Indlela i-DRG ichonga ngayo njani Isibhedlele esifumanayo sihlawulwa

I-Medicare kunye neenkampani ze-inshorensi zempilo yabucala zihlawula izibhedlele zabaxhamli babo ngokusebenzisa inkqubo yokuhlawula i-DRG . Ngasinye ixesha xa uvalelwa njengesigulana esibhedlele, isibhedlele sinika i-DRG ukuba yamukelwa. Isibhedlele sihlawulelwa isixa esicwangcisiweyo kwi-DRG, kungakhathaliseki ukuba ingakanani imali ekugqithiseleyo isebenza ngayo. Ukuba isibhedlele sinokukuphatha kakuhle ngemali engaphantsi kuneMediarethi ihlawula i-DRG yakho, ke isibhedlele yenza imali kuloo gulane.

Ukuba isibhedlele sichitha imali eninzi kunokunyamekela kunokuba i-Medicare inikezela i-DRG yakho, oko ke isibhedlele silahlekelwa yimali kwilo bhedlele.

Funda kabanzi malunga nale "kwi- DRG 101: Iyintoni i-DRG kwaye isebenza njani? "U

Ukuze ufumane ingakanani isibhedlele esikhokhelwa kuyo nayiphi na indawo yokulala esibhedlela, kufuneka uqale wazi ukuba yi-DRG eyabelwe ntoni kuloo bhedlele. Ukongezelela, kufuneka wazi isantya esibhedlele esibhedlele. Yibiza i-billing, accounting, okanye isebe lolawulo lweelasi esibhedlele kwaye ubuze ukuba yiyiphi i-Medicare idibeneyo.

Ukulinganisa Imali Ingakanani Isibhedlele Esifumana Ihlawulwe I-DRG Enikeziweyo

I-DRG ngayinye inikezelwa ubunzima besisiseko esisekelwe kumyinge ophakathi kwezibonelelo ezifunekayo ukunyamekela isigulane esinikezelwe kuloo DRG. Unokwazi ukujonga ubunzima obunxulumene ne-DRG yakho ethile ngokukhuphela isatidwe esinikezelwa ngamaziko e-Medicare kunye neeNkonzo zeMedicaid zilandelayo:

1. Yiya kule khasi lewebhu kwiwebsite yeCMS.
2. Skrolela phantsi kwezantsi kwephepha. Fumana indawo enesihloko esithi "Ukulanda."
3. Landa itafile 5.
4. Vula ifayile ebonisa ulwazi njenge-Excel spreadsheet (ifayile ephela nge ".xlsx".)
5. Ikholam ebizwa ngokuthi "iinqweliso" ibonisa ubunzima obulinganayo kwi-DRG nganye.

Isilinganiselo esilinganiselweyo sesiqingatha se-1.0. I-DRG ngesisindo esilinganiselweyo esingaphantsi kwe-1.0 sincinci kakhulu ekuphatheni kwaye ngokuqhelekileyo ixabiso eliphantsi lokunyanga. I-DRG kunye nesisindo esilinganiselweyo esingaphezu kwe-1.0 ngokubanzi sifuna izixhobo ezininzi zokuphatha kwaye zibiza kakhulu ukunyanga. Ephakamileyo ubunzima obuqingqiweyo, ezininzi izixhobo kufuneka ziphathwe isigulane kunye ne-DRG.

Ukufumana ukuba imali yakho isibhedlele ihlawulwe njani kwisibhedlele sakho, kufuneka ukwandise ubunzima bakho be-DRG ngesilinganiselo esibhedlele esibhedlele. Nasi umzekelo esibhedlele esinomlinganiselo odibeneyo wee-6,000 zamaRandi xa ubunzima bakho be-DRG buyi-1.3:

$ 6,000 X 1.3 = $ 7,800. Isibhedlele sakho sihlawulwe i-$ 7,800 zama-hospitali.

I-Hospital Blended Rate Rate isebenza njani?

Ekubeni iindleko zempilo kunye neengqesho zihluka kulo lonke ilizwe kwaye zivela esibhedlele ukuya kwisibhedlele, i-Medicare inikezela ngezinga elihlukeneyo esibhedlele kwisibhedlele ngasinye esibamkela i-Medicare. Ngokomzekelo, isibhedlele saseManhattan, isixeko saseNew York mhlawumbi sinemali ephezulu yezabasebenzi, iindleko eziphezulu zokugcina indawo yayo, kunye nezindleko eziphezulu ngaphezu kwebhedlele eKnoxville, eTennessee. Isibhedlele saseManhattan mhlawumbi sinomlinganiselo ophakanyisiweyo ngaphezu kwesibhedlele saseKnoxville.

Ezinye izinto ezenza i-Medicare zibangele ukuzimisela kwezinga lokubhengeza izibhedlele zibandakanya ukuba ingaba isibhedlele sokufundisa kunye nabahlali kunye nabafundi basekhaya, nokuba ingaba kungengendawo yasemaphandleni, nokuba ingaba ingakhathalele isabelo esingenasiphelo sabantu abahlwempuzekileyo nabangenasigxina. Ngolunye lwezinto zivame ukwandisa izinga lokubhedlele esibhedlele.

Ngolunye u-Oktobha, i-Medicare inikezela zonke izibhedlele isilinganiselo esitsha esibhaliweyo. Ngaloo ndlela, i-Medicare inokuthi idibanise indlela ehlawulisa ngayo nayiphi na isibhedlele esinikezelweyo esekelwe kuphela kwiimeko eziqhelekileyo ezifana nokunyuka kwamaxabiso, kodwa nakwiindawo zengingqi. Ngokomzekelo, njengendawo yendawo ihlala iphuhliswa ngakumbi, isibhedlele ngaphakathi kuloo ndawo sinokulahlekelwa ukutyunjwa kwendawo yasemaphandleni.

_Imithombo:

_{IRejista yeSithili, iNkqubo yeMida. Izibhedlele zeZibhedlele eziPhambili zoNyathelo lweNtlawulo zeZiko loKhathalelo oluPhezulu kunye neSibhedlele esiKhathalele ixesha elide. Ukuhlaziywa kweMigangatho yoBungqina beNgxelo kubanikezeli abathile, kuquka iiNguquko ezihambelanayo neNkqubo yeNgcaciso yeMpilo ye-Electronic Health Record; Izandiso ze-Medicare-Ixhomekeke kwiNkqubo yeZibhedlele eziNcinci kunye neNkqubo yokuThuthwa kweMali eNgezantsi kweeHlathi, 8/17/15.}