Sanderling Clinics are certified by the Centers for Medicare & Medicaid Services(CMS). Sanderling participates in the Medicare program. Medicare covers in-center and home dialysis. You must have both Medicare Part A and Medicare Part B coverage for dialysis services to be paid by Medicare. Medicare pays for 80% of the ‘Allowable Amount’, less any deductible. The Allowable Amount is the fee established by the Medicare program for a bundle of goods and services related to dialysis. This includes the cost of the dialysis treatment in the clinic or your home, certain laboratory tests which are routinely performed to monitor the adequacy of dialysis, the presence and possible cause of anemia, evidence of metabolic bone disease and secondary hyperparathyroidism, nutritional status, and miscellaneous other body chemistries. In addition, the bundle includes certain drugs used to correct anemia, iron deficiency, and vitamin D deficiency. The fee also includes equipment that is used by home patients for the performance of dialysis.
Medicare patients are responsible for paying the amount of the deductible and the coinsurance amount (20% of the allowable). These amounts are usually covered by ‘Medi-Gap’ insurance policies and/or Medicaid. Patients are responsible for amounts that are not covered by those secondary sources. Sanderling has financial counselors and social workers who can discuss and arrange for a reduction in the payment due from a patient, based on the person’s ability to pay.
Social Workers are also available to assist patients with enrollment in the Medicaid program and other entitlement programs. This assistance includes helping the patient determine if he or she is qualified under one of the entitlement programs, and if so, assistance with the application.