Uma ubhekene nesidingo sokugunyazwa kwangaphambili , owaziwa njengemfuneko yokugunyazwa kwangaphambili, kufanele uthole imvume yakho yezempilo ngaphambi kokuthola inkonzo yokunakekelwa kwezempilo noma izidakamizwa ezidinga ukugunyazwa kwangaphambili. Uma ungatholi imvume kusuka ohlelweni lwakho lwezempilo, umshuwalense wakho wezempilo ngeke akhokhele inkonzo. Uzobe unamathela ukukhokhisa lesi sikweletu.
Nawa amanye amathiphu okusiza ukuthi uthole imvume yesicelo sokugunyazwa ngaphambi.
Khuluma Nomuntu Ongenza Isinqumo
Ngenkathi yinkampani yakho yomshuwalense wezempilo edinga ukugunyazwa kwangaphambili, akuyona inkampani yakho yomshuwalense wezempilo okwenza isinqumo mayelana nokuthi isicelo sakho sokugunyazwa sokuqala sivunyiwe noma sinqatshelwe . Nakuba izinhlelo ezimbalwa zezempilo zisenza ngaphambi kokugunyazwa ngaphakathi endlini, abaningi bankontileka le misebenzi ukuze bazuze izinkampani zokuphatha.
Uhlelo lwakho lwezempilo lungenza isivumelwano nekhampani yokuphathwa kwezinzuzo ze-imaging radiologic ukucubungula izicelo zayo zokugunyazwa ngaphambi kwezinto ezifana ne-MRI ne-CT. Kungase kuvumelaniswe nenkampani yokuphatha izinzuzo zezempilo ukuziphatha ukuze kusetshenzwe izicelo zokugunyazwa ngaphambi kwezinzuzo zempilo yengqondo nokuziphatha. Kungase kuvumelaniswe nenkampani yokuphathwa kwezinzuzo zekhemisi ukucubungula izicelo zokugunyazwa ngaphambi kwemithi ethile kadokotela noma izidakamizwa ezikhethekile.
Uma udinga ukukhuluma nomuntu ngomzamo wokuthola isicelo sakho sokugunyazwa esandulele, umuntu angakusiza umbuyekezi wemitholampilo enkampanini yokuphatha izinzuzo, hhayi umuntu enkampanini yomshuwalense wezempilo. Umbuyekezi womtholampilo ngumuntu owenza isinqumo sokuvuma isicelo sakho sokugunyazwa ngaphambilini.
Uma ungaqiniseki ukuthi iyiphi inkampani yokuphatha izinzuzo ekusingatha isicelo sakho sokugunyazwa ngaphambilini, uhlelo lwakho lwezempilo luzokukhomba ngakwesokudla. Kodwa, ungaxhomeki kubasebenzi bakho bezempilo ukuze ukwazi ukwenza isinqumo mayelana nokuvuma noma ukuphika isicelo sakho. Gcina umoya wakho uze ukhulume nomuntu owenza ngempela isinqumo.
Bheka Imihlahlandlela Yomtholampilo Eyasetshenziselwa Ukwenza Izinqumo Ngaphambi Kokuthunyelwa
Kwezinye izimo, ungabona imihlahlandlela yomtholampilo ababuyekezi basekela izinqumo zabo. Lokhu kufana nokubona izimpendulo zemibuzo ngaphambi kokuthatha imibuzo, kuphela akukopela.
Angazi noma ngabe imikhombandlela oyithandayo iyini inthanethi? Buza uhlelo lwakho lwezempilo noma inkampani yokuphatha izinzuzo ozisebenzisela ukugunyazwa kwangaphambili. Uma imihlahlandlela yayo ikhona ku-intanethi, kuvame ukujabulela ukwabelana nabo.
Uma wena nodokotela wakho besazi ngemikhombandlela esetshenziselwa ukuvuma noma ukuphika isicelo sokugunyazwa kwangaphambili, cishe uzohambisa isicelo esilula ukuthi umbuyekezi avume. Uvame kakhulu ukuthola imvume ngokushesha uma unikeza umbuyekezi ngokunembile imininingwane abayidingayo ukuqinisekisa ukuthi uhlangabezana nemihlahlandlela yenkonzo oyicelayo.
Uma uhambisa isicelo sakho sokugunyazwa kwangaphambili:
- Faka ulwazi lomtholampilo olubonisa umbuyekezi ohlangabezane nemihlahlandlela yokuhlolwa, isevisi, noma izidakamizwa ozicelayo. Ungacabangi ukuthi umbuyekezi uyazi lutho mayelana nempilo yakho ngaphandle kwalokho ozokuthumela.
- Uma ungahlangabezane nemihlahlandlela, thumela ulwazi oluchaza ukuthi kungani kungenjalo. Ake sithi iziqondiso zithi kufanele uzame futhi uhluleke izidakamizwa A ngaphambi kokuvunyelwa izidakamizwa B. Awuzange uzame izidakamizwa A ngoba uzama ukuzama ukukhulelwa kanye nezidakamizwa A akuphephile kumntwana okhulayo. Pela lokho ngokucacile kwisicelo sakho sokugunyazwa kwangaphambili.
Qaphela Ngolwazi Othumele
Uma uhambisa isicelo sokugunyazwa kwangaphambili, qiniseka ukuthi ulwazi oluthumelayo lunembile futhi luphelele.Izicelo zokugunyazwa zinganqatshelwa noma zilibale ngenxa yephutha leziphutha ezifana nesicelo esithunyelwe isiguli okuthiwa uJohn Appleseed ngenkathi impilo yelungu lezempilo ikhadi le-inshuwalense libala igama lelungu njengoJonathan Q. U-Appleseed, Jr.
Ikhompyutha ingaba "umuntu" wokuqala ukucubungula isicelo sakho. Uma ikhompiyutha ingakwazi ukuthola ilungu lepulani lezempilo elilingana nolwazi oluthumelayo, ungangena ngaphambi kokuthi uqale.
Ngokufanayo, kungenzeka kube ikhompyutha efanisa amakhodi we- ICD-9 noma i-ICD-10 okuxilongwa ngezinqubo zamakhodi we-CPT oyithumelayo, obuka amabilidi ukuthi angavuma ngokuzenzekelayo usebenzisa i-algorithm yesofthiwe. Uma lezo zimakhodi zingalungile, isicelo esingase samukelwe ngokushesha yikhompiyutha sizobe sesithunyelwe emgqeni omude wombuyekezi womuntu ukuhlaziya. Uzolinda ezinye izinsuku ezimbalwa ngaphambi kokuthi uthole izinsizakalo zezempilo zengqondo, imithi yakho yesidakamizwa, noma iskena sakho se-MRI.
Uma unenkinga ukuthola ukugunyazwa kwangaphambili noma ucele isicelo sokugunyazwa ngaphambi, cela ukuthi ubone ukuthi yiluphi ulwazi oluthunyelwe ngesicelo. Ngesinye isikhathi, lapho abasebenzi behhovisi lika-odokotela behambisa isicelo sokugunyazwa ngaphambi, udokotela akakakapheli amanothi akhe omtholampilo ngokuhambela kwakho. Uma abasebenzi behhovisi behambisa amakhophi omsebenzi wakho wokugcina wehhovisi uvakashele amanothi kanye nesicelo sokugunyazwa ngaphambi, amanothi athunyelwe angase ahlangane neze nenkinga yezokwelapha okhuluma ngesicelo sokugunyazwa ngaphambi. Ngolwazi lomtholampilo olungavumelani nesicelo sakho, awunakwenzeka ukuthi isicelo sakho sokugunyazwa sokuqala samukelwe.
Ucele ukulahlwa? Zama futhi
Uma isicelo sakho sokugunyazwa kwangaphambili senqatshelwe, unelungelo lokuthi wazi ukuthi kungani. Ungacela i-ofisi yakho kadokotela, kodwa ungathola ulwazi oluthe xaxa ngokucela inkampani yokuphathwa kwezokwelapha ephikisana nesicelo kuqala. Uma ungaqondi i-jargon abayisebenzisayo, yisho kanjalo futhi ucele ukuthi bachaze, ngesiNgisi esilula, kungani isicelo singavunyelwe.
Ngokuvamile, isizathu sokuphika into ongayilungisa. Isibonelo, mhlawumbe lokho okucelayo kungavunyelwa kuphela emva kokuthi uzame futhi wehluleka ukwelashwa okubizayo kuqala. Izame; uma engasebenzi, thumela isicelo esisha sokubhalisa ukuthi uzame ukuphathwa kwe-XYZ futhi akusizanga isimo sakho.
Ngenkathi unelungelo lokukhalaza isicelo sokuphika isicelo sokugunyazwa, kungase kube lula ukuhambisa isicelo esisha esicacile. Lokhu kuyiqiniso ikakhulukazi uma ukwazi ukulungisa "inkinga" eyenza ukuphika isicelo sakho sokuqala.