Kulipira ngongole kumachitika mutatha kulipiritsa ndalama zanu, ndalama zothandizira ndalama kapena kampani yanu ya inshuwaransi nayenso akulipiranso zonse zomwe mukuyenera kulipiritsa pamalonda anu azachipatala. Ngati pangakhale ngongoleyo pa ngongoleyo ndipo dokotala kapena chipatala akuyembekeza kuti mubwerere malirewo, mukulipira ndalama.
Kodi Kulipira Ngongole Makhalidwe Kapena Osati?
Nthawizina ndizovomerezeka, ndipo nthawizina siziri; zimadalira zochitika ndi malamulo a inshuwalansi a boma lanu.
Kulipira ngongole nthawi zambiri sikuletsedwa :
- Pamene muli ndi Medicare ndipo mukugwiritsa ntchito wothandizira zaumoyo omwe amalandira ntchito ya Medicare.
- Pamene muli ndi Medicaid komanso wothandizira zaumoyo ali ndi mgwirizano ndi Medicaid.
- Dokotala wanu kapena chipatala ali ndi mgwirizano ndi ndondomeko yanu yaumoyo ndipo akukulipirirani kuposa momwe mgwirizano umaloleza.
Pazifukwa izi, mgwirizano pakati pa wothandizira zaumoyo ndi Medicare, Medicaid, kapena kampani yanu ya inshuwalansi ikuphatikizapo ndime yomwe imaletsa kubweza ndalama. Mwachitsanzo, pamene chipatala chimawauza Medicare kuti awone odwala a Medicare, ayenera kuvomereza kuvomera Medicare negotiated rate, kuphatikizapo kulipira kwanu, monga malipiro athunthu. Izi zimatchedwa kulandira ntchito ya Medicare .
Kulipira ngongole kumakhala kovomerezeka :
- Pamene mukugwiritsa ntchito wothandizira zaumoyo omwe alibe ubale kapena mgwirizano ndi inshuwalansi, Medicare, kapena Medicaid. Izi ndizofala muzochita zachipatala , ndipo ndizomwezo ngati mutasamala kunja kwa inshuwalansi yanu. Ndondomeko yanu ikhoza kubweza ndalama zowonongeka, koma wogwiritsira ntchito pa Intaneti sakakamizidwa kulandira kulipira kwa inshuwalansi mokwanira; iwo akhoza kukutumizirani ndalama za zotsalira zotsalira, ngakhale ziri zoposera za dongosolo lanu la kunja-la-network kapena deductible.
- Pamene mukupeza maofesi omwe sali otetezedwa ndi inshuwalansi ya umoyo wanu, ngakhale mutalandira malonda awo kuchokera kwa wothandizira omwe ali ndi mgwirizano ndi dongosolo lanu la thanzi. Izi zimakhala zachizolowezi zodzikongoletsa zomwe sizili zofunikira kuchipatala. Pankhaniyi, mudzakhala ndi udindo pa bili yonse.
Popeza inshuwalansi ya umoyo imayendetsedwa ndi boma lirilonse, malamulo a boma akhoza kuthandizira ngati komanso kulipira ngongole. Maiko ena ali ndi malamulo enieni okhudza kubweza ndalama zomwe zimasiyana ndi mfundo zapamwamba pamwambapa. Phunzirani zambiri za malamulo a boma pa kulipira ndalama kuchokera ku Kaiser Family Foundation.
Momwe Mungagwiritsire Ntchito Ntchito Zokongoletsera
Mukasamalidwa ndi dokotala, chipatala, kapena othandizira ena omwe sali mbali ya chithandizo cha inshuwalansi (kapena ngati muli ndi Medicare, kuchokera kwa wothandizira amene sakuvomereza ntchito ya Medicare), wothandizira zaumoyo angathe ndikukulembani chilichonse chomwe akufuna kuti akukakamizeni. Popeza kampani yanu ya inshuwalansi siinayambe kugwirizana ndi munthu ameneyo, iye sagwirizana ndi mgwirizano ndi dongosolo lanu la thanzi.
Ngati kampani ya inshuwalansi yaumoyo ikuvomereza kulipira kuchuluka kwa chisamaliro chanu cha kunja kwa intaneti , ndondomeko ya thanzi salipira peresenti ya zomwe kwenikweni zimalipira . M'malo mwake, amapereka chiwerengero cha zomwe akunena ziyenera kuti zidayikidwa, zomwe zimadziwika kuti ndizokwanira komanso zachikhalidwe . Monga momwe mungaganizire, ndalama zowonongeka ndi zachizolowezi zimakhala zochepa kusiyana ndi ndalama zomwe mumalipira. Ndalama yamalonda imachokera pa kusiyana pakati pa zomwe inshuwalansi akunena ndi zomveka komanso mwambo, ndi zomwe dokotala kapena chipatala amapereka.
Pano pali chitsanzo cha chipatala chomwe chimapereka ndalama zokwana 20% zothandizira ogwira ntchito m'zipatala komanso 40% zothandizira anthu ogwira ntchito kuchipatala.
| Chipatala cha intaneti (20% coinsurance) | Chipatala chakunja (networking 40%) ndi balance balance | |
| Chipatala chimadandaula | $ 60,000 | $ 60,000 |
| Inshuwalansi imayendera mlingo wotsika | $ 40,000 | Palibe kuchotsera chifukwa chipatalachi sichikutuluka |
| Insurer ali wokwanira komanso wamakhalidwe | $ 45,000 | |
| Inshuwalansi amapereka | $ 32,000 (80% ya $ 40,000 mtengo wotsika) | $ 27,000 (60% ya $ 45,000 olingalira ndi mwambo wamakhalidwe) |
| Mumalipira coinsurance ya | $ 8,000 (20% ya $ 40,000) | $ 18,000 (40% ya $ 45,000) |
| Kusamalipira ndalama ndalama | $ 0 | $ 15,000 (Chipatala choyambiriracho sichikhala inshuwaransi ndi malipiro a ndalama) |
| Mukamalipira mokwanira, mwalipira | $ 8,000 | $ 33,000 (Anu coinsurance pamodzi ndi otsalira.) |
Kodi Kulipira Ngongole Kumatheka Bwanji?
Ku United States, kubweza ngongole kumachitika makamaka mukasamalidwa ndi dokotala kapena chipatala chomwe sichiri gawo la kampani yanu yothandizira inshuwalansi kapena sakuvomereza ntchito ya Medicare.
Malipiro osadalirika omwe akugwiritsidwa ntchito: Zopereka Zogwiritsa Ntchito Zogwiritsa Ntchito Pa Intaneti
Izi zingachitike mosayembekezereka, ngakhale mutayesa kukhala mu intaneti. Mwachitsanzo, mumapita kuchipatala cha intaneti, koma radiologist yemwe amawerenga ma-ray anu sali mu-intaneti. Ndalama ya kuchipatala imasonyeza kuti mu-intaneti mulibe ndalama ndipo sizingatheke kulipira, koma radiologist, popeza alibe mgwirizano ndi inshuwalansi, akhoza kukulipirani chilichonse chomwe akufuna komanso ali ndi ufulu wolipira ndalama. Zomwe zimachitika ndi:
- Anesthesiologists
- Akatswiri a zachipatala
- Neonatologists (madokotala kwa ana obadwa)
- Intensivists (madokotala omwe amadziwika kwambiri ndi odwala ICU)
- Achipatala (madokotala omwe amagwira ntchito muzipatala odwala)
- Akatswiri a sayansi ya zakuthambo (madokotala omwe amatanthauzira x-rays ndi scans)
- Odwala ER
- Zomwe zimatha nthawi zonse zothandizira ogulitsa zipangizo zachipatala (ie, kampani yomwe imapereka zikhomo, ma-braces, ma wheelchairs, ndi zina zotero zomwe anthu amafunikira pambuyo pa chithandizo chamankhwala)
- Mapulogalamu alandiridwa kuchokera kwa wotsogolera wosankhidwa ndi wina. Izi zikhoza kuchitika ngati muli ndi mapepala kapena mapulogalamu opangidwa mu dokotala wanu, kapena magazi otengeka ndi namwino wathanzi. Ngati dokotala wanu kapena namwino atumiza kafukufuku ku labata yodutsa, ma labulo akhoza kukupatsani ndalama.
Izi zimakhala zowawa kwambiri kwa odwala, omwe amakhulupirira kuti ngati atasankha chipatala chachipatala, chisamaliro chawo chonse chidzagwiritsidwa ntchito motsatira ndondomeko yaumoyo wawo. Pofuna kuthetsa vutoli, mayiko angapo asankha malamulo ogwiritsira ntchito ogula malonda omwe amalepheretsa kubweza ndalama zolimbitsa thupi (ndizofunikira kudziwa kuti malamulo a boma akugwiritsidwa ntchito pazinthu zowonongeka za boma. Zolinga zaumwini, zomwe abwana ambiri amagwiritsa ntchito, zimayendetsedwa ndi lamulo la federal, pansi pa ERISA):
- Arizona inakhazikitsidwa ndi Senate Bill 1441 mu 2017. Idzayamba kugwira ntchito mu 2019, ndipo idzalola odwala omwe amalandira malipiro osadalirika (kuchokera kwa munthu amene sakhala naye pa intaneti omwe amapereka chithandizo pa intaneti) ya $ 1,000 kapena zambiri kuti afunefune kukangana. Ndondomeko ya kukakamiza idzathetsere vuto pakati pa wodwalayo ndi kampani ya inshuwaransi, motero amusiya wodwalayo kuti ali ndi udindo pa ndalama.
- New York yatha kuteteza odwala kuti azilipira ndalama zodabwitsa kuchokera mu 2015.
- California inakhazikitsidwa AB72 mu 2016; likugwiritsidwa ntchito pa mapulani omwe aperekedwa kapena atsopano pa July 1, 2017, ndipo amalepheretsa odwala kuti azilipiritsa ndalama zowonongeka pazinthu zosamalidwa zomwe zimapezeka pa-intaneti.
- Florida inakhazikitsa HB221 mu 2016. Lamulo limateteza odwala kuti asamangokhalira kulipira panthawi yovuta komanso pamene wodwala akufunafuna kusamala pa malo omwe ali pa intaneti ndipo amatha kuchitidwa-popanda njira ina - malo.
- Maryland, Illinois, ndi Connecticut imakhalanso ndi malamulo otetezera ogulitsa ku bizinesi yodabwitsa. Maiko ena ambiri ali ndi chitetezo chochepa m'malo.
Kulipira ngongole sikuchitika kawirikawiri ndi opereka mauthenga kapena othandizira omwe amalandira ntchito ya Medicare chifukwa, ngati akulipira ngongole, akuphwanya malamulo awo ndi inshuwalansi kapena Medicare. Amatha kutaya mgwirizano, akukumana ndi zolipira, amavutika kwambiri, komanso amatsutsidwa milandu nthawi zina.
Zosiyana ndi izi zikuchitika mukamagwiritsa ntchito intaneti, koma mukupeza utumiki umene sungapangidwe ndi inshuwalansi yanu ya umoyo. Popeza kuti inshuwalansi siyendetsa ndalama za ntchito zomwe sizikuphimba, simungatetezedwe ndi malingaliro omwe akugwiritsidwa ntchito pa inshuwalansi. Wothandizira angathe kupereka chilichonse chimene akufuna, ndipo ndiwe amene ali ndi udindo pa bili yonseyo.
Ngati Mukulimbitsa Ngongole
Ngati mwalandira ndalama zamalonda kapena mukuganiza kuti mudzalandira chithandizo chamankhwala chomwe chidzabweretsere ndalama, mumakhala ndi njira zina zothetsera vutoli. Phunzirani zomwe mungasankhe ndi njira zomwe mungagwiritse ntchito pokonza malipiro mu " Kulipira Ngongole-Momwe Mungachitire, Zimene Muyenera Kuchita ."
> Zotsatira:
> Thumba la Commonwealth. Kulipira Ngongole ndi Othandizira Zaumoyo: Kuwonetsa Kuteteza kwa Ogulitsa M'mayiko Onse
> United States Dipatimenti Yochita Ntchito. Wogwila ntchito pantchito yotenga ndalama pantchito.