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Heart Transplant Online Manual

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If you find information on a web site, show it to your transplant coordinator to make sure it is medically correct. Reliable web sites include:

Financial information

You may have concerns about your insurance and the cost of the surgery and recovery. These concerns can be overwhelming.

Thinking about money issues before surgery can help relieve some stress.

The costs of the transplant can be divided into:

  • evaluation
  • surgery
  • after-surgery care.

Sources to pay for medical expenses include health insurance or COBRA benefits, Medicaid or Medicare, CHAMPUS (Civilian Health and Medical Program of the Uniformed Services), charitable organizations or fundraising.

Other costs include living expenses while you are away from home and transportation to and from the hospital for appointments, tests, surgery or follow-up care.

These costs are usually not covered by insurance. They are your responsibility.

General guidelines

    Read your insurance plan.

    • Know if your insurance plan:
    • —has "approved providers." (You may need to receive care at a certain hospital or clinic.)

      —requires "pre-certification" for hospital stays, or "prior authorization" for appointments or procedures

      —requires a referral from your regular doctor before you can go to the transplant center.

    • Following your insurance requirements will help make sure that your care will be covered.
    • Call your insurance provider if you have any questions about your coverage.

    Call the transplant office if you change insurance plans or if your insurance ends.

    • Changing plans will affect the benefits you receive.
    • Be sure you know how any changes will affect your care. (For example, you may be required to change doctors.)
    • The financial operations supervisor will fill out the authorization for the surgery. This is done when you are accepted and listed on the national transplant list.
    • The financial operations supervisor will coordinate with your insurance company.
    • —He or she will coordinate information and get updated approvals for the heart surgery while you are on the transplant list.

      —Important: Tell the financial operations supervisor of any changes with your insurance as soon you know about them.

    Organize your insurance papers.

    • Create a filing system for papers including your insurance policy and any information you receive.
    • File bills and receipts by provider in the order in which they occur.

    Talk with your insurance provider and transplant coordinator.

    • Complete your insurance provider's requirements.
    • Talk to the transplant coordinator about any "pre-certification" requirements before any hospital stay.
    • Check with your insurance plan or regular doctor to get any required "prior authorizations" or "referrals."
    • Your clinic may require that lab work or other services be done at a certain hospital or clinic.
    • Tell the transplant coordinator when you talk about scheduling a hospital stay, appointment, procedure or test. Your transplant health care team will work closely with your regular doctor and clinic to coordinate your care.

    If there is a problem with any bill, call right away.

    • If you have a question or problem with a medical bill, call the phone number on the bill. This may help prevent a future problem.
    • If calling the provider doesn't solve the problem, call the transplant financial operations supervisor at 612-863-3652.
    • Keep notes of all phone conversations you have.
    • —Write down the date and time of your conversation, name of the person you spoke to, and a brief summary of what you talked about.

    Ask for help when needed.

    • The financial operations supervisor and social worker are available to help with your questions, concerns or problems.
    • They will work with you or your family members to find financial resources or resources that may be available.
    • Finish any applications or paperwork required.

 

Source: Allina Health's Patient Education Department, Care After Heart Transplant, cvs-ahc-95405 (4/13)

First published: 01/06/2013
Last updated: 01/06/2013

Reviewed by: Allina Health's Patient Education Department