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TFC Survey 2012 The Pulse of the Nation. Debbie Mast Stanford Hospital and Clinics, Database Administrator and Financial Manager Amy Hackney, MBA Manager, Transplant Reimbursement Tulane Transplant Institute TFCA Workshop September 18-20 th , 2013. TFC Survey 2012. 1 st Survey – 1997

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TFC Survey 2012 The Pulse of the Nation

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Tfc survey 2012 the pulse of the nation

TFC Survey 2012The Pulse of the Nation

Debbie Mast

Stanford Hospital and Clinics,

Database Administrator and Financial Manager

Amy Hackney, MBA

Manager, Transplant Reimbursement

Tulane Transplant Institute

TFCA Workshop

September 18-20th, 2013

Tfc survey 2012

TFC Survey 2012

  • 1st Survey – 1997

  • 2nd – 2002

  • 3rd – 2007

  • Who participated in the survey?

    • Transplant Administrators

    • Transplant Financial Coordinators – Solid Organ and BMT

2012 survey focus

2012 Survey Focus

  • Program volumes

  • FTE’s

  • Educational requirements

  • Reporting Structure

  • Salaries

  • Job duties and responsibilities

  • Certification

How was the survey conducted

How was the survey conducted?

  • E-mail via TFCA and Administrators List serves with link to survey


  • Secure and confidential

  • Professional online survey

  • Results collected and compiled

    Reminder notices were sent out encouraging everyone to complete along with passing along to other team members who might not be on the list serves.

Response rate by survey year

Response Rate by Survey Year

  • 133 of 274 (49%) of transplant centers responded to 1998 survey

  • 130 of 257 (51%) of transplant centers responded to 2002 survey

  • 147 of 261 (56%) of transplant centers responded to 2007 survey

  • 158 of 250 (63%) of transplant centers responded to 2012 survey

    67 Administrators and 175 TFC’s responded to the survey

Unos regional map

UNOS Regional Map

Tfc survey 2012 the pulse of the nation

Administrator Responses by Region

Types of transplants performed

Types of Transplants Performed

Number of referrals per calendar year

Number of Referrals per Calendar Year

How many transplants per year

How Many Transplants per Year?

Let s take another look

Let’s Take Another Look…

Are the transplant financial coordinators dedicated to the transplant program

Are the Transplant Financial Coordinators Dedicated to the Transplant Program?

Of the 4 centers responding NO; 3 Region 10 and 1 Region 3

Who handles the responsibilities of the tfc if there is no primary tfc dedicated

Who handles the responsibilities of the TFC if there is no primary TFC dedicated?

Social Worker 3%

Billing/Collections Representative 1.5%

Other (shared position) 1.5%

How many transplant financial coordinators fte s are assigned by program

How Many Transplant Financial Coordinators (FTE’s) are Assigned by Program

One Liver Program and One Kidney program had > 5 FTE’s per Organ

Program examples of fte per referrals transplants

Program Examples of FTE per Referrals/Transplants

Who is the tfc employed by

Who is the TFC Employed by?

Hospital/Medical Center – 63, 94%

Physicians Group – 1, 1.5%

Patient Financial group (Billing/PFS) – 2, 3%

Outside Contracted Agency - 1, 1.5%

Who does the tfc report to

Who does the TFC Report to?

  • Supervisor - Financial Coordinators 7.6%

  • Manager - Financial Coordinators 19.7%

  • Admissions Manager/Director 4.5%

  • Transplant Administrator 50%

  • Contracting Manager/Director 3%

  • Patient Accounts Manager/Director 9.1%

  • Other (includes: Medical Director; Program Manager; Operations Manager; Business Manager; Supervisor of Operations) 19.7%

Minimum education requirements

Minimum Education Requirements


BA Business; SW for combined role;

BA preferred; don’t know

Out of 64 respondents: 37 HS/GED; 5 AS/AA; 15 BS/BA; 1 Masters; 6 Other

Experience required

Experience Required

In comparison to 2007 survey:

0-2 years 31% increased by 16%

2-5 years 57% decreased by 10%

5-8 years 12% decreased by 7%

8 or more years 0% increased by 1%

Area of experience required

Area of Experience Required

Salary range

Salary Range


In comparison to 2007 survey:

Salaries above 35k in 2007 encompassed 59.5% of TFC’s

In 2012, 64.5% of TFC’s salaries are above 35k

Salary range by region

Salary Range by Region

On what position is salary based

On what Position is salary Based?

Similar positions within the hospital 80.3%

Specifically on TFC position 19.7%

Additional Compensation includes:

Overtime 60.9%

Compensatory Time 14.1%

Education and Travel expenses 71.9%

Call Pay 9.4%

Annual Bonus 17.2%

On call days

On-call Days


# Days on-call

Would your center be willing to pay for tfc certification

Would your Center be willing to Pay for TFC Certification?

66.2% - YES

7.7% - NO

16.9% - Maybe

9.2% - Not Sure

How do our administrators feel

How do our Administrators feel?

The TFC role is a requirement of the OPTN for transplant center membership. Education and certification will only help to emphasize the need for development of these positions within the transplant program.

We can't really have enough resources or expertise in this area.

I believe the certification of TFC's is very important to the organization and its credibility.

A certification program would allow us (administrators) to lobby for higher pay and stand along titles as we could establish the field better than we currently can

How do our administrators feel1

How do our administrators feel?

TFCs are one of the most under valued team members on the Transplant team. Somewhat due to lack of professional development opportunities. Please let us know how to better help develop this profession.

TFC is an excellent organization

This is a specialized position and very demanding. We would welcome certification to justify appropriate compensation for the role.

It would be awesome if you can provide certification for our team members. It will help internally to further differentiate them from the rest of the hospital employees as specialty trained

Tfc survey 2012 the pulse of the nation

Now It’s Our Turn

What Did the TFC’s have to say...

Tfc responses by region

TFC Responses by Region

What programs are the tfc s assigned to

What Programs are the TFC’s Assigned to?

Kidney = 122; Liver = 74; Lung = 32; Heart = 51; Pancreas = 73; Intestine = 12; Bone Marrow = 37



Primary method of training

Primary Method of Training

Training other

Training (other)

  • None provided

  • Prior experience

  • TFCA Forums

  • Supervisors

  • Training manual

  • “On my own”

  • “I had no help, I learned as I worked”

  • “I winged it”

  • Self trained

How long at your current position

How Long at your Current Position?

Educational level

Educational Level

Professional certifications or licensures

Professional Certifications or Licensures

Full time tfc

Full-Time TFC?

Do you have more than one role

Do You Have More Than One Role?

97 respondents reported they have a dual role in their program

  • 7 (7.2%) spend 0 - 10% of time as a TFC

  • 2 (2.1%) spend 10 - 20% of time as a TFC

  • 2 (2.1%) spend 20 - 30% of time as a TFC

  • 3 (3.1%) spend 30 - 40% of time as a TFC

  • 4 (4.1%) spend 40 - 50% of time as a TFC

  • 3 (3.1%) spend 50 - 60% of time as a TFC

  • 6 (6.2%) spend 60 - 70% of time as a TFC

  • 7 (7.2%) spend 70 - 80% of time as a TFC

  • 8 (8.2%) spend 80 - 90% of time as a TFC

  • 56 (57.7%) spend 90 - 100% of time as a TFC

> 82%

Hours worked

Hours Worked

The average responding TFC works 42 hours per week

Median hours = 40

Coverage availability during tfc absence

Coverage Availability During TFC Absence

Who is covering

Who is Covering?

TFC’s noted that coverage is typically only for URGENT issues that arise in their absence

Tfc job responsibilities

TFC Job Responsibilities

Attend patient selection 87.2%

Obtain insurance precerts for transplant admissions 87.2%

Verify RX benefits 77.3%

Maintain database for financial screenings 73.8%

Obtain insurance precerts for pre/post transplant services 73.8%

Research and explore alternate funding sources 71.5%

Obtain referrals for pre/post transplant outpatient services 64.5%

Coordinate contractual arrangements 55.8%

Monitor federal/commercial industry reimbursement changes 52.3%

Follow inpatient admissions (admitting office function) 51.2%

More responsibilities

More Responsibilities

Assist patients in completing Medicaid applications 43.0%

Verify RX benefits and obtain auths 37.8%

Assist patients in completing Medicare applications 34.3%

Prepare monthly financial reports 32.6%

Register patients (outpatient registration function) 29.1%

Assist patients in applying for manufacturer grants for RX 29.1%

Obtain RX auths 22.7%

Make payment arrangements for patient liabilities 22.1%

Additional duties noted as: Monitor clinic and inpatient accounts for charge capture and coding; Assist with Medicare D applications; RFI’s; VAD authorizations; Re-pricing claims; Policy and procedure development; clinical trial approvals

Average time spent on tasks

Average Time Spent on Tasks

Of tfc s responding to completion of tasks

% of TFC’s Responding to Completion of Tasks

Inpatient account handling: follow admit, notify case manager, update benefits93.7%

Outpatient registration90.3%

Handling patients' billing questions/billing problem resolution for transplant-related claims94.9%

Billing and collecting on transplant accounts90.9%

Informing patient/family of insurance benefits for transplant; advising of other funding options98.3%

Obtaining transplant approval and other ongoing communications with insurers97.1%

Verifying insurance coverage for transplantation97.7%

Prescription verification/authorizations93.7%

Patient educational classes

Patient Educational Classes

71.2% of respondents advised their programs offer/they participate in education classes to their patients

Tfc provides coverage for

TFC Provides Coverage for:

Tfc provides services for

TFC Provides Services for:

Staff education

Staff Education

On-site seminars

Off-site seminars

Self-guided manuals

TFCA Resource Guide

TFCA List serv

Medicare Manuals


UNOS Conference



None offered

Funding for off site seminars conferences

Funding for Off-Site Seminars/Conferences

10.1% of respondents advised they are not allowed to go to conferences or there is no funding available

Guidelines for seminars conferences

Guidelines for Seminars/Conferences

32 respondents were either unaware of guidelines for conferences or had to pay out of pocket with limited or no reimbursement

Unos regional meetings attendance

UNOS Regional Meetings Attendance

Unos transplant management forum attendance

UNOS Transplant Management Forum Attendance

Unos transplant management forum

UNOS Transplant Management Forum

Do you anticipate attending this coming year?

  • 6% Yes

  • 20.2% Possibly

  • 73.8% Unlikely

What educational opportunities would you like unos to provide

What Educational Opportunities would you like UNOS to Provide?



Where did these contacts come from

Where Did these Contacts Come From?

UNOS Regional Meetings 3.7%

UNOS Annual Management Forum 13.2%

Consortium or other multi-center affiliation 8.8%

TFCA Annual Workshop 10.3%

TFCA List serv 95.6%

Other 7.4%

Social Workers

Transplant Programs in area


Tfca member

TFCA Member?

Tfca workshop business meeting attendance

TFCA Workshop/Business Meeting Attendance

Member of tfc list serv

Member of TFC List serv

What are you thinking

What Are You Thinking?

  • I would very much like to attend the annual workshop and any seminars available. I would like to educate myself further in order to serve my Team and patients in the greatest capacity possible. I am also interested in becoming TFC certified, when the exam becomes available.

  • I believe our program would be better served if the financial coordinators were offered continued education.

  • I love my job and would like Administration & Management to recognized that our jobs are unique. We do not do the same job as Registration Reps or other financial coordinators.

  • TFCA was very helpful to me.

  • TFCA Forum is very helpful and is awesome to meet other fellow TFC's. Wish our center could afford the trip in the budget.

  • Would like to have access to financial coordinators reference book that addresses common problems that face this unique position. Not all hospitals permit attendance to conferences and my hospital does not reimburse membership dues.

What are you thinking1

What Are You Thinking?

  • I truly love what I do. I would like to be viewed as a professional and have it known at my facility that what I do is very different from any other "regular" financial coordinator. I play a vital role in the transplant arena and would like the administration and management to acknowledge this. In the last two years we have been "stripped" of our transplant financial coordinator title and are now referred to as revenue cycle 3 senior representatives. There are many others outside the transplant arena that have this title. We are also part of the financial team and are not officially part of the transplant team. On paper we look exactly the same but as transplant financial coordinators we do so much more!!!! I would like my title to be reinstated and to also be a formal part of the transplant team.

  • I am a TFC member and I love it very much. The conferences are always educational and informative.

  • Would like to have access to financial coordinators reference book that addresses common problems that face this unique position.

  • Not all hospitals permit attendance to conferences and my hospital does not reimburse membership dues.

What are you thinking2

What Are You Thinking?

  • Happy to see another survey to update TFC info!

  • I still need more info on the List Serv. I know that I am on it but have not used it. Not sure how it all works.

  • Our challenge has been in getting reclassified. Our reclassification has been shot down 3 times. We will try again and hopefully the organization will recognize our worth.

  • I feel it is imperative that we establish or take more seriously the need for a certification process, and a credential if we are to be regarded as true professionals, and establish our importance in the transplant network/process. How can we collectively move toward this goal? What is an appropriate timeline?

  • The roll of a financial coordinator is a very detailed position and it requires a lot of responsibility. I love the job position but the pay sucks. It's too much work and responsibility to not be compensated for it. What makes the job interesting is the fast pace and multi-tasking. Money(Pay) is its only downfall.

What are you thinking3

What Are You Thinking?

  • Attended my first TFC Conference in Memphis. It was wonderful and I learned a lot. Met some nice people and was able to network and get ideas.

  • I hope to see a TFC Certification soon.

  • Although I have not personally posted a question on the list serv, I look through the questions and answers. This serves as a great learning tool for me. I also enjoyed the TFCA Workshop this year, meeting my fellow TFC's and gaining new ideas from the group. Keep up the good work.

  • The information obtained thru the list serv is wonderful. There is so much knowledge out there !

  • TFCA is very helpful and the manual is an excellent source of reference .


  • I have learned many things from the List serv. It has been a great source of information for me.

What are you thinking4

What Are You Thinking?

  • TFCA is a very helpful organization. Thanks for all of the information. Keep it coming..

  • I would like for all TFC's to have the opportunity to attend the TFC Workshop. Great opportunity to learn and network with fellow TFC's. All centers should be required to send TFC's to conferences.

  • I firmly believe that your organization is valuable to the successful improvement of our transplant department however this opinion is not shared with ______ University Administrators

  • As I'm sure everyone else is, I'm interested in salaries of other TFC's in my region. I am the only TFC at my center and I have no comparison salary information to back myself up indicating my salary should be higher. I don't feel hospital administration understands my role and therefore always classify it at a lower grade salary range. I have been a TFC for almost 7 years and have fought every year to get more money, but with no back up it is always pushed aside.

What are you thinking5

What Are You Thinking?

  • Have asked List serv question, never received response.

  • I think for most financial coordinators we are probably under paid. Maybe with this survey, it will give us something to take our Director to resolve this matter.

  • The TFCA community is the most useful tool out there. The List serv is poorly managed where rules about what you can post are changed all of the time without a unanimous vote.

  • I am still pretty new to this position/field, and when I began I had extremely limited training both with the outgoing TFC and with any other type of training. I am very interested in any and all types of ongoing training that I can learn about through the TFCA.

  • I think the Transplant Financial Coordinators group is great. We can ask each other questions that you can't fine the answers to anywhere else.

2012 survey recommendations

2012 Survey Recommendations

  • Review the survey results with your administrator, program advocates and HR

    • Advocate for salary commensurate to your position

    • Request educational materials and access to meetings

    • Advocate for additional staffing based not only on transplant volumes but all the pre and post workload

    • Remind the team that your position is a UNOS required position and you should be recognized as such

What can tfca do for you

What can TFCA do for YOU?

  • Gain momentum on the certification process

  • Complete List serv By-Laws for continuity

  • Continue to provide networking and training opportunities

Tfc survey 2012 the pulse of the nation

A TFC’s work is never done and can sometimes be overwhelming. Our passion for what we do keeps us coming back for more.

Keep the passion as it truly makes a world of difference to your patients, your team, and yourself.

If you ever feel like you’ve lost your passion, find a way to get it back. Talk to your fellow TFC’s, put yourself in the footsteps of a patient and you will get that passion back.

Tfc survey 2012 the pulse of the nation

You’re taking care of your patients and their families…

You can only do that if you take care of yourself!

You can only do that if you take care of yourself!

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