What is a deductible?
A set amount owed for health care services by the patient prior to the health insurance or plan begins to pay.
What does “Out of Pocket” limit mean?
This is the maximum patient financial responsibility within a plans benefit year. Some health insurance plans don’t count all of your co-payments, deductibles, co-insurance payments, out-of-network payments or other expenses toward the limit.
What does In-Network vs Out-of-Network mean?
In network means there is an established contract between the provider and insurance company and out of network suggests there are no contracts between the provider and insurance company.
In order to maximize the insurance coverage and minimize patient costs insurance companies recommend accessing In Network providers. Some health insurance plans may not cover out-of-network or increase the deductible and co-insurance limits.
What does 80/20 or 70/30 mean related to out-of-pocket costs to me?
Co-insurance assigned responsibilities. The first number indicates insurance responsibility and the second number is the patient’s financial responsibility. The co-insurance applies to the Out of Pocket.
What is Preauthorization?
A decision by the health insurance plan that a health care service, treatment plan, or transplant is medically necessary.
We have a dedicated team of Transplant Financial Coordinators that obtain the Transplant Consult, Transplant Evaluation, Donor Evaluation and Transplant event authorizations. All other service authorizations are usually obtained by the ordering physician practice.
The Transplant Finance Team with over 80 years of experience is dedicated to provide guidance and support to maximize the health insurance benefits of every patient. Our mission is serving humanity to honor God by providing exceptional and cost-effective health care, accessible to all.
***Please contact your assigned Transplant Financial Coordinator for any insurance benefit questions, concerns, or any changes of insurance coverage****
In order for us to provide you with excellent service. Please have your Insurance and Pharmacy Card readily available or submit to your assigned Transplant Financial Coordinator listed below.
Lety De La Zerda: Transplant Financial Coordinator Team Lead (Alpha A-G)
Phone: (210)575-7363; Fax: (210) 510.7029; Email: Leticia.Delazerda@mhshealth.com
- Ten-year expertise as a Bone Marrow Transplant Financial Coordinator.
- Three-year knowledge registering and Hospital financial counseling.
- Six-year experience with assisting patients to obtain government assistance programs.
Maria Lungstrom: Transplant Financial Coordinator (Alpha H-R)
Phone: (210) 575-4776; Fax: (210) 510-6327; Email: Maria.Lungstrom@mhshealth.com
- Five-year experience as a Transplant Financial Coordinator.
- Five-year background billing for the Bone Marrow Transplant physicians.
- Seven-year familiarity of insurance verification and billing with a private practice.
Cindy Pribyla: Transplant Financial Coordinator (Alpha S-R)
Phone: (210) 575-8082; Fax: (210) 510-7627; Email: Cynthia.Pribyla@mhshealth.com
- Half a year experience as a Transplant Financial Coordinator
- Over fifteen-year background in insurance verification and in obtaining authorizations for high cost procedures.
Christina Perdue: Global Billing Analyst
Phone: (210) 575-3798; Fax: (210) 510-6885; Email: Marisa.Perdue@mhshealth.com
- Over a year experience billing for our Global Transplant patients.
- Ten-year understanding of insurance payment collections and underpayments making certain that the insurance company reimburses providers accurately.
- Four-year background with Health Information Management
Matias A Pelaez: Manager Transplant Finance
Phone: (210) 575-8533; Fax: (210) 510-6534; Email: Matias.Pelaez@mhshealth.com
- Five-year experience with the Transplant Program as a Financial Coordinator, billing, and reimbursement analyst.
- Two-year background assisting patients to obtain government assistance programs.
- Five-year knowledge in domestic/International Insurance verification/authorization.