Malangizo Polimbana ndi Kampani ya Inshuwalansi ya Zaumoyo
Ngati ndinu mmodzi mwa anthu mamiliyoni ambiri a ku America mwayi wokhala ndi inshuwalansi ya umoyo, panthawi inayake mukufunika kulimbana ndi kampani ya inshuwalansi. Ngakhale ndi inshuwaransi, anthu ambiri amakumana ndi vuto la kampani ya inshuwaransi yomwe imakana kulandira mayeso, mankhwala kapena mankhwala, ngakhale mankhwala omwe mankhwala anu amalimbikitsa kapena kuwalimbikitsa kuti mukhale ndi thanzi labwino kapena chithokomiro.
Kampani yanu ya inshuwalansi inganene kuti mukufunikira chilolezo cham'tsogolo kapena chisanavomereze musanakhale ndi mayeso enaake azachipatala kapena mankhwala, kapena musanayambe kumwa mankhwala enaake a chithokomiro. Ngakhale mutalandira chivomerezocho, bwana wanu inshuwalansi akhoza kutembenuka ndikukana kubweza ndalama, mankhwala kapena mankhwala. Kukana kubisa mankhwala nthawi zambiri kumakhala kovuta kwa odwala chithokomiro omwe amavomereza kuti mankhwala omwe amachititsa kuti asamakhale ndi chithokomiro monga Armor kapena Nature-Throid, kapena odwala khansa ya chithokomiro omwe madokotala amavomereza kugwiritsa ntchito mankhwalawa Thyrogen (thyrotropin alfa), yomwe ingakhale yotsika mtengo kwambiri ndipo sichipezeka mu mawonekedwe achibadwa.
Nchifukwa chiyani a inshuwalansi amakana kulengeza, ndipo mungachite chiyani za izo? Inuyo werengani zambiri za izi m'nkhaniyi, chifukwa chiyani Kodi Wathandizira Wanga Wathanzi Amakana Chisamaliro Changa?
Ogwiritsiranso amadziwikanso kuti amayenda madokotala okha, zipatala kapena ma laboratories, ndipo amakana kulengeza kwa ena.
Izi zingakhale zosokoneza, koma pali zifukwa zomwe inshuwalansi yamatcheri amasankha zawo. Pezani chifukwa chake ena a inshuwalansi akukana kulipira madokotala ena, mabala kapena maofesi, mu nkhani: Chifukwa chiyani Inshuwalansi Yanga Sindikuphimba Madokotala Ndikufuna Kuwawona?
Kodi inshuwalansi yanu ikhoza kumaphatikizapo mankhwala ochiritsira kapena mankhwala ena - monga mankhwala a zitsamba kapena matupi - chifukwa cha chithokomiro chanu ndi zizindikiro zowonjezera?
Ambiri samatero, kwenikweni. Pali zifukwa zomwe a inshuwalansi amakana kubisa chirichonse chomwe sichiri chachizoloŵezi.
Nthawi zina, munthu wothandizira inshuwalansi amakana kulengeza chifukwa cholembera ndalamazo ndizolembedwa ndi code yolakwika ya CPT. CPT imayimira "Mauthenga Amakono Otsatira," ndipo ma code CPT ndi njira zovuta zowerengera zomwe zimaperekedwa kuntchito iliyonse ndi utumiki wogwira ntchito monga mankhwala. Ngati dziko lonse la zida zachipatala liri ngati chinenero chachilendo, mukhoza kuphunzira zambiri za izi mu nkhani yodziwitsa: Kodi Mapu a CPT ndi ati? Kodi Zimakhudza Thanzi Lanu Labwino?
Zizindikiro za CPT sizokhazo zomwe zingakhudze ngati inshuwalansi akulipira kapena akukana kulipira kwanu. Pali njira za Healthcare Common Procedure Coding System (HCPCS) zomwe zimagwiritsidwa ntchito ndi Medicare, NDC (National Drug Codes), zizindikiro za DSM zomwe zimagwiritsidwa ntchito ku matenda okhudza matenda a maganizo, ndi zina zambiri. Mudzawona tsatanetsatane wa mauthenga onsewa mndandanda wa zidziwitso za ma Medical Codes: Guide ya Odwala pa Mauthenga Achipatala .
Kodi mwakonzeka kupita kukamenyana ndi kampani ya inshuwalansi yomwe yakana chigamulo chanu chokhudza chithandizo cha chithokomiro, mankhwala a chithokomiro, kapena mayeso ena opatsirana pogwiritsa ntchito mankhwala omwe dokotala wanu wakuuzani?
Mungaphunzire zambiri kuchokera kwa akatswiri a inshuwalansi ya zaumoyo, Dr. Michael Bihari, m'nkhani yomwe imapereka uphungu wabwino kwambiri pa Kulimbana ndi Thandizo la Inshuwalansi la Umoyo: Nthawi zina Mumapambana, ndipo Thanzi Lanu liyenera kulipira kapena gawo lanu .
Pamapeto pake, ngakhale kuti zikuwoneka kuti mphamvu yowonjezera imalemera kwa inshuwalansi, odwala chithokomiro ali ndi mwayi wonse wopatsidwa mphamvu zogulira thanzi. Wotsogolera Pakupatsa Mphamvu Pulezidenti Trisha Torrey waphatikizapo malangizo abwino kwambiri m'nkhani yake: Zowona za Kukhala Wogwiritsira Ntchito Thanzi Labwino . Trisha nayenso ali ndi mndandanda wabwino kwambiri wa zinthu zake mubuku la odwala la Savvy Pakompyuta .