Amagama ehhovisi lezokwelapha ezibalulekile awuzwayo ku-TV
Izigidi zezibukeli ziyakuthanda ukubukela "udokotela okhombisa" njalo ngesonto nokuthakazelisa ngombono wezokwelapha, ukuqoqa izinsimbi kanye nezicucu ze "udokotela ukukhuluma" futhi uzizwe unolwazi futhi uhlakaniphile. Kodwa uma umsebenzi wakho usehhovisi lezokwelapha, ukwazi i-ins kanye nokuphuma kwezokwelapha amagama kanye nesikhombimsebenzisi sehhovisi lezokwelapha kungaba yinselele. Awunakwenzeka ukuzwa okuningi kuwo engxoxweni emibonisweni yezokwelapha.
Kubukeka sengathi kunezigidi zemigomo ebalulekile okudingeka ukwazi, futhi kubalulekile ukwazi kuphela i-etymology kanye nezimpande zamagama ezempilo kodwa futhi nokukhokhisa nokubhala ngekhodi. Ngayinye ibalulekile, kanti ngenkathi kungadingeki ukwazi imigomo efanele yezokwelapha ingxenye ngayinye yesistimu yamathambo uma usebenzela i-proctologist, kubalulekile ukuba okungenani ube nolwazi olunolwazi lwazo zonke izinhlelo zomzimba. Amagama okukhokhisa nokubhalisa azohluka kodwa azoba nomenclature oweqa.
Imigomo Yokuhlinzeka
Eminye imisho yesikhungo sezokwelapha ijwayelekile. "Inethiwekhi" yilizwi lokuxhumana phakathi komshwalense kanye nodokotela, izikhungo, kanye nabahlinzeki abavunyelwene nale nkampani yomshuwalense. Umhlinzeki "ongaphandle kwenethiwekhi" ongenawo isivumelwano ne-insurer ethile. Kubaluleke kakhulu ezigulini zakho ukuthi wazi lo mthelela njengoba omunye uzokhokhwa ngesilinganiso esiphezulu kunomunye uma ekhokhwa nhlobo.
Abanye abahlinzeki benethiwekhi abakhokhwa ngaphandle kwezimo ezithile ezingavamile. "Okuphambene" yisikhathi sehhovisi lezokwelapha elisho ngaphansi kwezimo ezithile noma izimo njengoba kuchazwa umshwalense umhlinzeki angakhokhwa ngezinsizakalo.
Imigomo yokukhokha kwezokwelapha
Wonke umhlinzeki uzosebenzisa futhi amagama "izinzuzo ezivunyelwe," "ukufaka isicelo," "ukukhokhelwa ngokubambisana" kanye "nokukhipha imali." Le migomo ihlobene nalokho okukhokhayo oyokhokha umhlinzeki, izinkokhelo kumkhokheli wezohwebo, kanye nezinkokhelo ezenziwe isiguli kudokotela, indawo, noma umhlinzeki ngokuvamile ngesikhathi senkonzo kodwa ngezinye izikhathi ngaphambi kwenkonzo noma ngaphambi kokuba inkampani yomshuwalense izokhokha.
Kubalulekile ukuqaphela ukuthi nakuba lezi ziyimigomo evamile kubo bonke izinkampani zomshuwalense nabakhokhisi, amagama angeke asho into efanako phakathi komunye. Abakhokheli bezentengiselwano ngabanye banalo ulimi lwabo oluhlukile, kanti ngenkathi kuvamile ukuba kugcinwe izinga lokusetshenziswa kwamagama, kubalulekile ukuba unakekele ukuthi ufunda okuqondene nomkhokheli ngamunye wezokuhweba ukuze kuqinisekiswe ukuthi isiguli nomhlinzeki bathola izinzuzo eziningi.
Amagama amathathu abalulekile kakhulu abanikezeli bezokwelapha yi- HIPAA , i- ICD-9-CM , ne-Assignment kanye namafomu okugunyazwa. Ifomu lesabelo kanye nokugunyazwa ngenye yezimiso zokuqala zebhizinisi ehhovisi lezokwelapha njengoba linikezela ihhovisi lezokwelapha igunya lokukhokhisa inkampani yomshuwalense ngokuqondile futhi uthole ukukhokhelwa kwezinsizakalo ezinikeziwe. Lokhu kusiza isiguli ngokuthi sithathe ingxenye yomthwalo wemfanelo kubo ukuba bafake amafomu okufaka isicelo somshuwalense ongahle adideke kulabo abangenalwazi kumasu okukhokha kwezokwelapha.
Ukwengeza, umkhokheli wezohwebo angakhokha umhlinzeki ngokuqondile ukugwema noma yikuphi ukubambezeleka kokukhokha. I-HIPAA yiMthetho Wokubheka Umshwalense WezeMpilo nokuPhatha futhi unikwe igunya lokuqinisekisa. Lo Mthetho ucacisa izinhlawulo ezinkulu zokungahambisani nemithetho kuwo, ngakho ulwazi lwalokhu lubalulekile.
I-ICD-9-CM yi-International Classification for Diseases, umagazini we-9 nge-Clinical Modifications. Lawa amakhodi ajwayelekile amarekhodi wezokwelapha kanye nezicelo zomshuwalense. Edalwe futhi ihlolwe yi-World Health Organization, ukulinganisa kwalezi zinhlobo zamakhodi ezinombolo kusiza iziguli ngokwenza kube lula odokotela nabahlinzeki bezokwelapha noma yikuphi ukukwazi ukuqonda ukuthi yini udokotela noma ngabe ikuphi emhlabeni.
Amakilasi kanye Nezinsiza Zezokwelapha Zezokwelapha
Lezi zimbalwa nje zezinkulungwane zehhovisi lezokwelapha eziqondene nalokho okumele uchwepheshe wezokwelapha afunde khona.
Kukhona amakilasi, izikole, kanye nezitifiketi eziqondene nesilulumagama sehhovisi lezokwelapha. Ngenkathi isidingo ngasinye somsebenzi singazazi yonke yale migomo, kubalulekile ukuthi izinsiza zamanje zitholakale uma kudingeka, futhi abasebenzi basehhovisi lezokwelapha banolwazi olusebenzayo lwegama eliyisisekelo se-term office yezokwelapha.