Medicare ndi makampani ena apakampani a inshuwalansi yaumwini amapereka chithandizo cha chipatala cha omwe amapindula nawo pogwiritsa ntchito njira ya kulipira kwa DRG . Nthawi iliyonse mukavomerezedwa ngati chipatala kuchipatala, chipatalachi chimapereka DRG kuti alowe. Chipatalachi chimalipira ndalama zokwanira za DRG, mosasamala kanthu za ndalama zomwe zimagwiritsirani ntchito kukuchitirani. Ngati chipatala chingakupatseni ndalama zochepa kuposa momwe Medicare amalilipira pa DRG yanu, chipatala chimapanga ndalama pa chipatalachi.
Ngati chipatala chikugwiritsani ntchito ndalama zambiri kukusamalirani kuposa Medicare amapereka kwa DRG yanu, ndiye chipatala chimatayika ndalama kuchipatalachi.
Phunzirani zambiri za izi mu " DRG 101: Kodi DRG & Kodi Ikugwira Ntchito Motani? "
Kuti mudziwe kuchuluka kwa chipatala chomwe chimaperekedwa kuchipatala china chilichonse, muyenera kudziwa choyamba chimene DRG inapatsidwa kuchipatalachi. Komanso, muyenera kudziwa mlingo wa chipatala. Limbikitsani dokotala, ndalama, kapena dipatimenti yosungirako zochitika pa chipatala ndikufunseni zomwe Medicare yake ikulumikiza.
Kuwona Ndalama Zambiri Kodi Chipatala Chimalipidwa Chifukwa Chopatsidwa DRG
DRG iliyonse imakhala yolemera kwambiri chifukwa cha kuchuluka kwa zinthu zomwe zimatengera kusamalira wodwala amene wapatsidwa ku DRG. Mukhoza kuyang'ana kulemera kwake kwa DRG yanu polemba tchati choperekedwa ndi Centers for Medicare ndi Medicaid Services monga malangizo awa:
- Pitani ku tsamba ili pa webusaiti ya CMS.
- Penderera pansi pa tsamba. Pezani malo omwe ali ndi "Zosungidwa."
- Sungani tebulo 5.
- Tsegulani fayilo yomwe imawonetsa chidziwitso ngati Excel spreadsheet (fayilo yomwe imatha ndi ".xlsx".)
- Mndandanda wotchedwa "zolemera" umasonyeza kulemera kwake kwa DRG iliyonse.
Chiwerengero cholemera chiwerengero ndi 1.0. Ma CDG ndi olemera kwambiri oposa 1.0 ali ochepa kwambiri othandizira kuchiza ndipo nthawi zambiri amachiza mtengo wochizira. DRG ndi kulemera kwake kwaposa 1.0 kawirikawiri imafuna zina zothandizira kuchiza ndipo ndizofunika kwambiri kuchiza. Zomwe zimakhala zolemera kwambiri, zowonjezera zowonjezera zimayenera kuchitira wodwalayo ndi DRG.
Kuti mudziwe kuchuluka kwa ndalama zomwe chipatala chanu chinaperekedwa kuchipatala chanu, muyenera kuchulukitsa kulemera kwanu kwa DRG ndi chiwerengero cha chipatala chanu. Pano pali chitsanzo ndi chipatala chomwe chili ndi ndalama zokwana madola 6,000 pamene kukula kwa DRG yanu ndi 1.3:
$ 6,000 X 1.3 = $ 7,800. Chipatala chanu chinaperekedwa madola 7,800 kuti mupite kuchipatala.
Kodi Chipatala Chogwiritsidwa Ntchito Chakale Chimachita Chiyani?
Popeza kuti chithandizo chamankhwala chimagula komanso ntchito zimasiyana m'dziko lonse lapansi komanso ngakhale kuchipatala kupita kuchipatala, Medicare amapereka mlingo wosiyana pa chipatala chilichonse chomwe chimalandira Medicare. Mwachitsanzo, chipatala ku Manhattan, ku New York City, chimakhala ndi ndalama zambiri zogwirira ntchito, ndalama zowonjezereka kuti zisamalire, komanso ndalama zowonjezereka kuposa chipatala ku Knoxville, Tennessee. Chipatala cha Manhattan chimakhala chokwanira kuposa chipatala cha Knoxville.
Zinthu zina zomwe Medicare zimapanga mu chipatala chanu chotsatira chotsatira ndi monga kaya ndi chipatala chophunzitsira ndi anthu omwe akukhalamo komanso anthu ogwira nawo ntchito, kaya ali kumidzi kapena ayi, komanso ngati sakhala ndi gawo la anthu osauka komanso osalimbikitsidwa. Zonsezi zimapangitsa kuti chiwerengero cha chipatala chiwonjezeke.
Mwezi wa October, Medicare amapatsa chipatala chilichonse chiwerengero chatsopano. Mwa njira iyi, Medicare ikhoza kugwiritsira ntchito ndalama zomwe zimapereka chipatala chilichonse chomwe chimaperekedwa osati kudziko lonse lapansi monga momwe mitengo ya pansi pano imakhudzidwira, komanso mchitidwe wa chigawo. Mwachitsanzo, ngati malo amakula kwambiri, chipatala m'derali chikhoza kutaya malo ake akumidzi.
Zotsatira:
Federal Register, Medicare Program; Zachipatala Zopereka Zopereka Zopereka Zachipatala Zachipatala ndi Zomwe Zakhalapo Nthawi Zambiri Zopitiramo Chipatala Zosintha Zosintha Zosintha Ndondomeko ndi Chaka cha Ndalama 2016 Kulipira; Kuwonetseratu kwa Zofunikira Zowonetsera Zofunikira kwa Omwe Amapereka Zopadera, kuphatikizapo Kusintha Kogwirizana ndi Ndondomeko ya Zaumoyo za Zachipatala za zaumoyo; Zowonjezereka za Medicare-Dependent, Dipatimenti ya Chipatala Chaching'ono ndi Kukonzekera kwa Malipiro Ochepa kwa Achipatala, 8/17/15.