:

danner.sara@...

CHOOSE GREAT.

CHOOSE MEMORIAL.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of jbvaughan

Sent: Thursday, March 03, 2011 1:02 PM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor Complication

Somehow I knew that question was coming. I would have to look it up on the CMS/Medicare website. Would you mind doing it or look back

at the webinar materials and perhaps his contact information is there.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of on, :LPH Trnsplnt

Sent: Thursday, March 03, 2011 1:55 PM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor Complication

happy to, do you have his email Bill?

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however,

it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with

the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are

threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected

by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message.

Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

Mark A. Horney, From:TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of jbvaughanSent: Thursday, March 03, 2011 2:02 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant DonorComplication Somehow I knew that question wascoming. I would have to look it up on the CMS/Medicare website. Would you mind doing it or look back at the webinar materials and perhaps hiscontact information is there. From:TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Thursday, March 03, 2011 1:55 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant DonorComplication happy to, doyou have his email Bill? Post-Transplant Donor Complication Hello,I have a donor that donated his Kidney in 2005 and nowis having some complications. The recipient at the time of transplant hadMedicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now heis being billed for the professional fees from a different provider. Thatprovider states they have billed Mcare a few times with the recipient’s infoand donor’s info, they made sure it stated that this was related to acomplication from the Kidney donation, but Mcare has denied the claim statingthat recipient was not eligible at time of service. They have billed thedonor and are threatening him to send him to collections. Does anybodyhave any advice on this situation? What else can our Center do to helpthe donor?Thank you, your help is appreciated.Silvia AlfaroFinancial CoordinatorSharp Memorial HospitalKidney/Pancreas Transplant CenterThis message (including any attachments)contains confidential information intended for a specific individual andpurpose, and is protected by law. If you are not the intended recipient, youshould delete this message. Any disclosure, copying, or distribution of thismessage, or the taking of any action based on it, is strictly prohibited.CONFIDENTIAL: The information contained in this communication, including its attachments may contain confidential information and is intended only for the individual (s) or entity (ies) to whom it is addressed . The information contained in this communication may also be protected by legal privilege , federal law or other applicable law. If you are not the intended recipient of this communication , you are hereby notified that any distribution, dissemination or duplication of this communication is strictly prohibited. If you have received this communication in error please immediately delete and destroy all copies of this message and please immediately notify us of the error by separate communication . Thank you.

[Guest guest]

Thank you, we all appreciate itJ From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Danner, SaraSent: Thursday, March 03, 2011 2:07 PMTo: 'TxFinancialCoordinators 'Subject: RE: RE: Post-Transplant Donor Complication MHorneycms (DOT) hhs.gov Sara Danner | Transplant Financial Coordinator | Memorial Medical Center | Springfield, ILPhone: | Fax: | E-mail: danner.sara@... CHOOSE GREAT. CHOOSE MEMORIAL. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of jbvaughanSent: Thursday, March 03, 2011 1:02 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant Donor Complication Somehow I knew that question was coming. I would have to look it up on the CMS/Medicare website. Would you mind doing it or look back at the webinar materials and perhaps his contact information is there. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Thursday, March 03, 2011 1:55 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant Donor Complication happy to, do you have his email Bill? Post-Transplant Donor Complication Hello,I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?Thank you, your help is appreciated.Silvia AlfaroFinancial CoordinatorSharp Memorial HospitalKidney/Pancreas Transplant CenterThis message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

yes, Debbie, I don't have the transcript but somewhere in course of conversation there was discussion that even if the recipient dies after surgery, Part B will be there for the donor and I think Mark stated or implied that therefore, Medicare recognizes that the recipient's past Part B entitlement was sufficient for current donor complication coverage even if the Part B itself were no longer active.

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

Here is the transcript for the webinar.

Debbie Mast

Database Administrator/Financial Manager

Solid Organ Transplant/VAD Program

Stanford Hospital and Clinics

750 Welch Road, Suite 220

Palo Alto, CA 94304

Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal

Transplant Programs

Trustee, TFCA

Phone: Fax:

www.donateLIFEcalifornia.org/stanfordmed

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on,

:LPH Trnsplnt

Sent: Thursday, March 03, 2011 11:19 AM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor

Complication

yes, Debbie, I don't have the transcript but

somewhere in course of conversation there was discussion that even

if the recipient dies after surgery, Part B will be there for the donor

and I think Mark stated or implied that therefore, Medicare recognizes

that the recipient's past Part B entitlement was sufficient for current donor

complication coverage even if the Part B itself were no longer active.

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now

is having some complications. The recipient at the time of transplant had

Medicare A/B, however, it termed three years after transplant, in 2008.

The donor had an ultrasound done in September 2010 at out hospital, but now he

is being billed for the professional fees from a different provider. That

provider states they have billed Mcare a few times with the recipient’s

info and donor’s info, they made sure it stated that this was related to

a complication from the Kidney donation, but Mcare has denied the claim stating

that recipient was not eligible at time of service. They have billed the

donor and are threatening him to send him to collections. Does anybody

have any advice on this situation? What else can our Center do to help

the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments)

contains confidential information intended for a specific individual and

purpose, and is protected by law. If you are not the intended recipient, you

should delete this message. Any disclosure, copying, or distribution of this

message, or the taking of any action based on it, is strictly prohibited.

1 of 1 File(s)

Revised KPD Financial Issues Transcript.doc

[Guest guest]

You’re welcome! I seem to remember a discussion

about that also, but not 100% sure it was during this call….it should be

in the transcript though.

Debbie Mast

Database Administrator/Financial Manager

Solid Organ Transplant/VAD Program

Stanford Hospital and Clinics

750 Welch Road, Suite 220

Palo Alto, CA 94304

Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal

Transplant Programs

Trustee, TFCA

Phone: Fax:

www.donateLIFEcalifornia.org/stanfordmed

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on,

:LPH Trnsplnt

Sent: Thursday, March 03, 2011 11:59 AM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor

Complication

thanks Deb - whether I find the reference or just made it up, I'll

contact Mark and share the response on the listserv

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now

is having some complications. The recipient at the time of transplant had

Medicare A/B, however, it termed three years after transplant, in 2008.

The donor had an ultrasound done in September 2010 at out hospital, but now he

is being billed for the professional fees from a different provider. That

provider states they have billed Mcare a few times with the recipient’s

info and donor’s info, they made sure it stated that this was related to

a complication from the Kidney donation, but Mcare has denied the claim stating

that recipient was not eligible at time of service. They have billed the

donor and are threatening him to send him to collections. Does anybody

have any advice on this situation? What else can our Center do to help

the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments)

contains confidential information intended for a specific individual and

purpose, and is protected by law. If you are not the intended recipient, you

should delete this message. Any disclosure, copying, or distribution of this

message, or the taking of any action based on it, is strictly prohibited.

[Guest guest]

Sorry group, but I am not KIDNEY ….only deal with Heart Liver & Lung, please remove me from all emails that are kidney related, as today along I got over 35. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Jelali, TamaraSent: Thursday, March 03, 2011 1:54 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant Donor Complication I believe you would not bill the recepients Medicare directly however because this was a complication from donating then it would go under acquisition. From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Mast, DeborahSent: Thursday, March 03, 2011 2:49 PMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant Donor Complication [1 Attachment] [Attachment(s) from Mast, Deborah included below] Here is the transcript for the webinar. Debbie MastDatabase Administrator/Financial ManagerSolid Organ Transplant/VAD ProgramStanford Hospital and Clinics750 Welch Road, Suite 220Palo Alto, CA 94304Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant ProgramsTrustee, TFCAPhone: Fax: www.donateLIFEcalifornia.org/stanfordmed From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of on, :LPH TrnsplntSent: Thursday, March 03, 2011 11:19 AMTo: TxFinancialCoordinators Subject: RE: RE: Post-Transplant Donor Complication yes, Debbie, I don't have the transcript but somewhere in course of conversation there was discussion that even if the recipient dies after surgery, Part B will be there for the donor and I think Mark stated or implied that therefore, Medicare recognizes that the recipient's past Part B entitlement was sufficient for current donor complication coverage even if the Part B itself were no longer active. Post-Transplant Donor Complication Hello,I have a donor that donated his Kidney in 2005 and now is having some complications. The recipient at the time of transplant had Medicare A/B, however, it termed three years after transplant, in 2008. The donor had an ultrasound done in September 2010 at out hospital, but now he is being billed for the professional fees from a different provider. That provider states they have billed Mcare a few times with the recipient’s info and donor’s info, they made sure it stated that this was related to a complication from the Kidney donation, but Mcare has denied the claim stating that recipient was not eligible at time of service. They have billed the donor and are threatening him to send him to collections. Does anybody have any advice on this situation? What else can our Center do to help the donor?Thank you, your help is appreciated.Silvia AlfaroFinancial CoordinatorSharp Memorial HospitalKidney/Pancreas Transplant CenterThis message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited.CONFIDENTIAL: The information contained in this communication, including its attachments may contain confidential information and is intended only for the individual (s) or entity (ies) to whom it is addressed . The information contained in this communication may also be protected by legal privilege , federal law or other applicable law. If you are not the intended recipient of this communication , you are hereby notified that any distribution, dissemination or duplication of this communication is strictly prohibited. If you have received this communication in error please immediately delete and destroy all copies of this message and please immediately notify us of the error by separate communication . Thank you.

[Guest guest]

, the e-mails go to all who are signed up for the list

serv and, unfortunately, cannot be segregated by organ type.

Debbie Mast

Database Administrator/Financial Manager

Solid Organ Transplant/VAD Program

Stanford Hospital and Clinics

750 Welch Road, Suite 220

Palo Alto, CA 94304

Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal

Transplant Programs

Trustee, TFCA

Phone: Fax:

www.donateLIFEcalifornia.org/stanfordmed

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Storey,

Sent: Thursday, March 03, 2011 12:40 PM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor

Complication

Sorry group, but I am not KIDNEY

….only deal with Heart Liver & Lung, please remove me from all emails

that are kidney related, as today along I got over 35.

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Jelali,

Tamara

Sent: Thursday, March 03, 2011 1:54 PM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor

Complication

I believe you would not bill the

recepients Medicare directly however because this was a complication from

donating then it would go under acquisition.

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Mast,

Deborah

Sent: Thursday, March 03, 2011 2:49 PM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor

Complication [1 Attachment]

[Attachment(s)

from Mast, Deborah included below]

Here is the transcript for the webinar.

Debbie

Mast

Database Administrator/Financial Manager

Solid Organ Transplant/VAD Program

Stanford Hospital and Clinics

750 Welch Road, Suite 220

Palo Alto, CA 94304

Heart,

Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs

Trustee,

TFCA

Phone:

Fax:

www.donateLIFEcalifornia.org/stanfordmed

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on,

:LPH Trnsplnt

Sent: Thursday, March 03, 2011 11:19 AM

To: TxFinancialCoordinators

Subject: RE: RE: Post-Transplant Donor Complication

yes,

Debbie, I don't have the transcript but somewhere

in course of conversation there was discussion that even if the

recipient dies after surgery, Part B will be there for the donor and I

think Mark stated or implied that therefore, Medicare recognizes that the

recipient's past Part B entitlement was sufficient for current donor

complication coverage even if the Part B itself were no longer active.

Post-Transplant Donor Complication

Hello,

I have a donor that donated his Kidney in 2005 and now

is having some complications. The recipient at the time of transplant had

Medicare A/B, however, it termed three years after transplant, in 2008.

The donor had an ultrasound done in September 2010 at out hospital, but now he

is being billed for the professional fees from a different provider. That

provider states they have billed Mcare a few times with the recipient’s

info and donor’s info, they made sure it stated that this was related to

a complication from the Kidney donation, but Mcare has denied the claim stating

that recipient was not eligible at time of service. They have billed the

donor and are threatening him to send him to collections. Does anybody

have any advice on this situation? What else can our Center do to help

the donor?

Thank you, your help is appreciated.

Silvia Alfaro

Financial Coordinator

Sharp Memorial Hospital

Kidney/Pancreas Transplant Center

This message (including any attachments)

contains confidential information intended for a specific individual and

purpose, and is protected by law. If you are not the intended recipient, you

should delete this message. Any disclosure, copying, or distribution of this

message, or the taking of any action based on it, is strictly prohibited.

CONFIDENTIAL: The information contained in

this communication, including its attachments may contain confidential

information and is intended only for the individual (s) or entity (ies) to whom

it is addressed . The information contained in this communication may also be

protected by legal privilege , federal law or other applicable law. If you are

not the intended recipient of this communication , you are hereby notified that

any distribution, dissemination or duplication of this communication is

strictly prohibited. If you have received this communication in error please

immediately delete and destroy all copies of this message and please

immediately notify us of the error by separate communication . Thank you.

[Guest guest]

Awesome info. But I cant see the transcript. Can you email it to me directly?

Thanks,

>

> You're welcome! I seem to remember a discussion about that also, but not 100%

sure it was during this call....it should be in the transcript though.

>

> Debbie Mast

> Database Administrator/Financial Manager

> Solid Organ Transplant/VAD Program

> Stanford Hospital and Clinics

> 750 Welch Road, Suite 220

> Palo Alto, CA 94304

> Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant

Programs

> Trustee, TFCA

> Phone:

begin_of_the_skype_highlighting                    end_of_the_skype_\

highlighting Fax:

> www.donateLIFEcalifornia.org<http://www.donatelifecalifornia.org/>/stanfordmed

>

> [cid:image004.png@...]

>

>

>

> From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of on,

:LPH Trnsplnt

> Sent: Thursday, March 03, 2011 11:59 AM

> To: TxFinancialCoordinators

> Subject: RE: RE: Post-Transplant Donor Complication

>

>

> thanks Deb - whether I find the reference or just made it up, I'll contact

Mark and share the response on the listserv

> Post-Transplant Donor Complication

>

> Hello,

> I have a donor that donated his Kidney in 2005 and now is having some

complications. The recipient at the time of transplant had Medicare A/B,

however, it termed three years after transplant, in 2008. The donor had an

ultrasound done in September 2010 at out hospital, but now he is being billed

for the professional fees from a different provider. That provider states they

have billed Mcare a few times with the recipient's info and donor's info, they

made sure it stated that this was related to a complication from the Kidney

donation, but Mcare has denied the claim stating that recipient was not eligible

at time of service. They have billed the donor and are threatening him to send

him to collections. Does anybody have any advice on this situation? What else

can our Center do to help the donor?

> Thank you, your help is appreciated.

> Silvia Alfaro

> Financial Coordinator

> Sharp Memorial Hospital

> Kidney/Pancreas Transplant Center

>

> ________________________________

> This message (including any attachments) contains confidential information

intended for a specific individual and purpose, and is protected by law. If you

are not the intended recipient, you should delete this message. Any disclosure,

copying, or distribution of this message, or the taking of any action based on

it, is strictly prohibited.

>