Amatyala e-Medicare-For-Service (FFS) ngemini-yenkonzo okanye iintsuku zokukhutshwa okanye emva ko-Apreli 1, 2013, iya kuqhubeka nokwenza ukunciphisa ipesenti kwi-Medicare ukuhlawula kuze kube yesaziso esithile. Oku kuqhubeka ukusebenza ngo-2017. Ngaphandle kokuba utshintshwe, ukusikwa akuyi kuphinda kuphele ngo-2021.
Ukuchithwa kohlahlo lwabiwo-mali lwasemthethweni oluchaphazela ama- Medicare amabango lwaqalisa ukusebenza ngoMhla woLwaphulo lwama-Fools, kodwa kwakungekho nto ehlekayo.
Zichaphazela inkqubo ye-Medicare Fee For Service (FFS), eyaziwa ngokuba yi- Medicare HMO (Icandelo C) zamabango kunye nezixhobo zonyango ezizinzileyo, i-Prosthetics, i-Orthotics kunye ne-Supplies (DMEPOS).
Ukubala Iintlawulo zeeMali kunye noNciphiso loTywala
Ukunciphisa ipesenti ezimbini kwiintlawulo kubalwa emva kokuba i-deductible isigulane, i-coinsurance kunye ne-copay inqunywe kwixabiso elivunyelweyo.
Ngaphambi ko-Ephreli 1 ngo-2013, iintlawulo ze-Medicare zabalwa ngale ndlela
UKUKHALWA KWEMALI - UKUPHATHISWA KWEMPATHISELO (kubandakanya i-deductible, i-coinsurance, kunye ne-copay) = I-MEDICARE PAYMENT
Emva ko-1 uEpreli 2013, iintlawulo ze-Medicare zibalwe ngale ndlela
UKUVIKISWA KWEMALI - UKUPHATHISWA KWEMPATHETHO (kubandakanya i-deductible, i-coinsurance, kunye ne-copay) = IMALI YOKWENZA I-MEDICARE X 98% = UKUHLAWULWA KWE-MEDICARE
Isilungiso soBango Isizathu samaKhowudi
Iseluleko se-electronic remittance (ERA) dwelisa ibango lohlengahlengiso lwezizathu ezisetyenziselwa ukuqhuba ibango. Ezinye zazo ziquka ezi zilandelayo:
Isilungiso soBango Isizathu samaKhowudi
- CO 45
- PR 1
- PR 2
- PR 3
- PR 96
Iinkcazo zokuLungiswa kweziBango
- CO Ulungiso lweKontrakthi
- Uxanduva loMonde
- Inani elithengiweyo
- 2 Coinsurance Inani
- 3 I-Copay Inani
- Ukuhlawulwa kwedlula ireyithi yeshedyuli / ubuninzi obuvumelekileyo okanye obulungisiweyo bokuhlawulwa kwemali
- Iimali ezingabhalwanga (ii)
Ukuze kucaciswe ukunciphisa iipesenti ezimbini kwi-ERA, ikhowudi entsha yokulungiswa isetyenziswa.
I-CO 253: Ukutyalwa kwamatyala - ukunciphisa ukuhlawulwa komthetho.
Ngenxa yokuba i-253 ihambelana ne-CO, isiguli asikwazi ukuhlawulwa esi sixa. Kuyinto ebhaliweyo kumnikezeli. Olu ncitshiswa luchaphazela kuphela umboneleli, yingakho ukunciphisa kubalwa emva kokuba uxanduva lomguli lubekwe.
Umzekelo, kwibango eline-$ 50.00 yentlawulo evela kwi-Medicare esikhathini esidlulileyo ngoku iya kuba yi-$ 49.00 yokuhlawulwa kunye ne-1.00 yeeRhafu eyabelwe i-CO 253 ukumela ukunciphisa ipesenti.
Ukuchaphazeleka koTywala kwiCandelo leeMpilo
Ukuze ukwazi ukulawula kakuhle iinkalo zemali zeofisi yonyango, kuyimfuneko ukuhlaziya iingxelo zakho ukubonisa utshintsho kwi-reimbursement yakho. Oku kwazisa nemiba yezenzo ezininzi ezinokuchaphazeleka kakubi ngala manxeba. Abanye oogqirha banquma ukuba banciphise inani labagulane be-Medicare abayiphathayo okanye bayeka ukunyanga izigulane ze-Medicare ngokupheleleyo. Ngelishwa, oku kubangela ingxaki kwizigulane, ezinokukhetha ezimbalwa ukujongana neemfuno zabo zonyango kunye nexesha elizayo.
Ukufikelela okungaphantsi kwezigulane ze-Medicare kuthetha ukhenketwa kwamagumbi okuphuthuma, ukunyuka kwezibhedlele, kunye nezindleko ezithe zenziwa kwishishini zifuna iindlela zokunciphisa iindleko.
Kukho enye indlela yokuguqula izigulane zeMedare, eninzi zazo zingaphezu kweminyaka engama-65 ubudala kunye / okanye zikhubazeke ngokomzimba okanye ngokwengqondo. Abanikezeli bezonyango banokuguqula ukugxila kwizinto abazilahlekileyo kwi-Medicare kwaye baqalise izicwangciso zokuphucula ukusebenza kwezemali kwezinye iindawo.
Ukwenza iipesenti ezimbini ze-Medicare ukusika, enye indawo i-ofisi yakho yezobugqirha ingayigxininisa ngayo ngokunikela ngokukhawuleza ukuhlawula izaphulelo ukuze ukhuphe iinkampani zomshuwalense yemoto, abathinteli bokuhlawula abasebenzi kunye nabagulane bokuzihlawula ngokukhawuleza ukuhlawula imali ngokukhawuleza. Ukunikezela ngokukhawuleza ukuhlawula izaphulelo kwenza iofisi yakho yezobugqirha ihlangabezane nezibophelelo zezemali, ukwandise kwaye ukhule kwaye uphucule imisebenzi yakho efunyenweyo.
> Umthombo:
> C MS.gov I-MLN ixhuma uMboneleli eNews, kuMatshi 3, 2016.