Zindikirani Kuchita Zowononga ndi Zopindulitsa
Kudzudzula ndi kulipira kwachipatala konyenga komwe kumatiwononga ife ndalama zonse komanso mwinamwake thanzi. Zimatanthawuza mwambo umene wopereka ndalama amapereka inshuwalansi ya umoyo (kaya ali payekha, Medicaid kapena Medicare ) pogwiritsa ntchito chikhombo cha CPT pofuna ntchito yamtengo wapatali kusiyana ndi momwe anachitira.
Kutsutsanako sikuletsedwa. Ndizochita zachinyengo zomwe zimagwiritsidwa ntchito ndi opereka omwe akuyesera kubodza njirayo kuti adzalandire ndalama zambiri kuposa momwe adakambirana ndi owalipirawo.
Ndizofunika kwambiri kwa odwala payekha komanso kwa okhomera msonkho.
Kuwonjezera apo, kukweza mapulogalamu kungakhale ndi zolakwika za thanzi kwa odwala. Zimapereka chidziwitso chonyenga pamabuku awo a zachipatala ndipo zingakhudze momwe angakwanitse kupeza inshuwaransi.
Kutsindika Zambiri
Mchitidwe uliwonse wochitidwa ndi dokotala kapena wina wothandizira zaumoyo ali ndi malemba omwe amavomereza kuti azilipiritsa inshuwalansi, Medicaid kapena Medicare, kapena aliyense amene akulipira ndi-omwe mwina angakhale iwe, wodwalayo. Chikhocho chimatchedwa chikhombo cha CPT, chomwe chikuimira Current Procedural Terminology.
Dokotala wanu akamatumiza chikhombo pa malipiro anu, chiwerengerochi cha CPT chimatsimikizira momwe angaperekere. Zizindikiro zosiyana zimagwirizana ndi njira zosiyanasiyana kapena ntchito zosiyanasiyana ndipo zingakhale ndi ndalama zochepa kapena zochepa. Malingana ngati wothandizira akugwiritsa ntchito ndondomeko yoyenera, ndiye wothandizira amalipidwa malinga ndi machitidwe ndi ndondomeko zochitidwa.
Komabe, ngati wothandizira akukweza, amalemba kachidindo ka ntchito yamtengo wapatali kuposa momwe anachitira.
Zitsanzo za Kutsitsa
- Chitsanzo 1: Mwapitanso kwa dokotala kuti mukafufuze mwamsanga. Makhalidwe a ulendo umenewu akuwonetsa kuti adzalandira $ 50. Koma, ngati dokotala atumiza kachidindo ka CPT kuti awonongeke, adzalandira $ 100.
- Chitsanzo chachiwiri: Dr. Cheater amadziwa amayi a Smith ndi mwendo wosweka. Akazi a Smith a "kuphwanya" ndi kupweteka kwa tsitsi. Dr. Cheater amamuuza kuti asamalire ndipo agwiritse ntchito ndodo kuti asachoke pamtolo wake kwa milungu ingapo.
Komabe, pamene Dr. Cheater amapereka ndalama kwa Medicare chifukwa cha mwendo wa Smith wosweka, amalowamo chikhombo cha CPT chomwe chimasonyeza kuti anaika mwendo wake pamtunda, ndipo kenako amatsitsa kalata yochotsera ntchito zomwe zimamulipira kwambiri kuposa zomwe iye anachita kuti asamalire amayi a Smith, pogwiritsira ntchito zizindikiro zosiyana kuti azigulitsa inshuwalansi pazochitikazo.
Kukonzekera Kungakhale ndi Zotsatira Zoipa pa Umoyo Wanu
Kuwongolera kungakhale ndi zotsatira zoyipa pa chisamaliro chanu cha mtsogolo ndi luso lanu la m'tsogolo kuti mupeze inshuwalansi ya thanzi, malingana ndi chikho chimene dokotala amagwiritsa ntchito.
Mwachitsanzo, tiyerekeze kuti muli ndi zomwe zimamveka ngati mtima wamagalimoto. Dokotala wanu akhoza kuyendetsa EKG ndikupeza kuti mulibe vuto ndi mtima wanu. Mukuchoka, mutulutsidwa. Komabe, ngongole yanu ya dokotala ya EKG, komanso imakulembetsani kuti mupite kwa munthu wodwala mtima, zomwe zimabweretsa ndalama zambiri. Tsopano zolemba zanu zachipatala zimasonyeza kuti mungakhale ndi vuto ndi mtima wanu-zomwe sizili choncho.
Zochita zanu zamtsogolo zingasokonezedwe chifukwa mbiri yanu imasonyeza kuti muli ndi vuto la mtima. Dokotala wina akhoza kupereka mankhwala mosiyana, kapena ngati muwonetsera mu ER , akhoza kukuchitirani mosiyana. Simungalandire chithandizo choyenera chifukwa zolemba zanu ndizolakwika.
Komanso, mukutaya ntchito yanu yamakono ndipo mukupeza kuti mukufunikira kupeza inshuwalansi yotsatira. Inu panopa simungathe kusinthidwa kuti mukhale ndi chikhalidwe chisanayambe pansi pa Affordable Care Act , koma inshuwalansi yanu ikhoza kukuchitirani zambiri kuposa momwe muyenera.
Ndikofunika kuti odwala azitenga zolemba zathu zachipatala pofufuza zochitika ziwiri.
Kutsutsana sikuletsedwa ndipo Zimatipangitsa Ndalama
Kutsutsanako kuli koletsedwa ndi chinyengo . Wopereka wina aliyense yemwe amadzimvera mwachidwi akuswa lamulo.
Monga odwala, tikhoza kuganiza kuti zilibe kanthu kwa ife chifukwa ndi inshuwalansi amene akulipira. Komabe, kukonzetsa ndalama kumatipangitsa ife tonse ndalama, monga okhopetsa msonkho komanso olipiritsa ndalama.
Pamene mankhwala a Medicare kapena Medicaid akulembedwa, ndalama zowonjezera machitidwewa zimakula ndipo ife tonse timalipira chifukwa cha misonkho.
Ngati bwana wothandizira pakhomopo akulandira kalata yodalirika, ndiye kulipira kwa aliyense amene ali ndi inshuwaransi . Mmodzi wothandizira kukweza mapulogalamu angatipatse madola mamiliyoni ambiri panthawi.
Zomwe Muyenera Kuchita Ngati Mukuganiza Kukonza Mapulogalamu
Ngati muwone Zopindulitsa Zanu (EOB) ndipo mukukhulupirira kuti dokotala wanu ali ndi mlandu wokopa, pali njira zomwe mungachite kuti mutsimikizire kuti wobweza wanu sanapereke ngongole.
- Choyamba, kambiranani ndi wopereka wanu ndikufunsani za izo. Iwo akhoza kukufotokozerani chifukwa chake ndi zolondola, kapena angapereke kuti awongolere. Mulimonsemo, zidzakuwonetsani kuti mukuyenera kupitiliza kufufuza EOB yanu nthawi iliyonse yomwe abwera.
- Ngati simukukhutira ndi yankho lanu, ndipo ngakhale atapereka kuwongolera, mufuna kufufuza ma EOB kuti muwone ngati mungathe kuzindikira zovuta pakukweza.
- Ngati mukukayikira kuti wothandizira wanu akulemba kawirikawiri nthawi zonse, mudzafuna kuti mubwereze nthawi yomweyo. Ngati wothandizirayo akulembetsa chisamaliro chanu kangapo, ndiye kuti wachita kwa ena, nayenso.
Ngati wothandizira wanu ndi wothandizira pakhomopo, ndiye aitaneni munthu wogwira ntchito makasitomala ndikufunseni kwa yemwe mungamuuze zachinyengo.
Ngati mulandira Medicaid, muyenera kufufuza ndi ofesi ya Medicaid yanu kuti muwone momwe akufunira kukodola kapena chinyengo china.
Ngati kulipira kwanu ndi Medicare, mudzapeza njira zowonetsera zachinyengo, kuphatikizapo kukodula, pa webusaiti ya Medicare.