Iyini i-A / R Dashibhodi yakho ebukeka?

Umbiko wokuthola ama-akhawunti (A / R) wenzelwe ukuhlaziya impilo yezezimali yehhovisi lezokwelapha . Inhloso yombiko we-A / R ukuhlukanisa izikweletu zehhovisi lezokwelapha ngokwezinga le-akhawunti yeziguli zesiguli. Ukuguga, noma inombolo yezinsuku ezivelele, ze-akhawunti yesiguli, kubalulekile ekuboneni ukuthi yimaphi ama-akhawunti okwamanje angakhokhelwa futhi adinga ukuxazululwa

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Izinhloso eziyinhloko

Izinhloso eziyinhloko zombiko we-A / R yizi:

• Ukuqapha: Umbiko we-A / R iyithuluzi elibalulekile lokuphatha elivumela ihhovisi lezokwelapha ukuqapha izinkomba zokusebenza ezibalulekile (KPIs) ukuze kuhlolwe izinqubo nemisebenzi, wenze izinqumo ezibalulekile zebhizinisi, futhi kuthuthukiswe ukusebenza kwezimali.
• Ukuhlaziya: Umbiko we-A / R uvumela abaphathi ukuba bahlaziye ukusebenza kwehhovisi lezokwelapha ukuze bathole izinkinga ezingase zivele, baqaphele imbangela eyinhloko yezinkinga ezikhona, futhi banqume ukusebenza kwezinqubo nezinqubo zamanje zamanje.
• Ukuphatha: Umbiko we-A / R unikeza ulwazi oludingekayo ukuphatha ngokuphumelelayo abasebenzi bezokwelapha kanye nezinqubo ngokugxila okucacile nokuqondisa ukufinyelela izinhloso nezinhloso zenhlangano.

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Ukuqapha umbiko we-A / R

Umbiko we-A / R iyithuluzi elibalulekile lokuphatha evumela ihhovisi lezokwelapha ukuqapha izinkomba zokusebenza eziyinhloko (i-KPIs) ukuze kuhlolwe izinqubo nemisebenzi, wenze izinqumo ezibalulekile zebhizinisi, futhi kuthuthukise ukusebenza kwezimali. Ukuqapha umbiko we-A / R unikeza inkomba yokuthi ihhovisi lezokwelapha liphi ezindaweni ezimbili ezinkulu:

1. Umsebenzi wokukhokha: Umbiko we-A / R uzokhombisa lokho okukhokhelweyo nokuthi yini engakabanjwanga nsuku zonke, ngesonto nenyanga nenyanga.
2. Ukuphumelela kweqoqo: Umbiko we-A / R uzobonisa ukuthi yini eqoqwe, ukuthi yini engakaqoqwanga, nokuthi yini ekhulile noma engaphezu kwesikhathi esingakhokhiwe.

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Ihlaziya idatha ye-A / R

Umbiko we-A / R uvumela abaphathi ukuba bahlaziye ukusebenza kwehhovisi lezokwelapha ukuze bathole izinkinga ezingase zivele, baqaphele imbangela yezinkinga ezikhona, futhi banqume ukuphumelela kwezinqubo nezinqubo zamanje. Ukuhlaziya idatha ye-A / R kuvumela ukuthi abaphathi benze izinqumo ezibucayi ngendlela yokuguqula ama-akhawunti ngendlela engakhokhelwa esimweni esikhokhelwayo.

Umsebenzi wokukhokha

Izimangalo zomshuwalense kufanele zikhokhwe zingakapheli izinsuku ezintathu ngosuku lokukhishwa. Leli festile lezinsuku ezintathu livumela isimangalo ukuthi sidalwe ukukhokhisa futhi sinikeze isikhathi sokuthi isimangalo sibuyekezwe futhi sihlelwe ngokunemba. Ngezinye izikhathi ama-akhawunti agcinwe isikhathi esingaphezu kwezinsuku ezintathu silinde ukubuyekezwa okunye noma ulwazi ngaphambi kokukhokha. Ukugcina ithrekhi yokuthi izikweletu ezisheshayo noma kancane zithunyelwa kubanikazi bomshuwalense zihlinzeka ngokuqonda izindawo ezingadinga ukunakwa okwengeziwe.

Ukuphumelela kweqoqo

Lapho umbiko we-AR ubonisa ukuthi imali engenayo ayiqoqiwe zingakapheli izinsuku ezingu-30 usuku lokukhishwa kwesiguli, lokhu kuyisixwayiso kubaphathi ukuthi kukhona ingozi esimweni sezimali sehhovisi lezokwelapha. Ama-akhawunti asebekhulile aphelele ama-akhawunti wezguli eziphelile izinsuku ezingu-30. Umbiko we-A / R uvame ukukhombisa ama-akhawunti asebekhulile ngolwazi olulandelayo:

1. Igama lokukhokha
   • I-BCBS
   • Ukuhweba
   • I-HMO
   • Isibopho
   • I-Medicaid
   • Medicare
   • Ukuzikhokhela
   • Abasebenzi Comp
   • Okunye
2. I-oda lokukhokha
   • Okuyinhloko
   • Secondary
   • Ephakeme
3. Inombolo yezinsuku zokuguga ngemva kokukhishwa
   • Izinsuku 0 - 30
   • Izinsuku ezingu-31 kuya ku-60
   • Izinsuku 61 - 90
   • Izinsuku 91 - 120
   • Izinsuku ezingu-121 - 150
   • Izinsuku ezingu-151 - 180
   • Izinsuku ezingu-180 +

4. Ingqikithi yamaRandi evelele kanye namaphesenti

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Ukuphatha Ngokusekelwe ku-A / R Data

Umgomo jikelele we-A / R ukuphathwa ukufeza isikhathi esincane kunazo zonke zokuqoqa. Ukuqinisekisa ukugeleza kwemali kukwanele ukuphathwa okusebenzayo, ihhovisi lezokwelapha linomthwalo wokwandisa amathuba okuthola imali.

Ukuphathwa kwama-akhawunti okutholakele kuhilela cishe zonke izindawo zehhovisi lezokwelapha. Ukuphathwa okuphumelelayo kwama-akhawunti okumele kutholakale kudinga ukuqonda ngokugcwele ukuthi indawo ngayinye noma umnyango uhlobene kanjani futhi uthonya umjikelezo wemali kanye neqoqo le-A / R.

Imiphumela eqoqayo yokulandelela amaqoqo ekuxazululeni okusheshayo kwezimangalo zehhovisi lezokwelapha. Ukulandela okumangalelwa kufanele kuqale ngokushesha ezinsukwini ezingu-7 kuya kwezingu-10 ngemuva kokuthi isimangalo sakho sithunyelwe ngenkokhelo. Imizamo esheshayo yokuthola izimali ezikhokhwayo ngeke inciphise kuphela ama-akhawunti akho atholakele kodwa ikhulise nokugeleza kwemali.

Ukusebenza okwanele ngokuqeqeshwa okuqokelelwa kahle kuzohlinzeka ngomphumela oyifunayo kwisigaba sokuqoqa umjikelezo wemali. Abasebenzi behhovisi lezokwelapha kufanele baqaphele izinyathelo eziyisisekelo ezidingekayo ukuze kulandelwe ukulandelwa kwemali yomshuwalense.