Imigqaliselo ilandelwa Njengawo nje Ukusetyenziswa Kwetyala
Xa ufaka isicelo sempilo okanye i-inshorensi yonyango, kuya kuba nenani leemigwebo ezisetyenziswe ngababhali be-underwriters ukucacisa ukuba baya kukuhlawulisa kangakanani ukuba bakuqiniseke.
Ekubeni, ngokomthetho, abaqinisekisi abanako ukungafuni ukukuqinisekisa (njengoko kuhamba kwi- Care Affordable Act ), kufuneka ukuba kunoko baqonde ukuba kuya kuba neendleko zokuhlawula njani ukunakekelwa kwakho, koko bongeza kwixabiso lemali abayilindeleyo ukwenza njalo.
Ixabiso liza kubandakanya i- premium yakho ye- inshorensi yempilo .
Ukuqokelela Iinkcukacha Zonyango
Ukuze benze ezo zigwebo, baya kuthenga idatha evela kwimithombo eyahlukeneyo; Idatha eqokelelwe ngawe kunye nempilo yakho enokuba awuzange uyayiqonda iqokelelwe. Phakathi kwala macandelo eenkcukacha iya kuba ingxelo ye- Medical Information Bureau yakho, umlinganiselo wakho wesikweletu, umlando wakho weemviwo kunye nomlinganiselo wakho wokunamathela kumachiza.
Ininzi yethu ayikwazi ukuba umntu ngaphandle kwethu okanye oogqirha, ugcina imbali yemimiselo yethu. Enyanisweni, loo mlando ingathengwa ngabatshutshisi kunye nabanye kwiinkampani ezimbini. I-database ye-IntelliScript (eveliswe yinkampani ebizwa ngokuba yi-Milliman) kunye ne-MedPoint database (eveliswe yinkampani ebizwa ngokuba ngu-Ingenix) zombini ilandele le data, ize ithengise yona kwimpilo, ukukhubazeka, kunye nenkampani zomshuwalense wobomi.
Ekubeni ulwazi lubhekiselele kwimpilo yabantu kunye nokunyamekela, zombini le nkampani kufuneka ilandele imithetho ye-HIPAA .
Abakwazi ukuthengisa okanye ukwabelana ngolwazi ngaphandle kwemvume yakho. Nangona kunjalo, ukuze ufake isicelo se-inshorensi yempilo, kufuneka ukuba unike imvume.
Ukutsala le datha ndawonye kwifomu abanokuyithengisa kubashurensi, ulwazi lwe-IntelliScript kunye ne-MedPoint yokuthenga kwi-Pharmacy Benefits Managers (i-PBMs).
I-PBM ivela kwikhemisi yakho yekona (mhlawumbi inxalenye yechungechunge elikhulu) kwiifommkhulu ezinkulu zeposi zeseyili ezifana ne-ExpressScripts okanye i-CVS Caremark. Xa ugcwalisa imiyalelo yakho kwiyiphi na i-PBM, bayakwazi ukulandelela ukuba ngubani ugqirha wakho (kwaye ngoko ke ukuba yintoni na okhethekileyo), izidakamizwa kunye nemilinganiselo ugqirha wakho anikezele yona nayiphi na isizathu, nokuba awuyi umrhumo, kwaye nokuba ingazalwanga okanye awuyi kuzaliswa.
Ukususela kuloo datha, banokuthabatha izigqibo ezilandelayo:
- Bayakwazi ukubona oko kukufumanisa kwakho, okanye ubuncinane ukusondela, ngoko ke ukuba unayo (okanye unayo) ingxaki eqaqambileyo (enye iya kuhamba) okanye ingxaki engapheliyo (mhlawumbi iya kuphinda ibuye, okanye ikukhathaze bonke ubomi bakho.)
- Bayakwazi ukuxelela ubungakanani bokuba ukuxilongwa kwakho kukuchaphazela ngamandla ngamandla kumlinganiselo okanye ukuba kaninzi kangakanani ugqirha wakho acinga ukuba uyayifumana. Ingxaki enzima ayinakukukhathaza kwakhona, ngoko ayiyi kubabiza imali eninzi, ukuba nantoni na. Kodwa ingxaki engapheliyo, njengesifo sikashukela okanye isifo senhliziyo, nokuba nje ukunyuswa kwengcinezelo yegazi, inokubiza kakhulu ngexesha. Xa bebona iingxaki ezingapheliyo zonke eziphambili, kuya kuba yinkcazelo kubabhali be-underwriters abayifunayo ukuba baphonse iindleko ezingakumbi kwiinkampani, kwaye baphakamise ama-premium akho ngokufanelekileyo.
- Bangakwazi ukubona ukuba unobungozi , intsingiselo, ngaphezu kweyodwa into engalunganga kuwe. Ukuhlanganiswa kweengxaki zonyango kunokuzixabisa ngaphezu kweendleko zokunyanga ingxaki nganye. Ngokomzekelo, iindleko zokuphatha isifo senhliziyo kunye nomhlaza ngexesha elifanayo zinokubiza ngaphezu kokuphatha isifo senhliziyo kwisigulane esinye kunye nomhlaza kwesinye isiguli.
- Idatha iya kubonisa indlela ozalise ngayo rhoqo imimiselo yakho kwaye ngoko, nokuba uyahambelana okanye awuhambelani . Le ngcaciso efana neyo ekhankanywe yi-FICO yokunyaniseka kwamachiza apho abasebenzisi bangaphantsi bangasebenzisa ukuthelekisa. Ukuba unamathela, eqinisweni, imimiselo yakho yeziyobisi iya kuba neendleko anokuzenza. Kodwa kunokuthi kubo, ngokuxhomekeka kokuxilongwa kwakho, ukuba ulawula loo ngxaki kwaye ngoko ke akuyi kubakho iindleko ezinkulu kwixesha elifutshane elingalindelekanga.
- Ababhali phantsi baya kukhangela ukuba babone ukuba ngaba utyunjelwe ubuhlungu beziyobisi naluphi ubude bexesha. Ukuba ngaba ufuna iiminyaka embalwa edlulileyo kodwa awuzange uzalise imithi yabo kungekudala, ngoko ayiyi kuba neendleko ezongeziweyo. Kodwa ukuba okwangoku uthatha iipilisi zintlungu, kwaye ukuba i-dosage iye yanda ngamandla okanye ngokuphindaphindiweyo, iya kuba yibalagi ebomvu kubangaphantsi kwezinto ezifunekayo ukuphakamisa indleko zeeprimiyam zakho. Basenokuzama ukuvavanya ukuba usebenzisa kakubi iziyobisi, umzekelo. Okanye banokugqiba ekubeni bahlawulise ngakumbi kwiingxaki ezinkulu ezingabangela ukuba uqhubeke ufuna ukunyamekela intlungu yakho, okanye iindleko ezingaphezulu kwiintlungu ezibuhlungu.
Kukho ezinye izigqibo ezi zenzele ezi nkampani ekusebenziseni imbali yakho yesiganeko, kwakhona. Kwaye ngokugqitha kwexesha, njengoko ulwazi oluninzi luyafumaneka kwimithombo eyongezelelweyo njengamakhadi omvuzo wokunyaniseka , abancinci baya kugweba iinkalo ezongezelelweyo zendlela okhokela ngayo ubomi bakho, kunye nexabiso lentlawulo zabo ze-inshurensi ngokufanelekileyo.
Ukhuselo lweMonde
Ngelishwa, akukho nto eyenza ukuba akukho mvelaphi ukuba izigqibo kunye nezigwebo zabo zikhona, okanye azinjalo. Kwaye iindleko kuwe ziya kusekelwe kwezo zigqibo, kungakhathaliseki ukuba ziphosakele kangakanani.
Kukho izigulana ezincinci okanye ezingenanto ziyakwenza ukuze zikhusele kule nkcukacha ngaphandle kokuba kuqinisekiswe ukuba idatha yembali yesiganeko ichanekile. Ekubeni isetyenziselwa ukufumanisa iindleko ze-inshurensi yakho, zombini i-IntelliScript kunye neMedPoint kufuneka, ngokusemthethweni, ihambelane noMthetho we-Fair Credit Reporting Act (FCRA.) Oko kuthetha ukuba, njengamanqaku akho ekhredithi, unokucela ikopi yekhemisi yakho Ingxelo yembali ekhululekile kwiyiphi mibutho kanye ngonyaka, okanye ekugqibeleni uguqulwa kwi-inshorensi yobomi okanye yokukhubazeka.
Fumana IiRekhodi Zonyango Zakho
Kunengqiqo ke, ukuba uyimarike yempilo yomshuwalense, ukuba ufumane ikopi yeirekhodi zakho zonyango (zonke iirekhodi, kungekhona nje imbali yakho yezobisi), uhlaziye ngokucophelela kwaye ulungise naziphi na iimpazamo .
Ukufumana ikopi yengxelo yakho yeembali ze-IntelliScript yembali, shayela i-877-211-4816.
Ngxelo yeMediPoint, fowuni 888-206-0335 okanye ubhalele:
Ukuthotyelwa kweMediPoint
Ingenix, Inc.
2525 ILake Park Blvd.
I-West Valley City, i-Utah 84120