Ukufaka isimangalo nge-Medicaid

Isinyathelo ngesinyathelo usizo

I-Medicaid iyinhlangano yomshuwalense wezempilo kubantu abanomvuzo ophansi kanye nemindeni abangakwazi ukukhokhela ukunakekelwa kwempilo. Amasevisi we-Medicare ne-Medicaid Services (i-CMS) yi-agency federal elawula futhi iqondise yonke izinhlelo ze-Medicaid zombuso. Abamukeli abamukelekayo bathola ukunakekelwa kwezokwelapha kubahlinzeki abese bekhokha i-Medicaid ngezinsiza. Lokho kukhokhwa kwenzeka ezingeni lendawo ngakho wonke umbuso uhlukile endleleni uhlelo olulawulwa ngayo.

Masifunde ukuthi singafaka kanjani isimangalo nge-Medicaid.

Ngaphambi Kokuthi Ungabhalwa Umthamo Kufanele Ube Umhlinzeki

Abanikezeli kumele banikezwe ilayisense futhi bavunyelwe ngokwemithetho nemithethonqubo ethize esebenza enkonzweni enikeziwe.

Abanikezeli be-Medicaid abafanelekayo kumele bafake isicelo futhi babhalise ohlelweni lwe-Medicaid, banikezwe inombolo yomhlinzeki, futhi bavumelane nemibandela ethile yokubamba iqhaza ngaphambi kokuba inkokhelo ingenziwa ngezinsizakalo ezinikeziwe. Hlola ngesimo sakho.

Ubani Othinta Indlela Ofaka ngayo

Uhlobo lwesicelo ozifakela ukukhokha luhluka ngokuthi uhlukaniswa kanjani njengomhlinzeki. Izinhlangano ezilandelayo zihambisa izimangalo zesikhungo njengesibonelo:

• izindlu zokunakekela abadala
• ama-ejensi ezempilo ekhaya
• amasevisi okubhedlela
• izindawo zokwelapha

Izimangalo zomsebenzi zifakwe ngu:

• abahlinzeki bemishini yezokwelapha ezihlala njalo
• amasevisi we-infusion therapy ekhaya
• izinsizakalo zokunakekela abasebenza ngasese

Ukufaka isimangalo

Okulandelayo yiziqondiso ezijwayelekile. Uma kunesihloko kulesi sihloko kuhlola isimo sakho.

Ngokuvamile une unyaka owodwa kusukela ngosuku lwenkonzo noma ngosuku lokugcina lokusebenza ukuze ufake ifayela.

Nawa amanye ama-acronyms nezincazelo ezingakusiza njengoba uhamba ngezinhlobo zamafomu.
I-MPN : Inombolo Yokuhlinzeka Ngama- Medicaid, Inombolo ehlinzekwa nge-Medicaid enamadijithi ayi-7 atholakele ekubhaleni.
I-NPI : Isihlonzi seNhlinzeko kaZwelonke, inombolo ye-NPPES-ikhishwe ngamadijithi angu-11 atholakele ngesicelo.

I-Taxonomy Code : ikhodi yezinhlamvu ezingu-10 emele uhlobo lomhlinzeki kanye nokukhethekile.

1. Thola ifomu lakho lokumangalela lombuso. Amazwe ngokuvamile asekela amafomu abo okufaka izicelo ezivela kumgomo kazwelonke owakhiwe yiKomidi leZimangalo likaZwelonke. Thola ifomu lesicelo sesampula.
2. Ifomu lemali elikhulu lokufaka isicelo liyazichaza futhi libonakala ngokucacile njengoba uhlola ngakho sizohlanganisa izindawo ezingase zibe nzima kakhulu ngokusebenzisa ifomu lesampula kwisixhumanisi ngenhla. Ungase ufune ukukuphrinta. Ingxenye ephezulu yamafomu amaningi idinga imininingwane yabantu mayelana nesiguli kanye nomuntu ophephile (uma ehlukile kwesiguli). Ingxenye engezansi idluliselwa kumniningwane womhlinzeki noma umphakeli.
3. Isigaba 14 - Usuku Lokugula Kwamanje, Ukulimala - Usuku lokugula noma ukulimala okwamanje kubhekisela ekutholeni kokuqala kokugula, noma usuku oluqondile lokulimala.
4. Isigaba 17 - Igama Lomhlinzeki Obhekisela - Faka igama kanye neziqinisekiso zobungcweti abaye bakhuluma, bayala, noma baqondisa izinsizakalo noma banikezela (i) kumangalo. Into 17a - izihlonzi zomhlinzeki zinikezwa umhlinzeki. Into 17b: Faka inombolo ye-NPI yomdlulisi.
5. Isigaba 21 - Ukuxilongwa noma uhlobo lokugula noma ukulimala - Ukuxilongwa noma uhlobo lokugula noma ukulimala kusho uphawu, uphawu, isikhalazo noma isimo sesiguli esiphathelene nemisebenzi noma isimangalo. Faka uhlu lwamakhodi we -ICD-9 -CM.

1. Into 24B - Faka ikhodi efanele amadijithi amabili kusuka ohlwini lweNdawo Yezinsizakalo Zendawo ngayinye into esetshenzisiwe noma isevisi eyenziwe. Ikhodi Yendawo Yesevisi ichaza indawo lapho isevisi yenziwe khona. Thola lapha.
2. Into 24D - Izinqubo, Amasevisi, noma Izimpahla - Faka amakhodi we-CPT noma i-HCPCS kusukela kumakhodi afanele aqaliswe ngosuku lomsebenzi. Thola uhlu olunzulu kumaCenter for Medicare neMediicaid Services.
3. Fakela ifomu lesicelo ngokulandela imiyalelo ehlinzekwe yihhovisi likaMedique Medicaid. Ezimweni eziningi, ungahambisa kuphela isimangalo ngekhompyutha. Lokhu kungadinga ukuba ulande noma uthole isofthiwe ethile yezinhloso zokudlulisela. Uma kungenjalo, kuzodingeka uthumele ngefeksi noma uthumele ifomu lesimangalo ku-state of Medicaid processing processing unit.

Ngenxa yokuthi usebenzisana nohulumeni okudingeka ulandele imiyalelo ngokucophelela noma ubhekene nezimangalo zenqatshelwe bese ubese uphinde ubathumele. Qonda ukukopisha ukuze uhambise izimangalo ngokufanele ngenkathi unciphisa noma yikuphi amaflegi abomvu akhuliswa enqubo.