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- W1987448424 abstract "Stem cell transplantation (SCT) is an innovative treatment of hematological malignancies and offers potential long-term survival. SCT services offered at one of the largest transplant centers in the country include: autologous, allogeneic and cord blood transplant. Frequently, it is a challenge to obtain transplant financial coverage because of the high-cost of treatment and insurance carriers considering the treatment experimental. The SCT Patient Access Staff, which include RN's and Patient Access Specialists, handle this complex process daily. Strategies employed to assure transplant approval from insurance carriers are: 1) A letter of medical necessity is sent to the insurance company with a clinical dictation from the SCT physician explaining the plan of treatment and outlining the experience and success rate of the treatment, 2) The patients are informed of their treatment so they can actively participate in the approval process with their insurance carriers, 3) A professional working relationship with the insurance Case Manager is established as they are also patient advocates, 4) Patients are encouraged to research and learn about their rights, state laws and to seek available advocacy programs, 5) An appeal is completed for in-network benefits if transplant services are out-of-network. The Patient Access Coordinators work closely with the managed-care office to negotiate the transplant cost between the insurance company and the institution, 6) The insurance medical director or Case Manager are invited to the SCT program conference in which the latest trends in transplantation are presented. Very few patients have the financial means to pay for transplant without insurance coverage. The strategies employed enable patient's access to the most innovative treatment for cancer at one of the largest transplant facilities. Patients who are well-informed of their treatment can make proper medical and financial decisions regarding their SCT." @default.
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- W1987448424 date "2008-02-01" @default.
- W1987448424 modified "2023-09-26" @default.
- W1987448424 title "429: Obtaining Financial Coverage for Stem Cell Transplantation: Utilizing Creative Strategies" @default.
- W1987448424 doi "https://doi.org/10.1016/j.bbmt.2007.12.439" @default.
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