Uchitha nje iyure kwiofisi yakho ugqirha. Njengoko uhamba, unikwa isahluko sephepha. Ilinamagama amancinci amancinci kunye namaninzi amancinci kwaye inokuba yinxalenye enye yefom yeenxalenye ezininzi. Kuzo izigulane, kubonakala ngathi idilesi yokufumana idilesi yeenkonzo. Abasebenzi bakho ugqirha bangabibiza ngokuba ifom yokudibana, i-slip yokubhatala, ukugqithiswa okanye isishwankathelo esilandelayo.
Iiresidi zezibhedlele zinokubonakala zifana, nangona zikhulu kakhulu. Akunandaba nokuba zibukeka njani; ulwazi luya kufana nolwazi olufanayo.
Ungayisebenzisa idilesi yokuqeshwa kwegqirha ukuze uqonde iinkonzo zonyango ezenziwe.
Ungasebenzisa kwakhona irisidi kukukunceda uqhathanise iinkonzo ezenziwe kwilwayo yegqirha, kwaye kamva unomshuwalense wakho (okanye i-Medicare okanye omnye umhlawuli) I-EOB, Inkcazo yeeNzuzo, ukuqinisekisa ukuba awuhlawulwanga nayiphi imali ngaphezu kwakho kufuneke ku.
Ziziphi iinkcukacha ozakuzifumana kwiRiphablikhi yoNyulo loTywala?
Irisithi iya kubonakalisa yonke into eyenzeka ngexesha lokuqeshwa kwakho kwaye iya kulandelela ezinye okanye zonke iimvavanyo zokulandelelana okanye unyango olufunekayo, kwakhona.
- Ulwazi lwakho lomntu siqu kuquka ulwazi lwakho lwe-inshorensi (engaboniswa). Uya kufuna ukukhangela kabini xa ufumene idilesi ekunikezelwayo ukuba uqiniseke ukuba ichanekile, kwaye yona ingeyakho kwaye ayixutywanga nomnye umntu.
- Amagama ezinkonzo ezenziwe
- Iikhowudi ze-CPT zeenkonzo ezenziwe
- Amagama kunye neekhowudi ze-CPT iimvavanyo eziyalelwe
- Iikhowudi zokuxilonga, iikhowudi ze- ICD-9 okanye iikhowudi ze- ICD-10
- Kukho amanye amacandelo okuhlawula kunye kunye nokusayina.
Makhe sijonge kulowo mhlaba wolwazi.
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Thatha i Khangela kwieNkonzo eziHleliswe kwiNqununu yakho yoNyunjwaUhlobo ngalunye lwesenzo, nokuba luyinkathalo ephambili okanye i-specialty, iya kuba neenkonzo ezahlukeneyo kunye neenkcukacha kuyo, kuxhomekeke kwiintlobo zeenkonzo ezenzayo kunye nesimo somzimba okanye izifo abazijongayo.
Le fom ifom yokunakekela iphambili, kwaye iinkonzo zibandakanya iindidi ezahlukahlukeneyo ukusuka kwi-check-ups ezisisiseko, kwii-otho zovavanyo oluyisiseko, kwii-diagnostic ezisisiseko.
Lo mdwebo ubonisa inxalenye encinci yeenkonzo ezidweliswe kule risithi. Ukuba ufuna ukukhangela ezo nkonzo, unokukwenza ngokusebenzisa isichazi somsebenzi okanye uluhlu lweemvavanyo zonyango.
Khangela iinkonzo kwi-risithi yakho edibeneyo okanye i-markmarks okanye uphawu oluthile oluye lwenziwe okanye luyalwe. Cinga emva kwexesha ode uchithe kunye nodokotela kunye nabanye eofisini ukuqinisekisa ukuba uyavumelana ne risithi. Umzekelo, ukuba ubona "i-injection injection" ikhutshwe, kwaye awufumani naluphi na isibhamu, uya kufuna ukubuza malunga nokuba kutheni ukuba ihlolwe. Oku kuya kuba kubaluleke nakakhulu kamva xa ufumana ibhilikhi yegqirha .
Ngoku makhe sijonge kwiikhowudi ze-CPT, ezo manani ezinamahlanu adibene ngokubhekiselele kwinkonzo nganye.
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Iikhowudi ze-CPT zibhalwe kwiRiphablikhi yakho yoNyuloEmva kokuba ufumene iinkonzo kunye neenkonzo zokulandelelana kwi-bill yakho, uya kubona ukuba ngamnye udibene nekhodi yeefriji ezinhlanu.
Ezi zibizwa ngokuba yiikhowudi zeCPT. Yonke inkonzo omnye ugqirha uyakukunika yona ukuba ulindele ukuhlawulelwa iya kuhambelana nenye yale khowudi ye-CPT .
Iikhowudi ze-CPT zibalulekile ugqirha wakho kuba ziqikelela ukuba uza kuhlawulwa kangakanani uhambo lwakho. Kubalulekile kuwe ngenxa yokuba ufuna ukuqiniseka ukuba ibonakaliswe ngokuchanekileyo kwiirekhodi zakho. Iikhowudi ezingalunganga ze-CPT zingabangela ukuphazamiseka komonakalo onokuthi ungagqiba kwi-diagnostic engalunganga kuwe, unyango olungafanelekanga, kwaye kamva, ukuba ufune ukutshintsha i-inshurensi, kunokubangela ukukhanyela i-inshurensi kwiimeko ezikhoyo ngaphambili.
Kanye njengoko uhlolisisa ngokuphindaphindiweyo amagama enkonzo kunye neenkonzo zokulandelela ezinikezelweyo, uya kufuna ukuqinisekisa ukuba iikhowudi ze-CPT zichanekile, nazo. Qhathanisa iikhowudi ze-CPT kwiinkonzo zazo .
Ukuba ufumana ukungafani, kuya kufuneka usebenze kunye neofisi yakho yegqirha ukulungisa irekhodi lakho lezokwelapha .
Xa unayo iinkonzo kunye neekhowudi ze-CPT ezigqityiweyo, kuya kuba lixesha lokujonga ingcaciso yokuxilongwa.
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Ukuchonga kwakho kuluhlu lweNgcaciso yakho yoNyunjwaKwisiqendu esahlukileyo ukusuka kwiinkonzo kunye neemvavanyo, uya kufumana uluhlu lokuxilonga. Njengoko kuthethwe ngaphambili, ezi zifo ziya kufumaneka kwi-receipt yokukhathalela. Ezinye iingcali ziya kuba neengxaki ezahlukeneyo kwiiirisithi zabo, kuxhomekeke kwinkqubo yomzimba nezifo abasebenza nazo.
Ukuze uhlawulwe ngu-inshurensi yakho, i-Medicare, okanye omnye umhlawuli, ugqirha kufuneka akhethe ukuxilongwa. Xa uhlolisisa i-bill yegqirha, uya kuqonda ukubaluleka kokuqinisekisa ukuba iinkonzo zenza umgca ngokuxilongwa kwakho. Oku kunokuba yingxaki ngezizathu ezibini.
Isizathu sokuqala kukuba ungeke ufumaneke. Oko kuthetha ukuba ugqirha uya kuthatha uqikelelo olufundile kweli nqanaba. Ngelishwa, ukuba kunzima ngakumbi ukufumanisa iingxaki zempilo, le ndlela yokuqiqa ingabalalisa nayiphi na enye ingcali malunga neengxaki zangempela.
Okwesibini, ukuxilongwa, nokuba ngaba kuqala, kuya kubhalwa kwiirekhodi zakho. Ingaba okanye akunjalo, liyakwazi ukuba nefuthe kwixesha lakho elizayo lokufumana i-inshurensi ukuba ibonakalisa ukuba kukho imeko ekhoyo ngaphambili.
Ngezo zizathu, uya kufuna ukuphinda uqaphele ukuba ukuxilonga kubhalwe ngokuchanekileyo ngokunokwenzeka. Unokufumana ugqirha wakho akakucelanga ukuxilongwa kwoluhlu; kunoko, unokuthi ubhale phantsi kwindawo engenanto kwenye indawo kwi-risithi.
Ukuba ufumana ukungafani, kuya kufuneka usebenze kunye neofisi yakho yegqirha ukulungisa irekhodi lakho lezokwelapha .
Xa usubonile amagama asetshenziselwa ukuchaza ukuxilongwa kwakho, uya kufuna ukuphinda uhlolisise i-ICD Code - ewe-oogqirha beenkqubo zeefowuni ezimele zijongane nazo.
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Qhawula i-ICD-9 okanye i-ICD-10 Amakhodi kwiRiphablikhi yoNyulo loNyuloIikhowudi ze-ICD - izibane zobomi bakho-ziyikhowudi ezibonisa ukuxilongwa kwakho. Unokufunda okungakumbi malunga nokuba bavelaphi, kutheni kukho iiseti ezimbini ( ICD 9 ne-ICD 10 ) kwaye kutheni zibaluleke kakhulu kugqirha wakho.
Iikhowudi ze-ICD ziqulethwe ngabalingane abane okanye ezintlanu kwaye zinendawo yokugqibela. Uza kubafumana ngokubhekiselele kumagama okuxilongwa kwi risithi yokuqeshwa.
Njengamakhowudi e-CPT, amagama okufumanisa kwakho, kwaye iikhowudi zokuxilongwa kwakho kufuneka zifanane.
Ukuba udibanisa iikhowudi ze-ICD 9 okanye i-ICD 10 kumazwi ugqirha wakho abhale kwaye athetha kuwe kwaye ufumene ukungahambelani, wambize ngogqirha wakho kwangoko kwaye ucele iphutha ukuba lilungiswe . Awunako ukukwazi ukufumana ezi khowudi zichazwe kwiimaphepha ezinokuchaphazela ukukwazi kwakho ukunyamekela, okanye i-inshurensi oyifunayo, kwikamva.
Ngoku ukuba uyayiqonda ingcaciso kwirejista yokunikezelwa kwenkonzo yegqirha, isinyathelo sakho esilandelayo siya kuqhathaniswa nokufumana i-receipt yakho yokuqeshwa kwegqirha kwi-bill yegqirha, kwaye kamva i-EOB (inkcazo yenzuzo) evela kumhlawuli wakho.