Kubwezera inshuwalansi kumadalira kulondola kwa chiwerengero cha mankhwala
Kulemba coding ndi zamakono ndizofunikira kwambiri kupeza ndalama zobwezera inshuwalansi komanso kusunga mauthenga odwala. Zolemba zamakalata zimapangitsa wogulitsa inshuwalansi kudziwa matenda kapena kuvulala kwa wodwala komanso njira ya chithandizo.
Chigamulo chodandaulira zachipatala ndi ndondomeko yogwiritsidwa ntchito ndi a inshuwalansi kuti ayese kukopera ndikuyesa ngati njirayi idzabwezeredwa, kukanidwa, kapena kuchepetsedwa.
Ngati pali kulakwitsa mukopera, kungapangitse kuti chigamulocho chikutsutsidwa. Matenda kapena ndondomeko ya ndalama sizingapangidwe ndi pulogalamu ya inshuwalansi, kapena ikhoza kubvumbidwa pang'onopang'ono, ngakhale kuti idaperekedwa kale
Chifukwa chake, wothandizira sangathe kulipidwa mokwanira pa ntchito yomwe wapereka, kapena wodwalayo angakhale mosayembekezereka kuti azilipira ndalamazo kuchokera ku thumba.
Zoopsa za Kuwerengera ndi Kuwongolera
Pangakhalenso zotsatira za malamulo ndi zachuma pa zolemba zolakwika zamankhwala. Kukopa pa chiwerengero ndi malipoti amodzi mwa njira zomwe zimabweretsa malipiro apamwamba ndi inshuwalansi. Izi zikhoza kuonedwa kuti ndizochinyengo ndipo zimayambitsa kuimbidwa mlandu, ndi zolakwa zalamulo ndi zachuma.
Vuto losiyana ndilokulembera, osati kuphatikizapo zizindikiro za njira zonse zomwe zimayendetsedwa kapena kuzilemba pa njira zomwe zibwezeredwa pamtunda wotsika. Izi zimabweretsa ndalama zowonongeka kwa wopereka.
Mfundo zofunika kwambiri zokhudzana ndi zizindikiro zolembera ndi ICD (Dongosolo Lonse la Matenda) zomwe zimadziwika kuti zizindikiro za matenda.
Kuzindikira ndi Mapulogalamu Otsatira
Zizindikiro za kugwiritsira ntchito zimagwiritsidwa ntchito pofotokoza matenda, matenda, chikhalidwe, vuto kapena kudandaula komwe kumakhudzana ndi chithandizo cha wodwala.
Kusanthula kuyenera kuwerengedwera pamtundu wapadera wa ulendowu.
Kawirikawiri, ma ICD amagwiritsidwa ntchito pamodzi ndi ma HCPCS (Healthcare Common Procedure Coding System). Ma code HCPCS amafotokozedwa m'magulu atatu.
- Ndondomeko yoyamba ya CPT (Current Procedural Terminology) ili ndi nambala zisanu ndi ziwiri ndipo imayang'aniridwa ndi American Medical Association (AMA). Zipangizo za CPT zimagwiritsidwa ntchito pofuna kupeza chithandizo cha zamankhwala ndi njira zomwe amalamulidwa ndi madokotala kapena akatswiri ena ovomerezeka.
- HCPCS ya Pakati lachiwiri ndi zizindikiro za alfabata zomwe zili ndi kalata imodzi ya alfabata yotsatira nambala zinayi ndipo imayang'aniridwa ndi The Centers for Medicare ndi Medicaid Services (CMS). Zizindikirozi zimasonyeza kuti sizinali zachipatala monga ma ambulansi, zipangizo zamankhwala zolimba, ndi mankhwala.
- Makhalidwe a Mndandanda wachitatu ndi alphanumeric zizindikiro W, X, Y, kapena Z zotsatiridwa ndi zilembo zinayi. Mwinanso amadziwika ngati zida zapanyumba, zizindikirozi zimagwiritsidwa ntchito ngati code yosiyana pamene palibe mlingo Woyamba kapena ndondomeko yachiwiri yachiwiri kuti ndizindikire.
Zizindikiro zovuta kwambiri ndi DRG's (Kuzindikira Zogwirizana Zogulu). Ma CDG ndi ophatikiza:
- Kudziwa
- Ndondomeko
- Mavuto
- Zizindikiro
- Machitidwe omwe alipo kale
- Zaka ndi Gender
Ma DRG amagwiritsidwa ntchito polemba zifukwa zothandizira odwala. Ambiri a inshuwalansi amalipira molingana ndi DRG, choncho, kulondola kwa zigawo zonse ndizofunika kuti munthu azibwezeredwa.
Zolondola zimadalira pazigawo zambiri. Kukhazikitsa nthawi yatsopano kusintha kwa coding, kutsata ndondomeko yoyenera yolembera ndi kusunga ndondomeko yokhudzana ndi odwala ndi njira zosavuta kuti zitsimikizo zachipatala zikhale zolondola.