Iingcamango kwi-EOB yakho Ingabangela Ubunzima Ngomshuwalense Wakho
Inkcazo yeeNzuzo (i-EOB) yifom okanye uxwebhu olungathunyelwa kuwe kwinkampani yakho yomshuwalense emva kweenyanga ezimbalwa emva kokuba unikwe inkonzo yonyango ehlawulwe yinkampani yinshuwalense.
I-EOB yakho ifestile kwimbali yakho yokuhlawula ngonyango. Hlaziya ngokucophelela ukuqinisekisa ukuba ngokwenene ufumene inkonzo enikezelwayo, imali oyenayo ugqirha wakho kwaye isabelo sakho sisilungile, kwaye ukuba ukuxilongwa kunye nenkqubo yakho ibhalwe ngokufanelekileyo kwaye ikhowudiweyo .
Iiofisi ezininzi zoogqirha, izibhedlele, kunye neenkampani zenkxaso-mali zonyango zenza iimpazamo zokuhlawula . Iimpazamo ezinjalo zinokubangela ukucaphukisa kunye nefuthe elibi, elide lemali elide. I-EOB ingaba yinkcazelo yokukhwabanisa ngonyango. Inkampani yakho ye-inshorensi inokuhlawula iinkonzo ezihlawulwe egameni lakho ongayifumanayo.
Imizekelo yeziPhoso kwi-EOB yakho
Ukuhlawula kabini
UMary J. watyelela ugqirha wakhe wokunyamekela (PCP) kwaye wayenomkhuhlane weX-ray ngenxa yesibetho sokugula. I-PCP yayo ithumele i-X-ray kwisifo se-radiologist ukuba sifunde. Inyanga elandelayo uMariya wathola i-EOB kunye ne-bill ye-radiologist. Xa ekhangela i-EOB yakhe yabona ukuba zombini i-PCP kunye ne-radiologist bakhokhela inkampani yomshuwalense ukuba ifunde i-X-ray. Inkampani ye-inshurensi yamenzela ibango kwi-radiologist.
UMariya ngokuchanekileyo akazange ahlawule i-radiologist. Wabiza inkampani yakhe yenkampani yinshurensi ukulungisa ingxaki. Le mpazamo yenziwa yinkampani yakhe yokuhlawula i-PCP.
Ukuhlukana kweeNkcitho zakho zeMali
URobert M. wayenokuhlinzwa ngonyango esandleni sakhe. Uphakathi kwe- PPO kwaye uhlawula i- coinsurance ye-20% yeenkqubo zokuphululela izigulane. Ukulandela utyando, wathunyelwa ibhilikhi evela kwinkampani yokubambisa i-adireji ye-$ 1000, i-20% ye-bill ye-doctor 5000. Nangona kunjalo, xa uRobert efumana i-EOB yakhe, waphawula ukuba nangona ugqirha wazalisa i-$ 5000, wahlawulwa kuphela i-$ 3000 ngecebo lezempilo likaRobert.
URobert wenza izibalo waza wacinga ukuba kufuneka ahlawule i-20% yee-3000 zamawaka, kungekhona i-20% ye-$ 5000. Isicwangciso sakhe sempilo siqinisekisile ukuba sisilungileyo kwaye uRobert wakwazi ukuhlawula i-$ 600 esikhundleni se-$ 1000.
Ukuchongwa okungalunganga okanye iNkqubo
UBetsy D. waya kwi-PCP yakhe emqaleni. Xa wamkela i-EOB wabona ukuba esikhundleni sokuhlawuliswa kwenkcubeko yomqala, ugqirha lakhe liye lahlawula ngephutha ukuhlolwa kwegazi le-diabetes. Inkqubo yekhompyutheni esebenziswe yinkampani yecala lokugqithisa ugqirha ngokuzenzekelayo ibeke ukuxilongwa kwesifo sikashukela, esiyi-Betsy.
Nangona kwakungekho mpazamo yezemali, uBetsy ngokukhawuleza wambiza icebo lakhe lempilo kunye neofisi yegqirha ukuze alungise iphutha lokuxilongwa. Kwixesha elizayo, ukuba wayefuna ukuthenga i-inshorensi yempilo, unokuphikiswa ngenxa yokuba wayefumene unesifo sikashukela. Okanye, ukuba kungenakuphikiswa, isicwangciso esitsha sezempilo sinokumisela ixesha elilindelekileyo lokulinda imeko.
Utyhutshiso lwe-inshurensi kunye noLwazi lwezoLwazi
Ngaphandle kokufumana uxinzelelo oluphezulu lwegazi, uJerry R. usempilweni enempilo kwaye ujabulise ukudlala igalofu kwindawo yasePlorida yomhlalaphantsi. Uyabhalisa kwi- Medicare rhoqo kwaye u tyelele ugqirha wakhe kabini ukuya kathathu ngonyaka. UJerry wathola i-EOB ebonisa ukuba wayefumene isitulo sabakhubazekile, isibhedlele esibhedlele ukusetyenziswa kwekhaya, kunye nomatshini ophathekayo ukuze amphefumule.
UJerry wabiza igosa lakhe kugqirha ukuba ugqirha akazange ahlawulise ngesinye isiguli. Umongikazi kwiofisi yakhe ugqirha wathi kuJerry le nto yayingumkhwabaniso we-Medicare kwaye wamnika inamba yokuqhelisa inkohliso ukubiza. UJerry wabelana ngephepha lakhe neofisi ye-Medicare yasekhaya.
IziCwangciso zeMpilo
UMarta S. usanda kutshintshwa imisebenzi kwaye kufuneka atshintshe izicwangciso zempilo. Emva kweveki emva kokutshintsha, wayetyelele ugqirha ngokulandelelana kwe-cholesterol yakhe ephakamileyo. Ngaphandle kokuhambela iofisi yakhe, uMarta wafumana iimvavanyo zegazi. Wothusa xa efumene i-EOB ebonisa ukuba ugqirha kunye neebhanti zamabhanki enkonzo zakhe zanqatshelwe.
UMarta waphawula ukuba i-EOB yayingekho kwisicwangciso sayo sempilo esitsha.
UMarta wambiza i-ofisi yakhe ugqirha waza wafumanisa ukuba i-ofisi yokuhlawula ayizange ihlaziye ulwazi lwakhe kwaye ihlawulise isicwangciso sayo sempilo sangaphambili.
Khangela ngaphezu kwe-EOB kunye neYilwayo Yonyango
Okokuqala, qiniseka ukuba ufumana i-EOB emva kokuba u tyelele ugqirha okanye omnye umboneleli wezempilo. Njalo ixesha umniki-mboleko uthumela ibango egameni lakho, inkampani yakho yomshuwalense kufuneka ikuthumele i-EOB. Biza isicwangciso sakho sezempilo ukuba awufumani i-EOB kwisithuba ezintandathu ukuya kweebhozo zeenkonzo ezinxulumene nempilo.
Xa ufumana i-EOB yakho:
Khangela ukuqinisekisa ukuba imihla neenkonzo ozifumene zichanekile. Ukuba ufumana impazamo okanye awuqinisekanga malunga nekhowudi, fownela i-ofisi yakho ugqirha uze ubuze unobhala wenkokhelo ukuchaza izinto ongaziqondiyo.
Jonga ukukhwabanisa kwintlawulo okanye ubusela bezokwelapha. Ukuba awufumani iinkonzo okanye izixhobo ezidweliswe kwi-EOB, qhagamshelana nesicwangciso sakho sezempilo.
Funda iingcaciso okanye iinkcazo zeenkcukacha ezantsi okanye emva kwe-EOB yakho. Ezi zichazi ziya kuchaza ukuba kutheni isicwangciso sakho sempilo singabhatali inkonzo ethile okanye inkqubo okanye uhlawula ngaphantsi. Ezinye iingxoxo eziqhelekileyo zi:
- umnikezeli wenethiwekhi-usetyenzise umboneleli ongekho kwinethiwekhi yakho yesicwangciso senkonzo kwaye inkonzo ayinakukhutshwa okanye ingaxhomekeke kwi-coinsurance
- Inkonzo ayiyiyo inzuzo efunyenweyo-yakho yinshurensi ayifuni le nkonzo, njengendlela yokuzilungisa
- Inkonzo ayilona imfuneko yonyango - ugqirha wakho akakubhalanga ukuba inkonzo okanye inkqubo yayimfuneko kwimpilo okanye kwimpilo yakho
- ikhowudi engavumelekanga - ibonisa ukuba umniki-nkonzo wakho wezempilo wenza iposenti yekhowudi, mhlawumbi kwi-diagnostic okanye inkqubo
Kukho amanyathelo amaninzi kwinkqubo yokuzalisa nokuthumela ibango lonyango. Ngendlela, abantu kunye neekhompyutheni ezibandakanyekayo kwinkqubo zingenza iimpazamo. Ukuba ibango lakho liphikisiwe, ungaba neentloni ngokubiza zombini iofisi yakho ugqirha kunye nesicwangciso sakho sezempilo.