Umbutho we-National Health Care-Fraud Association uqikelela ukuba u-3% weedola ezigidi ezingama-2 zamawaka asetshenziselwe ukunakekelwa kwezempilo ngo-2007 ulahlekelwa ngumsebenzi wokukhohlisa. Enye imibutho iqikelela ukukhwabanisa kwi-akhawunti ukuya kwi-10% yazo zonke iindleko. Ubuqhetseba beMedare buyingqungquthela kwaye ixesha elininzi lihamba lingabonakali, abahlawuli berhafu bahlawula iibhiliyoni zeedola ngonyaka.
Ubuqhetseba bezempilo buyenzeka ngeendlela ezininzi, kunxalenye yabanikezeli abaninzi kwiinkonzo zempilo, abanokuthi:
- Yilwayo ngeenkonzo ezingaboneleli.
- "I- Upcode ," ithetha ukuba inikezela ngenkonzo, kodwa ihlawuliswa kwinqanaba eliphezulu le nkonzo efanayo. Umzekelo, unokuba neempawu zokubanda. Kodwa ugqirha wakho unokunyanzelisa i-pneumonia, nangona yonke into enobusika.
- Ukubonelela ngeenkonzo ezingadingekile. Unokufumana i-EKG kwiofisi yegqirha, nangona awuyidingi. Ezi nkonzo zisoloko zenziwa kwiofisi yelo dokotela, ngokukodwa ukukwazi ukuhlawula into ethile, kungekhona ngenxa yokuba uyayifuna le nkonzo.
- UMthetho oYilwayo kwiinkonzo ezingekho phantsi kwee-inshorensi ezihlawulelwayo, kwaye zingabizwa kwakhona ukuze zihlawulwe. Ngokomzekelo, uphando lweplastiki "umsebenzi wempumlo" ongenakutyhulwa yinshuwalense ingabizwa ngokuba yi-septum ephosakeleyo, eyinkqubo ekhokhwayo.
- "Ukungahambisani" nenkonzo. Ngeenkqubo ezifuna inani lamanyathelo kwaye zingahlawuliswa ngesinye isixa, umniki-nkonzo unokuthi ahlawule ngokuzikhethela ngamnye, ngoko ke adibanise ukuhlawula imali.
- Izigulana zeBill ngaphezu kweefayili zabo zeenkonzo. Oku kubizwa ngokuthi " ukuhlawula imali ." Njengoko ubuqhetseba buya kuhlawulwa isiguli xa kukho iinkonzo sele zibuyiselwe.
- Yamkele iifizi zokuhanjiswa kwabanye ababoneleli.
Enyanisweni, ukukhwabanisa kwezempilo kungabungozi kokubili kwimpilo yezigulane kunye neengxowa zabo.
Ngaphandle kokokuba kuthatha imali eninzi kwiipokethi zethu, ingakumbi i-Medicare kunye nobuqhetseba beMedicaid ezikhupha izibonelelo zethu zerhafu, le mi sebenzi yokukhohlisa ibhalwa kwiirekhodi zethu zonyango . Ekugqibeleni, ezi zikhohlakeleyo zingakhokelela ekwenzeni unyango olungalunganga, iimpazamo kwiirekhodi zeeNkcukacha zezoNyango zezoBucala , kunye nokwebiwa kwezokwelapha .
Izigulane ezihlakaniphile zikwazi ukuhlaziya iirekhodi zabo zonyango ngeephene , kubandakanya ukuqikelelwa kwee-inshorensi zabo, kunye nokulungisa iziphoso abayifumanayo.
- Ukuba uhlaziya iirekhodi zakho kwaye ufumene iimpazamo ezichaphazela ukuba umniki wakho umvuzo unjani, ke uchaze ukungafani nesikhorensi sakho.
- Ukuba umhlawuli-mali uhlawuliswe yi-Medicare, i-Medicare inikezela inkqubo yokwenza ingxelo.
- Ngokufanayo, ukuba ingxaki iquka ibango leMedicaid, kukho inqubo yokubika ubuqhetseba beMedicaid, nayo.
Ngenxa yokuba ubuqhetseba bezempilo buxhaphakile kwaye bubiza, ngokuqhelekileyo kuthathwa njengengxenye yengxoxo yokuguqulwa kwezempilo kwi-United States.