Iisiseko zeMedPay Reimburments

I-Medpay , okanye i-Personal Automobile Medical Payments, ifom ye-inshorensi yemfanelo yonyhorensi ehlawulela yonke into okanye inxalenye yesibango sonyango oqhutywe ngomshuwalense ngenxa yokulimala ngenxa yengozi yemoto kwaye ihlawula kungakhathaliseki iphoso.

I-FAQ-Pay Pays

Ngubani Ofihliweyo nguMed-Pay?

Ngokuxhomekeke kuhlobo lokubambisa i-insured, i-Med-Pay iya kubakho iindleko zonyango zomqhubi kunye nabagibeli bayo bezithuthi. Iindleko zonyango ezenziwa ngumqhubi olimele kunye / okanye abagibeli kwelinye isithuthi zihlawulwa ngenye indlela.

Ziziphi iinkonzo zezoNyango ezihlawulelwayo kwi-Med-Pay?

• Ukuvakatyezelwa kwamagumbi okuPhupha
• Ambulance kunye ne-EMT Imirhumo
• Iilebhu kunye ne-X ray
• Iinkqubo zoPhando
• Isibhedlele soMhlalaPhala

Ingaba i-Med-Pay ithatha indawo yomshuwalense wezempilo?

Ininzi Imigaqo-mali ye-Med-Pay kuphela ihlawula i-$ 5,000 ngomntu ngamnye ngengozi nangona ezinye iinkqubo zinokuhlawula ukuya kwii-100,000 zamawaka ngamnye ngomntu ngamnye. Xa ungeniswa ngamabango e-auto ngenjongo yokuhlawula, landela le nkqubo:

1. UMthetho oyi-Bill Med-Pay njenge-inshorensi yokuqala
2. Ifayili yonyango yonyango kuphela xa:
   • Isigulane asiyi kubonelela ngolwazi lwe-inshurensi yokuhlawula i-inshorensi
   • Ukuhlawulwa kokukhawuleza, okanye inkokhelo zingakapheli iintsuku ezingama-30, ayenziwanga yi-Med (hlawula izikhokelo zeNtlawulo zemiqathango yezigulane ze-Medicare)
   • I-Med-Pay iphika ibango ngokugcwele
3. Faka ifom ye-inshorensi yezempilo njengesibini xa iMed-Pay yenza inkokhelo kwibango kodwa inzuzo ayifihla inani lebango

Ingaba i-Ofisi yezoNyango kufuneka ifake i-Claim Med-Pay?

I-Ofisi yezoNyango iyakwazi ukubeka iipolisi zayo kunye neenkqubo ezikuphelayo ezichanekileyo ukuba zichonge ukuba ingafaka iimali ze-Med-Pay. Akukho mithetho evimbelayo okanye ukunyanzelisa ukuhlawulwa kweMed-Pay, nangona kunjalo, ngokweMSP Guidelines Medicare ifuna ukuba xa isigulane sineengxelo zeMedikezelo ukuba zonke iinzame zenziwe ukuba zihlawulwe iMed-Pay ngaphambi kokufakela i-Medicare.

I-Medicare Secondary Payer okanye i-MSP ibhekisela kwiintlawulo zeMedare xa i-Medicare engekho yinshuwalense eyona nto. I-Medicare idinga ukuba bonke abanikezeli bezempilo banikezele indlela yokuchonga xa i-Medicare yi-inshurensi yokuqala okanye eyesiqhelo kwiigulane zabo zeMedare.

Ngaba Umonde angagqalwa ngokuthe ngqo kwiNyango?

Iimeko ezininzi zinokwenzeka ukuba i-Ofisi yezoLimo kufuneka ifune isigulane ukuba ihlawule imali ngaphambili.

• I-Ofisi yezoNyango ayinayo i-lien esayinwe kwaye isigulane siye saqesha ummeli
• Isigulane, umphathiswa we-Med-Pay, kunye / okanye ugqwetha lomguli wenqaba ukuxoxisana nenkqubo yokuhlawula ngaphambi kokulungisa imeko.
• Isigulane sithatha ukusayina imvume yokunika iintlawulo zentlawulo ukuba ithunyelwe ngqo kwi-Ofisi yezoLimo
• Isigulane sinokufumana iindleko zonyango eziphezulu ngenxa yokuhlinzwa okugqithisileyo okanye ukutyelela ngokuphindaphindiweyo njengonyango lomzimba, ukutyelelwa kwezilwanyana, njl njl.

ImiThetho Yomshuwalense Wezithuthi

Imithetho ye-inshurensi yemoto iyahlukahluka kummandla ukuya kummandla. Ngaphambi kokuthatha nayiphi na inyathelo lezemali okanye ukuphuhlisa umgaqo-mali malunga nezigulane ezichaphazelekayo kwizithuthi zengozi, uyaziqhelanisa nemimiselo yelizwe ngokumalunga neemali zamabango. Amanye amazwe anemithetho yomshuwalense "engekho-mpazamo" engathi inokuchaphazela isigqibo sakho ngokumalunga ne-Med-Pay.

I-Ofisi yezoNyango kunye nazo zonke izinto ezibonelelweyo zenzelwe ukubonelela ngolwazi oluchanileyo noluncedo. Yonke imizamo efanelekileyo eyenziwe ukuqinisekisa ukuchaneka kolwazi olunikeziwe. Nangona kunjalo, zonke iimithombo ezifanelekileyo kufuneka ziqinisekiswe njengokuba umbhali akafanelekanga kwaye akenzi isiqinisekiso okanye iwaranti; okanye ibonisa ukuba ulwazi oluqulunqwe okanye olunikezwayo alukho mpazamo.

Nangona zonke iinzame zenziwe ukuba kugcinwe amanqaku afikelele kwixesha kwaye ngoku, ulwazi luya kutshintshwa ngaphandle kwesaziso. Bonke abasebenzisi kufuneka baqinisekise ulwazi ngeCMS, DOJ, OIG, kunye nee-arhente zorhulumente zengingqi, zikarhulumente kunye neseburhulumenteni. Umsebenzisi uthatha yonke umngcipheko kunye noxanduva lokusebenzisa kunye / okanye ukusetyenziswa kakubi kolwazi.