Kwiofisi yezobugcisa, iqoqo eliphambili lokuhlawula i-co-pay are part important to the cycle. Iqoqo eliphambili linciphisa inani lamagulane ezigulane ezigqitywa ngetyala elibi okanye i-collections status. Kulula ukuqokelela kwiigulane ngaphambi kokuba iinkonzo zinikezelwe ngaphezu kweentsuku ezingama-60 kamva emva kokuba inshorensi iphelile.
Ukuphuhlisa inkqubo
Iofisi yakho yezokwelapha okanye umkhwa ufuna inkqubo yokuqokelelwa kwangaphambili echanekileyo kwaye ehambelana. Umgaqo-nkqubo kufuneka uhambe ngaphezu kokuqinisekisa ukuba izigulane zicelwa i-copay okanye umrhumo xa zifika ukuqeshwa kwazo okanye inkqubo.
Inkqubo yakho iya kuqalisa ngokukhawuleza ukuba kuqeshwe ukuba kuqeshwe ukuba ukwazi ukuba uya kuba yintoni uxanduva lomguli. Emva kokuba uqikelele oku, kufuneka uqinisekise isigulane siyazi ukuba singalindela njani uxanduva lwabo lwemali ngaphambi kokuqeshwa. Xa befika kwinkonzo, uya kuphinda wenze iinkqubo ngokuqhubekayo ukucela ukuhlawula kunye nokubonelela.
Ukuchaneka nokungqinelana, kunye nenkqubo yokumisela nokuqokelela uxanduva lwezonyango, izihluthulelo zomgaqo-nkqubo wakho wokuqokelela. Xa uhlakulela umgaqo-nkqubo wokuqokelela i-ofisi yakho, qiniseka ukuba uquka amanyathelo alandelayo.
Inyathelo 1: Qhagamshelana neNkampani ye-Intsholongwane kaMguli ngaphambi kokutyelela
Ngokukhawuleza emva kokuba kuqeshwe ukuba kuqeshwe, qhagamshelana nenkampani ye-inshorensi yesigulane ukuqinisekisa ukuba isigulane sisagcinwa kwaye senze isheke saso nasiphi na izikhokelo zokuqala. Fumana i- copay yesigulana , i-deductible, kunye ne-coinsurance ngolwazi.
Inyathelo 2: Hlola iNkontrakthi Yakho yoKhathalelo eLawulayo
Hlola isivumelwano sakho sokunyamekela esilawulwayo ukuqinisekisa ukuba ukubuyiswa kwakho kwesigulane, ukuvavanya, okanye inkqubo. Uya kufuna le nani ukubala i-copay.
Inyathelo 3: Bala i-Co-Pay
Bala ukuba uxanduva olujongene nesigulane. Funda umzekelo apha ngezantsi.
I-100.00 Iindleko zeNkqubo
x 80%
= 80.00 evumelekileyo
- 50.00 Isigulane esineDatuctible
- 10.00 Umonde weCopay
= 20.00
x 20% Amagumbi okuQinisekisa iMonde
= 4.00 Umonde weNgxowa-mali
+ 50.00 Isigulane esidlulileyo
+ 10.00 Umonde weCopay
= 64.00 Uxanduva oluxhaswa nguMonde (iCopay)
Inyathelo 4: Isikhumbuzi Isibizo kwiMonde equka i-Co-Pay ekulindelekileyo
Faka phakathi uxanduva olujongene nesigulane kwi-call reminder call, imeyile, kunye neleta. Xa uqhagamshelana nesigulane ukuqinisekisa ukuqeshwa kwabo okuzayo, qiniseka ukuba ubakhumbuze ukuba balethe ilayisenisi yabo yokuqhuba okanye enye ifomu ye-ID kunye nekhadi le-inshorensi. Ukwazisa ukuba baya kulindeleka ukuba bahlawule umthwalo wabo oqikelelwayo phambi kokuba benze inkqubo yabo kwaye bahlule iindlela zokufumana iintlawulo ezamkelekileyo.
Inyathelo lesi-5: Intlawulo yesicelo ekufikeleleni kwi-Appontment
Abasebenzi beedesksi zangaphambili kufuneka bacele ukuhlawulwa xa isiguli sifika kwinkonzo ngaphambi kokuba sibonwe ngumboneleli. Mkhumbuze isiguli ukuba imali abahlawulayo isekelwe kuphela kuqikelelo. Ungalokothi ubhale ukhokhe ngokugcwele kwiirisithi de emva kokuba ufumene inkokhelo kwinkampani yomshuwalense kwaye uxanduva lomguli luboniswe kwingcaciso yeenzuzo (EOB).
Inyathelo 6: Izinketho zokuhlawula iintlawulo
Ukunikezela kwenkqubo yokuhlawula isicwangciso semvavanyo ephezulu kunye neenkqubo zokucoca.
Isinyathelo 8: Thumela uphawu
Qinisekisa ukuba iimpawu zithunyelwe kwiindawo zokulinda isiguli ngokucacileyo:
"Intlawulo ibonelelwe phambi kweenkonzo ezinikezelweyo"
Qaphela: Musa ukucela iNgxowa kwiiNgcali eziPhezulu eziPhezulu
Ungaze uzame ukuqokelela ukuhlawula kwiiGulane zeGumbi eziPhezulu ukuza emva kokuba zibonwe ngugqirha ngenxa yemigaqo ye-EMTALA.