Malemba Akutsatiridwa Monga Momwe Mumagwiritsira Ntchito Ngongole
Mukapempha za inshuwalansi kapena inshuwalansi ya zachipatala, padzakhala ziganizo zingapo zomwe olembawo angagwiritse ntchito kuti awononge kuchuluka kwa zomwe angakulipire kuti akukulimbikitseni.
Popeza, mwalamulo, a inshuwalansi sangathe kukutsutsani (monga mwa gawo la mtengo wodalirika wa Act ), ayenera kuti adziŵe kuchuluka kwa ndalama zomwe adzakwanitse kulipira, zomwe zimawonjezera phindu lomwe akuyembekezera kuti, inenso.
Chiwerengerocho chidzakhala ndi premium yothandizira inshuwalansi .
Kuchokera kwa Medical Data
Kuti apange chigamulochi, adzalandira deta kuchokera kumagulu osiyanasiyana; Deta yomwe yasonkhanitsidwa ponena za iwe ndi thanzi lako zomwe mwina simunadziwe zinalikusonkhanitsidwa. Zina mwazomwezi zidzakhala ndondomeko yanu ya Medical Information Bureau , ndondomeko yanu ya ngongole, mbiri yanu ya mankhwala ndi mankhwala anu omatira.
Ambiri a ife sitidziwa kuti wina kupatula tokha kapena madokotala, akusunga mbiri ya malamulo athu. Ndipotu mbiri yakale ingagulidwe ndi inshuwalansi ndi ena kuchokera ku makampani awiri. Ndalama ya IntelliScript (yofalitsidwa ndi kampani yotchedwa Milliman) ndi database ya MedPoint (yotulutsidwa ndi kampani yotchedwa Ingenix) onse amayang'ana deta iyi, ndikuigulitsa ku thanzi, olumala, ndi makampani a inshuwalansi.
Popeza kuti zokhudzana ndi thanzi la munthu ndi chisamaliro, makampani onsewa ayenera kutsatira malamulo a HIPAA .
Iwo sangakhoze kugulitsa kapena kugawa nawo chidziwitso popanda chilolezo chanu. Komabe, kuti mupeze inshuwalansi ya umoyo, mukuyenera kupereka chilolezocho.
Kujambula deta iyi pamodzi ndi mawonekedwe omwe angathe kugulitsa kwa inshuwalansi, uthenga wa IntelliScript ndi MedPoint kuchokera ku Pharmacy Benefits Managers (PBMs).
Ma PBM amachokera ku kampani yanu yamakona (yomwe mwina ili mbali ya makina akuluakulu) ku ma pharmacies akuluakulu a ma mail monga ExpressScripts kapena CVS Caremark. Mukamadzaza malamulo anu pa PBM iliyonse, amatha kufufuza kuti dokotala wanu ndi ndani (ndizofunika kuti adziwe), mankhwala ndi dokotala yemwe adakulamulirani chifukwa chake, kaya mwadzaza kapena ayi mankhwala, komanso ngati ayi.
Kuchokera ku deta, iwo akhoza kupeza ziganizo zingapo:
- Iwo amatha kudziwa zomwe mukupeza, kapena kuti pafupi, ndipo ngati muli ndi (kapena muli) vuto lalikulu (lomwe lidzatha) kapena vuto lalikulu (lomwe mwina lidzabwereranso nthawi zina, kapena kukuvutitsani kwa moyo wanu wonse.)
- Angathenso kudziwa momwe matenda anu amakukhudzirani ndi mphamvu ya mlingo kapena momwe dokotala akuganizira kuti mukuyenera kutero. Vuto lalikulu silingakuvutitseni, choncho silidzawawononga ndalama zambiri, ngati chili chonse. Koma vuto lalikulu, monga matenda a shuga kapena matenda a mtima, ngakhale kuthamanga kwamphamvu kwa magazi, kungakhale okwera mtengo kwambiri pakapita nthawi. Akawona mavuto aakulu omwe apita patsogolo, adzakhala chitsimikizo kwa olemba malembawa omwe amafunika kuwongolera ndalama zambiri ku kampaniyo, ndi kukweza malipiro anu moyenera.
- Angathe kudziwa ngati muli ndi comorbidities , kutanthauza, kuposa chinthu chimodzi cholakwika ndi inu. Kuphatikiza kwa mavuto azachipatala kungawawononge ndalama zochuluka koposa momwe mungagwiritsire ntchito vuto lililonse payekha. Mwachitsanzo, mtengo wochiza matenda a mtima ndi khansara nthawi yomweyo ukhoza kukhala wotsika mtengo kuposa kuchiza matenda a mtima m'magulu amodzi kuphatikizapo khansa mu wodwala wina.
- Deta ikuwonetsa momwe mumadzaza nthawi zonse malamulo anu, choncho, ngati simukugwirizana nawo. Izi ndizofanana ndi zomwe zinalembedwa ndi FICO mapiritsi othandizira mankhwala omwe olemba mabuku angagwiritse ntchito kuyerekezera. Ngati muli ovomerezeka, ndithudi, mankhwala anu okhudzana ndi mankhwala adzakhala ndi ndalama zomwe angathe kukonza. Koma zikhoza kuwalankhulanso, malinga ndi momwe mukudziwira, kuti mukuwongolera vutoli kotero kuti sipadzakhalanso ndalama zazikulu mu nthawi yochepa zomwe sizingatheke.
- Olemba mabukuwo adzayang'ana kuti awone ngati mwauzidwa mankhwala opweteka kwa nthawi yaitali. Ngati munazifuna zaka zingapo zapitazo koma simunadzaza mankhwalawa posachedwa, ndiye sipadzakhala ndalama zina. Koma ngati pakalipano mukupiritsira mapiritsi, ndipo ngati mlingo wawonjezeka mwamphamvu kapena kawirikawiri, udzakhala mbendera yofiira kwa olemba mabuku omwe amafunika kuti awononge mtengo wa mapepala anu. Angayese kufufuza ngati mukugwiritsa ntchito mankhwala osokoneza bongo, mwachitsanzo. Kapena angasankhe kukulipirani zambiri ngakhale mavuto akuluakulu omwe angapangitse ngati mupitiliza kufunafuna chisamaliro chanu, kapena ndalama zambiri mukumwa mankhwala osokoneza bongo.
Mwina pangakhale zifukwa zina zomwe makampaniwa amagwiritsa ntchito pogwiritsa ntchito mbiri yanu ya mankhwala. Ndipo pakapita nthawi, ngati zambiri ndi zambiri zimakhalapo kuchokera kumagwero ena monga makhadi odala malipiro , olemba mabuku adzaweruza zina za momwe mumatsogolere moyo wanu, ndipo mtengo wawo wa inshuwalansi ndi wofunika kwambiri.
Chitetezo cha Odwala
Tsoka ilo, sizimapanga kusiyana ngati ziganizo ndi ziweruzo zawo ziri, kapena sizolondola. Ndipo mtengo kwa inu udzakhala wochokera pa zogwirizanazo, ziribe kanthu momwe zingakhalire zolakwika.
Pali odwala ang'ono kapena opanda kanthu omwe angachite kuti adziteteze okha ku chidziwitso ichi kupatula kutsimikizira kuti deta ya mbiri yakale ndi yolondola. Popeza kuti amagwiritsidwa ntchito kudziwa mtengo wa inshuwalansi yanu, onse a IntelliScript ndi MedPoint ayenera, mwalamulo, kutsatira ku Fair Credit Reporting Act (FCRA). Izi zikutanthauza kuti, monga momwe mulili ngongole, mukhoza kupempha mankhwala anu lipoti la mbiri kwaulere ku mabungwe awa kamodzi pachaka, kapena pamapeto pake mumatsitsimula inshuwalansi ya moyo kapena kulemala.
Pezani Zolemba Zanu Zamankhwala
Ndizomveka choncho, ngati muli pamsika wa inshuwalansi yaumphawi, kuti mulandire zolemba zanu zachipatala (zolemba zonse, osati mbiri yanu ya mankhwala), muziwongolera mosamalitsa , ndi kukonza zolakwika zilizonse .
Kuti mulandire lipoti la mbiri yanu ya mbiri ya IntelliScript, pitani 877-211-4816.
Pempho lanu la MedPoint, pitanani 888-206-0335 kapena lembani kuti:
Kugwirizana kwa MedPoint
Ingenix, Inc.
2525 Lake Park Blvd.
West Valley City, Utah 84120