Finances and Insurance

Hospital Costs for a Liver Transplant

At times, the cost of a liver transplant may seem overwhelming. The Children’s Liver Transplant team is here to help you. A financial counselor can help you learn about your insurance benefits and payment options.

Liver transplant costs may be covered by a health insurance policy, a managed care plan, a government medical assistance plan or other means. We work with a full range of third-party payors and will work with you to develop a financial plan for your particular coverage.

The evaluation and testing, as well as the liver transplant surgery, hospital stay, follow-up care and medications are included in the liver transplant costs. A patient’s insurance coverage plays a vital role, whether it is through a private company or a governmental program. It is important that each patient’s family fully understands the amount of financial coverage that is available. Here are some of the most important questions to ask your insurance company as you begin to consider liver transplant as a treatment option.

  • Is liver transplant a covered benefit?
  • Is there a maximum allowance on liver transplant and liver transplant-related services?
  • Is there a maximum allowance on procurement of the liver?
  • Is there a lifetime maximum or “cap” on the policy?
  • Is there adequate coverage for post-transplant medications?
  • What is the annual “out-of-pocket” maximum amount on the policy?

The Children’s Liver Transplant financial counselor can:

  • Contact your insurance company and find out about your child’s benefits
  • Get approval for evaluation and liver transplant
  • Meet with you through the liver transplant evaluation to review your insurance benefits
  • Answer benefits questions
  • Help assess your financial needs
  • Talk about making a long-term financial plan for your child’s healthcare needs
  • Help get your child into a case management program if your insurance company has this service
  • Help you learn about government programs for which you qualify
  • Teach you about hospital and doctor billing practices

Financial counselors at Children’s can also help you with:

  • Financial aid packets for the Charitable Hospital Fund. Aid is based on federal poverty guidelines and other financial guidelines.
  • Questions regarding Medicare, Medicaid, Georgia’s PeachCare for Kids program, hospital and doctor payment plans.
  • What government assistance your child can receive. The counselor can help you fill out forms and paperwork. There may be a lot of paperwork to complete. Fill out all the forms as soon as possible. The sooner the papers are sent, the sooner you may qualify for benefits. This process may take weeks or months to complete.

Insurance Companies

Children's contracts with many different insurance providers for transplant services. It is important that you know about your insurance policy.

Helpful Hints:

  • Ask someone in the human resources department where you work to explain your benefits.
  • If your child’s doctor or hospital is not “in-network,” please contact your insurance company to discuss your co-insurance rates and out-of-pocket costs.
  • Your insurance company may ask you to give them a letter of medical necessity so your child can be treated at Children’s. Please contact the hospital financial counselor to help you get this information from your child’s liver transplant surgeon.
  • Bring a copy of your insurance card each time you visit the hospital. It lists your benefits, deductible and co-payment amounts.
  • Be sure to tell the Children’s Liver Transplant office right away of any changes in your address, phone number or insurance coverage.

Helpful Hints in the Billing Process

You will receive bills from several places: hospital bills known as technical or facility fees, and doctor bills known as professional fees.

  • If you have a question about a bill, please call the phone numbers listed on your billing statement.
  • Make a file for hospital bills and insurance forms. This will help you to track payment, denials and requests for more information.
  • You may need to call your insurance company to ask questions about the liver transplant. Ask to speak to someone that can answer liver transplant benefits questions.

Below is a list of common offices that will send you bills:

  • Children’s Healthcare of Atlanta for all services received at any of the Children’s hospitals or satellite locations
  • Emory Children’s Center for any doctor-related services
  • Emory Clinic for any radiology, pathology and anesthesiology services
  • Other staff or doctors who care for your child

Read bills closely. You may receive statements that are still pending payment. These statements are for your records and are not bills. Please respond to all inquiries from your child’s caregiver’s billing offices or your insurance company.

For more information, please contact the Children’s transplant financial counselors at 404-785-6478.