Zomwe Mungatenge Ngati Wopereka Inshuwalansi Akusiya Maphunziro
Mochulukira, olipira akulimbikira kuti odwala alandire chilolezo asanayambe kuchipatala kapena mankhwala. Ndipo, atatha kubwereza, angasankhe kusaphimba mankhwalawa. Pokhala ndi mapepala apamwamba omwe anthu ambiri amapereka, izi zingakhale zosokoneza kwambiri. Chifukwa chiyani amalipira nthawi zina amakana kufalitsa kwa dokotala yemwe analimbikitsa chithandizo, ndipo mungachite chiyani ngati izi zikuchitika?
Kodi njirazi ndi ziti?
Mizu ya Inshuwalansi Yopanda Chisamaliro
Pali zokhumudwitsa zochepa zomwe zimatsutsidwa pofuna kupezeka chithandizo pambuyo pa dokotala atapereka ndondomeko yeniyeni yothetsera vuto lanu lachipatala. Izi sizikudetsa nkhaŵa nokha ndipo zingatheke ngati muli ndi inshuwaransi yapadera kapena muli pulogalamu ya boma monga Medicare kapena Medicaid. Mukamaliza kumverera ngati muli ndi yankho ndi / kapena yankho la vuto, kukana izi kungawonongeke.
Nchifukwa chiyani izi zimachitika?
Monga zinsinsi zambiri za chithandizo chamankhwala zomwe zimakhudzana ndi mtengo wa chisamaliro, yankho loyamba la funso ili, " Tsatirani ndalama ."
Kunyalanyaza chisamaliro ndi mawonekedwe a zothandizira zaumoyo . Mungaganize motere: Wa inshuwalansi kapena wobwezera akuyembekeza kutenga ndalama zambiri kuposa zomwe amalipira. Izi zikutanthauza kuti nthawi iliyonse yomwe mukusowa mayeso kapena chithandizo, adzafufuza ngati ndi njira yabwino kwambiri yodziŵira kapena kukuthandizani.
Ngati mukusowa chithandizo kapena mayeso, ndipo sichiwerengedwa kuti ndi gawo la chisamaliro cha matenda anu, ndiye kuti akhoza kukhala ndi chifukwa chosunga ndalama mwa kukana mayeso kapena mankhwala anu.
Omwe akulipira akudziwa kuti pakati pa katatu ya chisamaliro (iwe, dokotala, ndi malipiro anu) zolinga za aliyense ndi zosiyana.
Mukungofuna kuti mukhale bwino. Wa inshuwalansi akufuna ndalama. Dokotala wanu amafuna zonse ziwiri, ngakhale kuti zomwe zikutanthawuza zikhoza kusintha chifukwa chochita. Madokotala ena angasankhe mayeso kapena njira zomwe zingapangitse kuti azipeza ndalama, kapena m'malo mwake, azidalira kutali ndi mayesero kapena mankhwala omwe angapangidwe nawo. Pokhala ndi malipiro, kupanga ndalama zambiri sikukutanthauza kuti kukana mayesero. Zinthu zomwe sizikuchitiridwa bwino zingawononge ndalama zambiri pamapeto pake.
Ngakhale kusiyana kotereku kungakhale kokhumudwitsa kwa odwala, sizowopsa ngati mankhwala ena kapena mayesero omwe ali othandizira alipo. Ndalama zochepa zomwe wobwereketsa amatha, zochepa zomwe timalipira pamalipiro.
Kusiya Pamene Palibe Njira Yoyenera Kapena Chithandizo
Kusiya kungakhale kovuta makamaka pamene palibe njira yothetsera yothetsera. Zitsanzo zomwe sipangakhale njira zina ndizo:
- Matenda osadziwika, opempha mankhwala okwera mtengo, opaleshoni, kapena mtundu wina wa chithandizo.
- Njira yatsopano yothandizira zamankhwala.
- Mankhwala osokoneza bongo (mankhwala operekedwa kwa mankhwala ena osati omwe amavomerezedwa).
- Mankhwala ogwiritsira ntchito mankhwala osokoneza bongo ( mankhwala osanthula omwe sanavomerezedwe, koma omwe angakhale abwino kwambiri).
- Zitsamba ndi / kapena zakudya zowonjezera.
Kodi Mungatani Ngati Mumakanidwa Chifukwa Cholipira?
Ngati mukutsutsa chithandizo kwa olipira, musawope. Kukana sikukutanthauza kuti wokhometsa wanu sangawononge konse mayeso kapena ndondomeko. Pali mitundu yosiyanasiyana ya mankhwala ndipo palibe anthu awiri ofanana. Nthawi zina wolipira amafunikila kuphunzitsidwa chifukwa chake mayesero kapena mankhwala ena apadera angakhale othandiza kwambiri munthu wina.
Musanayambe kutengapo mbali iliyonse yotsatira masitepe ochepa. Sizodziwika kuti mayesero kapena ndondomeko yotsutsidwa chifukwa chakuti sichikopera molondola . Ambiri okwiya amakana kungoyitana foni kumvetsetsa chikhalidwe ndi chiwonetsero.
Kachiwiri, musanayambe kuitanitsa onetsetsani kuti chithandizo chimene mukufuna kuti chikhalepo sichikutchulidwa mwachindunji ku dongosolo lanu. Mwachitsanzo, ngakhale mutakhala ndi chidziwitso chovomerezeka, inshuwalansi sangathe kulipira chamba . Pa nkhani ngati iyi, inshuwalansi sakhoza kulipira ziribe kanthu kaya muli ndi chiani kapena zizindikiro zomwe mukulimbana nazo.
Ngati inu mukukanidwa chisamaliro ndi olipidwa anu, pali zinthu zingapo zimene mungachite.
- Limbani kukana . Nthawi zina zonse zomwe zimafunikira ndikuyenera kuyankhulana ndi chithandizo cha makasitomala anu. Funsani chifukwa chake inu mwakana, ndipo ndi umboni wotani umene angafunike kusintha. Ndiye yesetsani kusintha maganizo awo.
- Funsani dokotala wanu njira zomwe zingakhalepo . Izi ziyenera kuti zizichitidwa panthawi imodzimodzimodzi pomenyana ndi kukana chifukwa chotheka wanu inshuwalansi adzakuuzani kuti pali njira ina. Kukhala ndi chidziwitso chimenechi kukuthandizani kupitiliza kumenyana kwanu, kapena kukupatsani mtendere wa malingaliro omwe akukonzekera A sizomwe mungasankhe.
- Perekani ndalama kwa msonkhano . Ndi kosavuta kuiwala kuti mutha kuyesa mayeso kapena ndondomeko yomwe inshuwaransi yanu imakana mukasankha kulipira nokha. Ngati mwasankha kupita patsogolo ndi ndondomekoyi, onetsetsani kuti mukukambirana mtengo ndi dokotala wanu. Kawirikawiri madokotala omwe amalandira ndalama (osati zonse) amachepetsa malipiro awo akamadziwa kuti munthu ayenera kulipira.
- Musapitilize mayeso kapena mankhwala . Njira iyi ndi yachinayi yakutali. Njirayi ndi yolandiridwa ngati simukukhulupirira kuti mukusowa mayeso kapena mankhwala. Ngati simungathe kufunsa funso ili.
Malangizo ena omwe angawathandize njirayi ikuyenda bwino ndi awa:
- Sungani makalata osamala . Lembani masiku, nthawi, ndi mayina a aliyense amene mumayankhula naye pa kampani yanu ya inshuwaransi. Pemphani kuti malangizidwe kapena kusintha kumatsimikizidwe mwalemba, makamaka kudzera pa imelo kotero kuti imatenga sitampu nthawi ndi tsiku. Mwa kuyankhula kwina, pangani pepala njira.
- Werengani kudzera mwa dongosolo lanu lopindulitsa mosamala. Khalani okonzeka kupereka zifukwa zomwe zimagwirizana ndi zofuna zanu. Mwinamwake mukumverera wokhumudwitsidwa poti muuze kampani yanu ya inshuwalansi zomwe zalembedwa mu ndondomeko yawo, koma si zachilendo kuti muchite zimenezo.
Mfundo Yofunika Ngati Tizilombo Tanu Wa Inshuwalansi Tikutaya Ntchito
Kukana kwa inshuwalansi yaumoyo kungakhale kokhumudwitsa kwambiri pamene ndinu wodwala. Zochuluka kwambiri pamene dokotala wanu akukhulupirira kuti muyenera kukhala ndi mayeso kapena mankhwala enaake. Ndi zophweka kukwiya ndipo amafuna kufuula!
M'malo mwake, nthawi zambiri ndi bwino kuganizira mozama kudzera muzochita zanu. Monga sitepe yoyamba, kambiranani ndi dokotala wanu za njira zina zomwe zilipo . Kudziwa izi mungathe kuziganizira m "mene mukulembera zofunikira komanso zokhudzana ndi mankhwala osaphimbidwa. Munthu aliyense ndi wosiyana ndipo pangakhale zizindikiro zoonekeratu kuti mankhwala amodzi ndi abwino (kaya ndi othandiza kapena zotsatirapo) kuposa wina malinga ndi matenda anu. Madokotala ambiri "amapita kukamenyera" ngati ndi choncho.
Ngati izo zikuwoneka moona mtima kuti mayeso osaphimbidwa kapena chithandizo chingakhale bwino kwa inu, musataye mtima. Limbani kukana. Pamene mukuchita izi kumbukirani kuti inshuwalansi akuyang'ana mawerengero pakupanga zisankho, ndipo anthu sali owerengeka. Wa inshuwalansi ali ndi chidziwitso chokha pokhapokha atayang'ana pempho lanu, ndipo nthawi zina amafunikira "maphunziro" pang'ono mu mbiri yanu komanso mbiri yachipatala kuti muzindikire kufunikira kochizira.
Ngakhale ngati inshuwalansi akutsutsa mankhwala anu (mutatha kulimbana ndi kukana) kumbukirani kuti siwo omwe ali ndi udindo waukulu pa thanzi lanu. Ngakhale kuti zingakhale zodula zazikulu, njira yodzipangira yekha imakhalabebe. Ngati mulibe ndalama mu akaunti yanu, monga momwe anthu ambiri salili, ganizirani njira zomwe mungagwiritsire ntchito chithandizo monga kulandira ngongole, kubwereka kwa abwenzi ndi abambo, pogwiritsa ntchito masamba a Go Fund Me pa Facebook, pokhala ndi ndalama zothandizira ndalama komanso zambiri. Ngati mupita mumsewuwu, kumbukirani kuti ndalama zomwe mumalipiritsa mumatumba nthawi zambiri zimachotsedwa msonkho , ndipo muzochitika ngati izi, nthawi zambiri zimangowonjezera kuti mupumule.
> Zotsatira:
> Gilmore, A. Kukhwima Ndikofunika kwa Zitsanzo Zomwe Zidasintha. Healthcare Financial Management . 2016. 70 (4): 80-5.
> Healthcare.gov. Momwe Mungapempherere ndi Kampani ya Inshuwalansi Chisankho. https://www.healthcare.gov/appeal-insurance-company-decision/appeals/