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Pediatric Bone Marrow Transplant: A Guide for Families
Cost/Insurance
Geri Quinn, RN, MSN and Janine Petitgout, RN, MA
Peer Review Status: Internally Peer Reviewed
Prior to your
child's admission to The University Hospitals' PBMT unit, a number of people here
have been working as a team with your insurance company to reduce your costs and
the possibility of problems arising in the future. The team consists of the PBMT
coordinator, financial management and your PBMT social worker. The transplant
coordinator identifies with the physician what pre-transplant tests, donor searching,
etc. will be necessary in your child's case. The PBMT coordinator acts as a liaison
between the hospital and your insurance company obtaining specific benefit information
and making sure that the insurance company has the information they need (i.e.,
letter of medical necessity from the doctor). When the benefits you have under
your insurance policy have been identified, financial management personnel will
go over your coverage and the areas where you may lack coverage. For example,
some insurances will not pay for donor searching or donor testing while others
have a "cap", a limited amount of dollars that are available for these services.
Examples of services that may not be covered may include dental visits for your
child and diapers. (This is often viewed as a normal family expense.) Some homegoing
supplies may be cheaper when purchased from a drug store than from the hospital.
If you want to submit your costs to the insurance company, you may be able to
save some by shopping yourself; however, most drug stores do not carry all of
the supplies you need or may not have them in the quantity you desire. In any
case, personnel from the business office will be able to help you understand your
coverage for transplant-related expenses.
If it appears that your insurance will not pay for a significant amount of
your child's medical expenses, you may wish to speak with the PBMT social worker.
He/she will be able to assess your family's financial situation and recommend
appropriate assistance programs for which you may be eligible. In some instances,
there may also be funding available to assist with transportation and living
expenses while you are here with your child.
If you still end up having outstanding medical bills, you may wish to set up
a payment plan with the hospital's billing department located on the first floor
between Elevators B and C. Keep in mind that you will receive two types of bills,
one for hospital services and one for medical services. The following tips may
be helpful to you as you try to make sense of your finances:
1. Keep good records. Keep copies of all the bills you receive.
If you believe a mistake was made, good records will help you straighten things
out. You should record the following:
- a. Bills when received.
- b. Phone conversations and personal visits to the billing department.
- c. Your payment towards each bill.
- d. The insurance payments toward each bill.
2. Keep a copy of your insurance card with you.
3. Bring insurance forms and mailing address for bills.
4. Make a monthly payment on every bill. Remember that you will receive
two each month, one for medical services, the other for hospital services.
You will need to pay a little on each one in order to keep your account active.
If you have difficulty paying each month, you should let the billing department
know. In many cases, this will keep your bills from being turned over to a
collection agency and ruining your credit rating.
5. It is "okay" to question your bills. If you have a question, you
can ask for a detailed copy of your bill that shows each charge. You may request
an audit if you think an error was made or there is a duplication of charges.
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