Unyathelo ngoncedo
I-Medicaid yinkqubo ye-inshorensi yempilo yabantu abanomvuzo ophantsi kunye neentsapho ezingenako ukufumana unyango lwempilo. Amaziko e-Medicare kunye neeNkonzo zeMedicaid (i-CMS) yi-arhente ye-federal elawulayo nokulawula zonke iinkqubo ze-Medicaid zaseburhulumenteni. Abamkelekileyo abafumanayo bayafumana unyango lwangonyango kubanikezeli banikezela i-Medicaid ngeenkonzo. Le ntlawulo iqhutyelwa kwinqanaba lendawo ukuze yonke imeko ihluke kwindlela inkqubo ilawulwa ngayo.
Masifunde indlela yokufaka ibango ngeMedicaid.
Ngaphambi kokuba Ungayilwayo kufuneka ube ngumboneleli
Ababoneleli kufuneka banikezwe ilayisenisi kwaye bavunyelwe ngokwemiqathango ethile nemimiselo esetyenziswa kwinkonzo enikezelwayo.
Ababoneleli beMedicaid kufuneka bacele kwaye babhalise kwinkqubo yeMedicaid, banikezelwe ngenani lomnikezeli, kwaye bavumelane neemeko ezithile zokuthatha inxaxheba ngaphambi kokuba inkokhelo ingenziwa kwiinkonzo ezinikezelweyo. Hlola ngelizwe lakho.
Ngubani ochaphazela indlela oyifake ngayo
Uluhlobo lwesibango ofakela kuyo ukuhlawula luyahluka ngendlela ochazwe ngayo njengomboneleli. Amacandelo alandelayo afaka amabango eemviwo ngokomzekelo:
- amakhaya anakekela abantu abadala
- arhente zezempilo ekhaya
- iinkonzo zokubhedlele
- amaziko oongikazi
Amangalo amashishini afakwe ngu:
- ababoneleli bezonyango
- iinkonzo zonyango lokunyuswa kwamayeza
- iinkonzo zonyango zabasebenzi
Ukufaka iBango
Ezi zilandelayo zikhokelo eziqhelekileyo. Ukuba kukho umxholo kule nqaku uhlolisisa nelizwe lakho.
Ngokuqhelekileyo unonyaka owodwa ukususela kumhla wenkonzo okanye umhla wokugqibela wenkonzo kwifayile.
Nazi ezinye ii-acronyms kunye neenkcazo ezinokukunceda njengoko uhamba ngeefom zamabango.
I-MPN : Inombolo yoMboneleli weMedicaid, inombolo ekhutshwe nge-Medicaid ekhutshwe nge-Medicaid efunyenwe kubhaliso.
I-NPI : I-Identifier Provider kazwelonke, inombolo ye-NPPES ekhutshwe nge-11 efunyenwe kwisicelo.
Ikhowudi ye-Taxonomy : ikhowudi yempawu ezili-10 emele uhlobo lomnikezeli kunye nokuzodwa.
- Fumana ifom yesicelo sakho seburhulumenteni. Amazwe ngokuqhelekileyo aseka amafomu amabango abo kumgangatho wesizwe omiselwe yiKomiti yeeNkcazo zeSizwe. Fumana ifom yebango yesampula.
- Ifomu yefowuni eninzi iyazichaza kwaye iyabonakala njengoko uhlolisisa ngoko siza kujonga indawo ezinokuba nzima ngakumbi ngokusebenzisa ifomu yesampula kwikhonkco elingentla. Unokufuna ukuyiprintela. Isiqingatha esiphezulu seefom ezininzi zifuna ulwazi lwentlalo malunga nesigulane kunye nomntu okhuselekile (ukuba ahluke kwisigulane). Isiqingatha esiphantsi sinikezelwe kumnikezeli okanye ulwazi lomthengisi.
- Inqaku 14 - Umhla wokugula okwangoku, ukulimala - Umhla wokugula okanye ukulimala okwangoku kubhekisela kumhla wokuqala kokugula, okanye umhla owenziweyo wokulimala.
- Isiqendu 17 - Igama loMboneleli ojongene naloo nto - Faka igama kunye neenkcukacha zobungcali abazithumele, abayalele, okanye bajongise iinkonzo okanye banikezele (i) kwibango. Inqaku 17a - abachongi beenkonzo banikwa umboneleli. Inqaku 17b: Faka inombolo ye-NPI yomthumeleli.
- Icandelo 21 - Ukuxilonga okanye uhlobo lokugula okanye ukulimala - Ukuxilongwa okanye uhlobo lokugula okanye ukulimala kubhekisela kumqondiso, uphawu, isikhalazo okanye imeko yesigulane esiphathelene nenkonzo kwiibango. Uluhlu olungaphelelanga ezine ezineekhowudi ze -ICD-9 -CM.
- Inqaku 24B - Faka ifowuni efanelekileyo yeefayile ezimbini ukusuka kwiNdawo yeeNdawo zeNkonzo zoNyaka kwento nganye esetyenziswayo okanye inkonzo eyenziwa. I-Code of Service Code ichaza indawo apho inkonzo inikwe khona. Fumana apha apha.
- I-24D - Iinkqubo, Iinkonzo, okanye iiNkonzo-Faka iikhowudi ze-CPT okanye ze-HCPCS kwiikhowudi ezifanelekileyo ezenziwe ngomhla ngomhla wenkonzo. Fumana uludwe olubanzi kwiiNkonzo zeMagare neeNkonzo zeMedicaid.
- Hambisa ifom yebango ngemimiselo enikezelwe yiofisi ye-Medicaid yelizwe. Kwiimeko ezininzi, ungangenisa kuphela ibango ngekhompyutha. Oku kunokufuna ukuba ulande okanye ufumane iprojekthi ethile yeenjongo zokudlulisela. Ngaphandle koko, kuya kufuneka ufeksi okanye uthumele ifom yefowuni kwi-Medicaid yocandelo lokucoca i-claim.
Ngenxa yokuba usebenzisana noorhulumente kufuneka ulandele imiyalelo ngokucophelela okanye ubhekane namabango enqatshelwe kwaye emva koko kufuneka uphinde ubambele. Qonda ukubhalwa kwenkcazo ukuze uhambise amabango ngokufanelekileyo ngelixa uyanciphisa iifowuni ezibomvu eziphakanyisiweyo kwinkqubo.