UkuLawulwa kweeMangalo zonyango

Ukuba unomdla wokuba ngumgqwetha wezonyango, nantsi isifundo kwiinkqubo zonyango zonyango.

Iinjongo zezifundo

Injongo ye-1: Iimali zamabango ezixhasiweyo

• Chaza i-837-P
• Chaza i-837-I
• Ukuchonga amacandelo eSetter Set Set
• Chaza indawo yokucoca

Injongo yesi-2: Iimfuno zePhepha lokuBala

• Ukuchonga iifomati zokuhlawula iifayile ezahlukeneyo
• Gcwalisa ifom ye-CMS-1500 okanye iB-04
• Ukufakwa ngokufanelekileyo kwebango lephepha

1 -

Iimali zamabango ezixhasiweyo

I-Medicare , iMedicaid , kunye nezinye iinkampani zomshuwalense zamkela amabango e-elektroniki njengendlela yokuqala yokuhlawula. Inkcazelo yekhompyutheni ye-CMS-1500 ibizwa ngokuba yi-837-P, i-P imele ifomathi yobugcisa. Ikhompyutheni ye-elektroniki ye-UB-04 ibizwa ngokuba ngu-837-mna, mna ndimelela ifomathi yeziko.

Ukuphumelela ukufaka iibango zecomputer, ii-billers zimele ziqonde iimfuno zeentlobo ezahlukeneyo zomshuwalense zithumela amabango. Ukuthunyelwa ngalunye kwe-837 kuthumela ifayile yedatha kwi-inshurensi ebizwa ngokuba yi-Transaction Set. I-Transaction Set iphulwe ngamacandelo:

1. Intloko yeNtengiso
2. Inkcazo yoMboneleli Wentlawulo
3. Iinkcukacha zobhaliso
4. Iinkcukacha zeMonde
5. Iinkcukacha zobango
6. Trailer Trailer

Nangona kungabalulekanga ukuba abaqulunqi baqonde ukusetyenziswa kweetekethi, kubalulekile ukuba into nganye ingeniswe kwinkqubo yokuhlawula ilandela izikhokelo ezifanelekileyo ukukhusela iimpazamo kunye nokufunwa kwecala.

Indlu yokuhlanza yinkampani eya kwamkela onke amabango akho kunye nekhompyutheni ngokuyithumela kubakhokheli bomshuwalense ukulungiselela. Baye bahlela endaweni ukuze bahlole iimpazamo kwibango lakho ukuze bancede ukuphepha ukulibaziseka kwintlawulo.

Inzuzo enkulu yokuhlawulwa kwekhompyutheni ingaba usebenzisa i-clearinghouse okanye u-oya kubhalwa i-bill ukuba uya kukhawuleza ukuqhubela ibango lakho. Iphepha lokuhlawula linga kuthatha iintsuku ezingama-45 ukucubungula ngelixa ukuhlawulwa kwe-elektroniki kungathatha iintsuku ezi-7 ukuya kwezi-21.

2 -

Iimfuno zamaphepha eziBhengezo

Iphepha lokuhlawula akulolo lokuqala lokukhetha amabango ezonyango kodwa ngezinye izihlandlo eziyimfuneko. Kakade, inkqubo yebango le-electronics ilula kakhulu kwaye ikhawuleza xa kuthelekiswa nenkqubo yokubhaliweyo yokuhlawula iphepha.

Nanini na ukusetyenziswa kwephepha lephepha, zigcine ezi ngqondweni:

• Khetha ifomu efanelekileyo yokuhlawula: Kubalulekile ukuqonda nokusebenzisa ifom yefowuni yebango eliqhelekileyo. Khetha phakathi kwe- CMS-1500 kunye nefomu zeBB-04 zefowuni.
• Qinisekisa ukuba ifom echanekileyo: Abanye abakhokheli bamkele iinguqu ezimnyama-kunye ezimhlophe zenguqu zamabango ezonyango kodwa inkqubo efanelekileyo kukungenisa ingqungquthela yokuqala ebomvu neyemhlophe. Ngokuxhomekeke kumbahlawuli, xa ifom yesibango sokuqala ayisetyenzisiweyo, ibango alikwazi ukukhangela kwinkqubo yabo ngokufanelekileyo ukudala ukulibaziseka okanye ukuphika inkokhelo.
• Faka idatha echanekileyo kwindawo efanelekileyo: Hlola umrhumeli ngamnye we-inshorensi ukuze ubone ukuba yeyiphi idatha efunekayo. Qinisekisa ukuba yonke idatha ingeniswe ngokuchanekileyo kunye ngokuchanekileyo kwiindawo ezifanelekileyo.
• Faka amaxwebhu afanelekileyo: Ngamanye amaxesha ukuhlawula iphepha kufuna ukuba amaphepha afanelekileyo athunyelwe ngefom yefom yesicelo.

Kaninzi

Isifundo 4: I-Medicare, iMedicaid, kunye nabanye abahlawula

Ukuqonda iingcamango ze-Medicare, i-Medicaid, i-Tricare, kunye nabahlawuli bomshuwalense wezoNkcitho