Meet the Experts: Transplant Financial Services

May 11, 2021 | Kristin Eggebraaten | @keggebraaten

One of the most complex and important aspects of transplant evaluation and surgery is your financial situation and insurance coverage. Between commercial insurance, hospital billing, and Medicare coverage, many of us are dealing with a complex system of financial agencies and worries before and after transplant. At Mayo Clinic, we have a team of financial experts who can assist our patients with their questions and collaborate with their insurance companies to be sure there are no surprises when it comes to bills and coverage.Meet the Experts:Finance

We want to introduce you to this very large group of experts at Mayo Clinic so you can learn more about how they can assist you and your family with your transplant journey. The team we interviewed is from all three Mayo Clinic locations in Rochester, MN, Jacksonville, FL, and Phoenix, AZ.

Describe your teams’ job and role on the care team.

The Transplant Financial Team interacts and collaborates with insurance companies, patients, Transplant Clinical Care Team, and other departments to ensure the financial wellbeing of the patient as they progress through their transplant care.

We verify insurance coverage for our transplant patients. We work before, during and after transplant to ensure the patients’ insurance coverage is in place. We monitor the status of the patients throughout the process to ensure they are covered financially, and we make sure to communicate clearly with patients regarding their benefits and limitations.  We want our patients to know with confidence they have a dedicated team at Mayo Clinic.

What is the best part about your work?

It is very rewarding to work on a complex/challenging case for a patient and know they have had a successful transplant experience. We are one of the initial contacts that a patient has at Mayo Clinic, and we get to follow them throughout their transplant journey until they receive their life-saving organ. Easing patient’s financial concerns during their transplant journey is one of the highlights of our jobs. It is very rewarding to obtain approvals for a patient’s transplant.

What is the most challenging part of your job?

It can be very challenging to work with insurance company guidelines and timeframes to obtaining approvals for patients.  It can also be challenging when there are communication discrepancies between member services and provider services.

It’s never fun to discuss out-of-network plans or self-pay amounts with patients. We sympathize with patients’ situations and want to help as best as we can.

What type of information should patients know about their financial situation prior to undergoing a transplant?

Understanding what insurance coverage, they have such as:

  • Benefits
  • Coverage for specific facilities
  • In Network vs. Out of Network
  • Is a Referral needed
  • Exclusions on the policy

Patients need to understand that transplant is a lifelong financial commitment. They should have a thorough understanding of their coverage through the entire process before they get started from evaluation pre-transplant, surgery and all the way through post-transplant follow-up. They need to know their deductibles, co-pays and co-insurance information to avoid surprise expenses. And finally, they need to understand that this surgery requires continuous treatment for life. 

What does a typical visit with the financial team include?

Right now all the visits are performed over the phone. The Transplant Financial Team will meet with the patient during their transplant evaluation to do an insurance and financial review.

We discuss:

  • The patient’s coverage and make sure that we have updated the patient’s account with correct payer information.
  • Update Medicare #’s if necessary.
  • Deductibles, out of pocket expenses, co-insurance, co-pays, and pharmacy coverage.
  • We go over transplant benefits, travel and lodging if it’s available to the patient.
  • We provide the contact # for travel and lodging if available so the patient can reach out.
  • Depending on the organ, we’ll discuss donor benefits. And for kidney patients we confirm dialysis type and start date.

What should patients bring with them to a financial visit?

  • All current Insurance cards
  • Notepad to take notes
  • Come prepared to ask questions and communicate any challenges/concerns during the appointment.
  • Caregiver
  • Be in a place where there are no distractions to have a focus on the financial visits.

What are some things you wish patients would ask you?

It’s important for patients to understand coordination of benefits and how this impacts them.  They need to know why it’s important to contact Transplant Financial when there is a change or update to their insurance and understand the impacts when these changes occur. Patients need to know there is a difference between general medical and transplant benefits.

Our team always provides their contact information to make sure the patient can reach out to the Transplant Financial Team with any insurance or coverage related questions/concerns they may have.

What will patients and families find at Mayo Clinic that will give them the best experience possible?

The Transplant Financial Team has a culture of putting the needs of the patient first by working extensively on our patient cases prior to the patient’s transplant journey. We want to ensure the patient is educated about financial and insurance information including understanding their benefits. We offer quick, informative communication along with excellent customer service and guidance.  The dedication, continued support, education and research, and an amazing feeling that they finally found the right team to help.

Is there anything else you would like patients to know about the Transplant Financial Team?

We are always here to help navigate and educate our patients with their insurance.  We strongly encourage any/all patients to call us prior to making any insurance changes.

HELPFUL LINKS

Interested in more newsfeed posts like this? Go to the Transplant blog.

Please sign in or register to post a reply.
  Request Appointment