Iingcebiso malunga nokulwa neNkampani ye-inshurensi yezempilo
Ukuba ungowesinye sezigidi zabantu baseMerika enentlonelo ngokwaneleyo ukuba ube ne-inshorensi yezempilo, ngandlela-thile ekuhambeni kwendlela oya kufuna ngayo ukulwa nenkampani ye-inshorensi yezempilo. Ngaphandle kwinshuwalense, abaninzi abantu baya kujongana nomngeni wenkampani yomshuwalense ophika uvavanyo lweemvavanyo ezithile, unyango okanye amayeza, nangona unyango okanye unyango ogqirha ngokugqithiseleyo okanye olumisela impilo yakho okanye imeko ye-thyroid.
Inkampani yakho yomshuwalense inokuthi ufuna imvume yangaphambili okanye ukuvunywa ngaphambi kokuba ufumane uvavanyo oluthile lwezonyango okanye unyango, okanye ngaphambi kokuba unqunywe imithi ethile ye-thyroid. Nangona ufumana imvume yokokuqala, i-insurer yakho ingajika kwaye ingavumi ukuhlawula iindleko zemvavanyo ethile, unyango okanye amayeza. Ukukhanyela ukugubungela amayeza kudla ingxaki kwizigulane ze-thyroid ezinqunywe zizidakamizwa ze-thyroid ezifana neCarmor okanye Nature-Throid, okanye izigulane ze-thyroid (i-thyrotropin alfa), ezinokuthi zibiza kakhulu kwaye ayifumanekanga kwifomu yesizukulwana.
Kutheni ama-inshorensi enqaba ukukhutshwa, kwaye unokwenza ntoni ngawo? Ufunde ngokubanzi malunga nalo kweli nqaku elibhaliweyo elibhaliweyo .
Abatshutshisi bayaziwa ngokuhlala begubungela oogqirha abathile, izibhedlele ezithile okanye ii-laboratories, kwaye bayakukhanyela ukuhanjiswa kwabanye.
Oku kuya kudideka, kodwa kukho izizathu zokuba kutheni i-insurers i-cherry ikhethe i-coverage. Fumana ukuba kutheni abanye abatshutshisi bempilo benqaba ukuhlawula abanye oogqirha, ii-lab okanye izibonelelo, kwinqaku: Kutheni i-Inshurensi yam yeMpilo ayibhicothi iiDokotela endifuna ukuyibona?
Ingaba i-inshorensi yakho iya kupheliswa okanye iyonyango ekhethiweyo - njengamachiza emfuyo okanye i-acupuncture-- ngenxa yesimo sakho se-thyroid kunye nempawu ehambelana nayo?
Uninzi alukho, ngokwenene. Kukho izizathu zokuba kutheni i-insurers inqabile ukukhupha nayiphi na into engaqhelekanga.
Kwezinye iimeko, i-insurer iya kukhanyela ukubambisana ngenxa yokuba i-bill yakho ibhalwe ngekhowudi ye-CPT engalunganga. I-CPT imele i-"Current Procedural Terminology," kwaye iikhowudi ze-CPT ziinkqubo ezinzima zekhowudi ezinikezelwa kuyo yonke imisebenzi kunye nenkonzo ugqirha unika njengenxalenye yonyango lwakho. Ukuba ihlabathi lonke lekhowudi yezobugqirha lifana nolwimi lwangaphandle, unokufunda okungakumbi malunga nalo kweli nqaku elinolwazi: Ziziphi iikhowudi ze-CPT? Ngaba Ziyakuthinta Unonophelo Lwezempilo?
Iikhowudi ze-CPT azikho kuphela iikhowudi ezinokuchaphazela ukuba ngaba umgcini-mali wakho uyahlawula okanye uyayiphika inkokhelo yakho. Kukho iinkqubo zeCoding System Coding System (HCPCS) ezisetyenziswa yi-Medicare, i-NDC (i-National Drug Codes), iikhowudi ze-DSM ezisetyenziselwa ukugula kwezifo zengqondo, kunye nezinye ezininzi. Uza kubona iinkcazo zazo zonke iikhowudi kwinqaku leenkcukacha ezifundisayo Iinkcukacha zonyango: Isikhokelo soMonde kwiikhowudi zezoNyango .
Ngaba ulungele ukuhamba yonke indlela yokulwa nenkampani yomshuwalense ophikile ibango lakho ngokunyamekela ngokusemthethweni kwe-thyroid, imithi ye-thyroid okanye ezinye iimvavanyo zonyango ocebisiweyo okanye unyango lwakho ugqirha ugqirha kuwe?
Unokufunda okunye kwiNgcali Yomshuwalense wezeMpilo, uDkt. Michael Bihari, kwinqaku elinikeza iingcebiso ezintle malunga nokulwa neNtsholongwane yeNtsholongwane yezeMpilo: ngamanye amaxesha uyayinqoba, kwaye iMpilo yakho iyakuhlawula yonke into okanye inxalenye yebango lakho .
Ekugqibeleni, nangona kubonakala ukuba ukulinganisela kwamandla kunzima kuma-insurers, izigulane ze-thyroid zinamathuba onke okunika amandla abathengi bezempilo. Isikhokelo sokuXhobisa uMonde uTrisha Torrey ubeke isiluleko esihle kakhulu kwinqaku lakhe: Iisiseko zoba ngumThengi wezeMpilo . U-Trisha unalo uluhlu oluhle kakhulu lwezibonelelo kwi- Toolkit yakhe ye- Savvy Patients 'Toolkit online.