This page is for billing offices at hospitals, physician groups, and other providers submitting claims to Tampa General Hospital (TGH) for services provided to living donors through the TGH Living Donor Swap (paired exchange) programs.
TGH reimburses eligible services used to determine a donor's candidacy and, when applicable, medically necessary care related to post-donation complications, consistent with applicable law, Medicare guidance, OPTN policy, and the applicable matching program agreement. Payment is issued by the TGH Living Donor Transplant Department at the program's allowable fee schedule, including Medicare-based allowable amounts where applicable, for both professional and facility claims.
Not a billing office?
If you are a living donor, a transplant patient, or a family member, please do not use this page. To learn more about living donation at TGH, visit:
- Living Donor Kidney Program: Click Here
- Living Donor Liver Program: Click Here
For questions about a bill you received, please call us at 813-844-7291
Living Donor Program Claim Submission
Complete this step once before your first claim, or any time your billing, remittance, or tax information changes.
- Download and complete the [Living Donor Program Submitter Setup Application].
- Provide your organization's current, signed W-9.
- If you want payment by ACH/direct deposit, include a signed letter from your financial institution showing the account number, routing number, and bank contact.
- Upload the application, W-9, and bank letter (if applicable) using the [Living Donor Claims and Setup Upload Form] and select "New setup" or "Update existing setup."
Each claim submission must include all items below. Incomplete submissions will be returned.
- Your standard claim form: CMS-1500 for professional services (most claims), or UB-04 for facility/hospital services, such as care for post-donation complications.
- A completed [Living Donor Claim Cover Sheet], including the expected reimbursement amount.
- Itemized charges, if not fully shown on the claim form.
Your claim must show the following details for each line item. This is the complete list:
- Donor name and date of birth
- Matching program and exchange/SWAP ID (for example, NKR or APKD)
- Date(s) of service
- Rendering provider name and NPI
- Facility name, if applicable
- CPT/HCPCS procedure codes and units
- ICD-10-CM diagnosis codes
- Billed charges
Upload your claim package using the Living Donor Claims and Setup form below and select "Claim submission."
- By submitting a claim, you agree to bill TGH directly as instructed and not bill, balance bill, or seek payment from the living donor or recipient for covered services.
- Claims are reviewed for eligibility, duplication, and completeness before payment.
- Please allow up to 60 days for processing after TGH receives a complete submission.
- This payment process covers reasonable costs associated with living donor evaluation and donation-related care. No payment may be offered or provided in exchange for an organ, and nothing on this page permits any prohibited inducement or "valuable consideration."