I-HCPCS Inokunceda Unqumle iiBhilidi zonyango kunye neZingeniso zeeNzuzo
(Funda iikhowudi ze-HCPCS, zibukeka njani kwaye ziphi na ukuzifumana ngaphambi kokuba uzikhangele.)
Kule khowudi ye-HCPCS ye-Medicare yokukhangela, uza kufumana izinto ezintathu: inkcazo yekhowudi nganye ye-HCPCS, iNani lexabiso lexabiso (RVU) kunye ne-Geographic Practice Cost (GPCI). Xa zihlanganisiwe, ziba yiShedyuli yoTywala yeMgqirha.
Yiyiphi iNani lexabiso elithintekayo (RVU)?
Ikhowudi nganye ye-HCPCS inikezelwa ixabiso-imali yemali i-Medicare iya kuhlawula isibhedlele okanye ugqirha kuloo nkonzo ngokomyinge.
Emva koko, izixeko kunye nezinye iindawo zendawo zinikwe ixabiso leRVU - isixa-mali esithandanayo-esiyipesenti, esiphezulu okanye esezantsi, intlawulo ye-HCPCS.
Nantsi indlela esebenza ngayo: Ngokuxhomekeka apho uhlala khona, i-RVU iya kuba phezulu okanye iphantsi kweyona miyinge, ngokusekelwe kwiindleko zokwenza ibhizinisi. Ngoko, umzekelo, indleko yokwenza ibhankini iphezulu kunomyinge kwisixeko saseNew York. Umyinge = 1. I-RVU yeSixeko saseNew York ingaba ngu-1.3. EBirmingham, eAlabama, enexabiso eliphantsi kakhulu lokuqhuba ishishini, iRVU ingaba .75.
Yiyiphi iNkcazo yeNdleko zeGeographic Practice Index?
I-GPCI yintlawulo ehlawulwa nganye yekhowudi ye-HCPCS xa umyinge ukwandisiwe yi-RVU. Ayikho ipesenteji - iyona mali ekhoyo. Ukujonga iCode X ukusuka ngasentla, ugu lwamanzi (RVU = 1.0) lunokuba ngu-100. KwiSixeko saseNew York, apho i-RVU i-1.3, i-Code X ifanele i-$ 130. EBirmingham, eAlabama apho iRVU ikhona .75, iCode X iya kuba yi-$ 75.
Xa zidibeneyo, inani lemali yokuhlawula ikhowudi, i-RVU, kunye ne-GPCI kubangelwa iirhafu zempilo nganye kwinkonzo okanye inkqubo abanokukunika yona, isigulane sabo. Ibizwa ngokuba yiShedyuli yoTywala yeMgqirha.
Khumbula, iShedyuli yoTywala yeMgulane ikuxelela nje ukuba yiyiphi i-Medicare ehlawulela ezo nkonzo. Ukuba uneshuwalense yangasese , imali ehlawulwa ugqirha okanye isibhedlele ingaba ngaphezulu okanye ngaphantsi.
Xa wenza i-HCPCS, ufunde izinto ezine:
- Ungasebenzisa ikhowudi yeHCPCS ukufumana ukuba yintoni inkonzo okanye inkqubo emele ngayo.
- Ungasebenzisa inkonzo okanye inkqubo yokujonga iikhowudi ze-HCPCS ezingasetyenziswa.
- Unokufumana ukuba uninzi lweMedareri lihlawula ugqirha kunye nesibonelelo kwindawo yakho kwisevisi okanye inkqubo (i-RVU).
- Unokufumana ixabiso eliqhelekileyo elihlawulwe kwi-US kule khowudi.
Nantsi indlela yokujonga ngayo i-Medicare HCPCS yakho yehhala:
- Inyathelo 1: Uza kuqala kwiphepha lokujonga ngokubanzi elichaza izinto ozozijonga ngayo. Funda ngeenkcukacha kwiphepha lokujonga, uze uqakraze kwi-START SEARCH.
- Inyathelo 2: Kwiphepha elilandelayo, uya kufumana isihloko esithi ukhangele iikhowudi ze-CPT. Ezi khowudi zifana neefowuni zeHCPCS, nangona i-HCPCS iquka iikhowudi ezongezelelweyo kwiidivaysi, iinkonzo ze-ambulensi kunye nezixhobo zonyango ezizinzileyo.
Uza kufumana iLayisensi yokuSetyenziswa kokuSiphelo. Ngokwenene, ikuxelela ukuba unokwazi ukujonga ezi khowudi kuphela ngolwazi lwakho kunye nokuba awukwazi ukuzithengisa kwabanye. Kukho olongezelelweyo ngokomthetho omele ufunde ngawo.
Inyathelo lesi-3: Cofa kwi-ACCEPT okanye Ungamkeli. Ukuba ucofa UNGAKUMBI, awuyi kuvunyelwa ukufikelela kwikhowudi yokukhangela.
- Inyathelo 4: Ikhasi elilandelayo likhasi lakho lokukhangela. Okokuqala, uya kukhetha unyaka okanye inxalenye yonyaka oya kujonga iikhowudi. Emva koko, uya kukhetha uhlobo lweziphumo ozifunayo. Ukuba awuqinisekanga, kwaye uqhathanisa iphepha lakho lokuhlawula kwixabiso, ke ukhethe i-GPCI yabaqalayo. Ukuba kuvela ukuba kungabi yiloo nto oyifunayo, ungabuyela ukujonga enye ixabiso.
Uya kufuneka kwakhona ukhethe "umphathi" okanye "indawo". Oku kunzima ukukhetha ukususela kuba bahamba ngendlela engaqhelekanga. Ungadinga ukufunda ngokubhekiselele kwimeko nganye kuba ayinalo i-alfabhethi. Umzekelo, ndihlala eCentral NY engaboniswa naphi na kufuphi neNew York. Iludwe "njenge-Rest of New York."
Hit SUBMIT.
- Inyathelo lesi-5: Faka i-HCPCS ikhowudi ozama ukuyijonga kwikhasi elilandelayo. Bese ukhetha BONKE ABASEBENZISELEKILEYO kuba baya kukunika lonke ulwazi malunga naloo khowudi.
Qhubeka ukhangele phezulu kwiikhowudi ozifunayo. Ukurekhoda ulwazi oluyifunayo kuye kuxhomekeke kwizinto ozakuzisebenzisa.
Qhagamshelana nemiyalelo ye:
- Ukufunda i-EOB yakho ye-EOB-Inkcazo yeeNzuzo
- Ukuba ukholelwa ukuba ugqirha wakho uyinkokhelo yeenkonzo ezinganikiweyo kuwe okanye ukuhlawula kwinqanaba eliphezulu leenkonzo kunokuba ufumene, uya kufuna ukwazi ukuba wenze ntoni ngale ndlela, ebizwa ngokuba yi- Upcoding .