All transplant centers should identify one or more staff members who will be responsible for coordinating and clarifying patient-specific financial aspects of care. The Financial Coordinator shall be a designated member of the transplant team and will be assigned primary responsibility for coordinating financial aspects of care. The Coordinator will work with patients and their families beginning with the evaluation for transplantation and continuing through and after transplantation, in a compassionate and tactful manner in order to help facilitate access to
and provide continuity of care. The Coordinator will also work with other members of the transplant team, insurers and administrative personnel at the Transplant Center.
Specific responsibilities should include, but are not limited, to:
1. Obtaining detailed patient insurance benefit information for all aspects of the transplant process, including, but not limited to, outpatient prescription drugs, organ acquisition, follow-up clinic visits, and travel and housing if necessary.
2. Discussing benefits and other transplant financial issues with patients and/or family members during initial evaluation.
3. Advising patients on insurance and billing issues and options. Serving as a resource for patients and their family members on financial matters.
4. Obtaining all necessary payor authorizations. Verifying transplant coverage and other medical benefits and acquiring necessary referrals and authorizations.
5. Monitoring and updating information regarding insurance data, physicians, authorizations, and preferred providers. Assisting patients with questions concerning insurance and other financial issues.
6. Identifying and effectively communicating financial information to transplant team members, patients and their families with emphasis on identifying any potential patient out-of-pocket liability.
7. Working with patients, their families and team members when possible to help address insurance coverage gaps via alternative funding options.
8. Facilitating resolution of patient billing issues.
(Click here to link to the full By-Laws description on the UNOS Web Site)