Vitalant Special Collections Request Form

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Directed Donation (From Vitalant Website)

A directed blood donation provides blood from a compatible donor selected by recipients or guardians, requested by their physician, and approved by the blood center physician.

The U.S. blood supply is extraordinarily safe, and almost all patient transfusion needs are met through community blood donations. Directed blood donations are medically indicated in a very limited number of circumstances. Directed donors must meet the same eligibility criteria as community blood donors. People asked to make a directed donation may feel pressured to ensure that they are not deferred, and these donations carry a slightly higher infectious disease risk than volunteer community blood. Further, some donors may pose additional risks to patients, like their potential marrow or organ donors, male partners of persons of childbearing age, and for babies with specific illnesses – donations from a parent.

An additional fee is required for directed donations due to the special handling involved, even if the designated recipient does not use the blood and/or if blood is not available due to an incomplete collection, an incompatible blood type, subsequently-discovered donor or product information disallowing transfusion, or losses occurring during manufacturing, shipping and storage.

If you are an individual who would like to set up an appointment for a directed donation or the patient’s physician, you can start the appointment process by downloading and filling out the order form below. When completed, fax the form to 480-795-2376 or e-mail to donorcarespecialservices@vitalant.org. We will evaluate the form and contact you to schedule an appointment or discuss further. Please allow 72 hours for the order to be processed.

Does Vitalant assess a fee for directed/autologous donations?

As a nonprofit blood services provider, Vitalant may assess a cost-recovery fee to patients for the costs associated with the special scheduling, processing and medical consultation involved. Vitalant is not a medical provider and therefore unable to bill insurance companies for these services. Like other medical services, patients are responsible for payment and submitting for insurance reimbursement as appropriate.

Why are you requiring me to schedule in advance?

To provide a consistent experience for therapeutic procedures, Vitalant requires appointments to ensure all necessary paperwork is complete and adequate staff are available. Please allow up to five business days for a response to all inquiries

Can you bill my health insurance?

Health insurance companies may cover the cost of providing this service; however, Vitalant is not a medical provider, therefore unable to bill insurance companies directly for this service, including Medicare and other government-sponsored insurance coverage. If you intend to seek insurance reimbursement for this service, you are responsible for determining if it is a covered service under your plan and for submitting your own reimbursement claim.

What if I (the patient) am unable to afford the cost-recovery fee?

You may wish to contact your physician to determine whether a medical provider would be a better option for your needs. Health insurance companies may cover the cost of providing this service, but because Vitalant is not a medical provider, we are unable to bill insurance companies directly for this service, including Medicare and other government-sponsored insurance coverage. If you intend to seek insurance reimbursement, you are responsible for determining if it is a covered service under your plan and for submitting your own reimbursement claim.

Can I pay when I arrive for my appointment?

All fees must be received in advance to confirm an appointment, and our blood donation centers are not set up to process payments. We ask that you pay with a credit card by phone when scheduling an appointment.

What if I have paid for a procedure and must cancel?

In the event you need to cancel a therapeutic phlebotomy appointment or Vitalant is unable to honor an appointment, payment can be applied toward your next appointment. If you will have no further procedures, Vitalant will process a refund. Please allow 14 days for reimbursement.

If I need to donate for therapeutic purposes, can my blood be used for the community blood supply?

In general, if your diagnosis is hereditary hemochromatosis or you are on testosterone therapy, and are generally in good health and feel well, your blood may be used. This determination will be made during your health history evaluation.

Directed Donation (From Vitalant Website)

A directed blood donation provides blood from a compatible donor selected by recipients or guardians, requested by their physician, and approved by the blood center physician.

The U.S. blood supply is extraordinarily safe, and almost all patient transfusion needs are met through community blood donations. Directed blood donations are medically indicated in a very limited number of circumstances. Directed donors must meet the same eligibility criteria as community blood donors. People asked to make a directed donation may feel pressured to ensure that they are not deferred, and these donations carry a slightly higher infectious disease risk than volunteer community blood. Further, some donors may pose additional risks to patients, like their potential marrow or organ donors, male partners of persons of childbearing age, and for babies with specific illnesses – donations from a parent.

An additional fee is required for directed donations due to the special handling involved, even if the designated recipient does not use the blood and/or if blood is not available due to an incomplete collection, an incompatible blood type, subsequently-discovered donor or product information disallowing transfusion, or losses occurring during manufacturing, shipping and storage.

If you are an individual who would like to set up an appointment for a directed donation or the patient’s physician, you can start the appointment process by downloading and filling out the order form below. When completed, fax the form to 480-795-2376 or e-mail to donorcarespecialservices@vitalant.org. We will evaluate the form and contact you to schedule an appointment or discuss further. Please allow 72 hours for the order to be processed.

Does Vitalant assess a fee for directed/autologous donations?

As a nonprofit blood services provider, Vitalant may assess a cost-recovery fee to patients for the costs associated with the special scheduling, processing and medical consultation involved. Vitalant is not a medical provider and therefore unable to bill insurance companies for these services. Like other medical services, patients are responsible for payment and submitting for insurance reimbursement as appropriate.

Why are you requiring me to schedule in advance?

To provide a consistent experience for therapeutic procedures, Vitalant requires appointments to ensure all necessary paperwork is complete and adequate staff are available. Please allow up to five business days for a response to all inquiries

Can you bill my health insurance?

Health insurance companies may cover the cost of providing this service; however, Vitalant is not a medical provider, therefore unable to bill insurance companies directly for this service, including Medicare and other government-sponsored insurance coverage. If you intend to seek insurance reimbursement for this service, you are responsible for determining if it is a covered service under your plan and for submitting your own reimbursement claim.

What if I (the patient) am unable to afford the cost-recovery fee?

You may wish to contact your physician to determine whether a medical provider would be a better option for your needs. Health insurance companies may cover the cost of providing this service, but because Vitalant is not a medical provider, we are unable to bill insurance companies directly for this service, including Medicare and other government-sponsored insurance coverage. If you intend to seek insurance reimbursement, you are responsible for determining if it is a covered service under your plan and for submitting your own reimbursement claim.

Can I pay when I arrive for my appointment?

All fees must be received in advance to confirm an appointment, and our blood donation centers are not set up to process payments. We ask that you pay with a credit card by phone when scheduling an appointment.

What if I have paid for a procedure and must cancel?

In the event you need to cancel a therapeutic phlebotomy appointment or Vitalant is unable to honor an appointment, payment can be applied toward your next appointment. If you will have no further procedures, Vitalant will process a refund. Please allow 14 days for reimbursement.

If I need to donate for therapeutic purposes, can my blood be used for the community blood supply?

In general, if your diagnosis is hereditary hemochromatosis or you are on testosterone therapy, and are generally in good health and feel well, your blood may be used. This determination will be made during your health history evaluation.