Usanda kuchitha ihora ehhovisi likadokotela wakho. Njengoba usuka, unikezwa ucezu lwephepha. Inamagama amancane afakiwe futhi amaningi ezinamba ezimbalwa futhi ingaba yingxenye eyodwa yefomu lezinhlobo eziningi. Kithi iziguli, kubonakala njengokwamukela idijithali yokuqokwa kwamasevisi. Abasebenzi bakho udokotela bangabibiza ngokuthi ifomu lokuhlangana, isiliphu sokukhokhisa, ukukhwabanisa, noma isifinyezo esilandelayo sokuvakashela.
Amarisidi wezibhedlela angase abukeke afana, nakuba avulekile kakhulu. Akunandaba ukuthi babukeka kanjani; ulwazi luyoba uhlobo olufanayo lwolwazi.
Ungasebenzisa iresidi yokuqokwa kwaladokotela ukuze uqonde izinsizakalo zezokwelapha ezenziwa.
Ungasebenzisa futhi irisidi ukuthi ikusize uqhathanise nezinsizakalo ezenziwe kubhilidi kadokotela wakho, futhi kamuva umshwalense wakho (noma u-Medicare noma omunye umkhokha) i-EOB, Incazelo Yezinzuzo , ukuqinisekisa ukuthi awukhokhiswa imali engaphezu kwakho kufanele.
Yikuphi Ukwaziswa Okuyoyithola Emtholameni Wokuqokwa Kwodokotela?
Iresidi izokhombisa konke okwenzekile ngesikhathi sokuqokwa kwakho futhi uzohlelela ezinye noma zonke izivivinyo zokulandelela noma zokwelapha okudingeka zenzeke, futhi.
- Ukwaziswa kwakho komuntu siqu kubandakanya imininingwane yakho yomshuwalense (engaboniswa). Uzofuna ukuhlola kabili lapho uthola irisidi ukuze uqiniseke ukuthi lilungile, futhi ukuthi kungokwakho futhi akuzange kuhlanganiswe nomunye umuntu.
- Amagama ezinsizakalo ezenziwe
- Ama-CPT Amakhodi wezinsizakalo ezenziwe
- Amagama namakhodi we-CPT wokuhlola ahlelwe
- Amakhodi wokuthola, amakhodi we- ICD-9 noma amakhodi we- ICD-10
- Kungase kube nezinye izingxenye zokukhokhela kanye nokusayina.
Ake sibheke ngalunye lwalezi zinsimu zolwazi.
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Thatha Bheka Izinsizakalo Ezibekwe ohlwini Lokuqokwa KwakhoUhlobo ngalunye lomkhuba, kungakhathaliseki ukunakekelwa okuyinhloko noma okukhethekile, kuzoba nezinhlelo ezahlukene zezinsizakalo namakhodi kuwo, kuye ngokuthi izinhlobo zenkonzo ezenzayo kanye nesistimu noma izifo ezizibhekene nazo.
Leli fomu ifomu lokunakekelwa okuyisisekelo, futhi izinsizakalo zimboza ezihlukahlukene ezihlolweni zokuhlola eziyisisekelo, kuya kuma-oda okuhlola okuyisisekelo, kuya kuzifo eziyisisekelo.
Lesi sithombe sibonisa ingxenye encane yezinsizakalo ezibalulwe kule risiti kadokotela. Uma ufuna ukubheka lezo zinsizakalo, ungenza kanjalo ngokusebenzisa isichazamazwi sezokwelapha noma uhlu lwezivivinyo zezokwelapha.
Bheka izinsizakalo zokuthola kwakho ezitholakala emibuthanweni noma emasikweni noma ezinye iziqalo ezenziwe noma ezibekiwe. Cabanga ngesikhathi osanda kuchitha nodokotela wakho kanye nabanye ehhovisi ukuze uqiniseke ukuthi uvumelana nelamudi. Isibonelo, uma ubona "umjovo wokungezwani komzimba" uvaliwe, futhi awutholanga noma yikuphi ukudubula, uzofuna ukubuza ukuthi kungani lokho kuhloliwe. Lokhu kuzoba okubaluleke nakakhulu kamuva uma uthola ibhilidi kadokotela .
Manje ake sibheke amakhodi we-CPT, lawo manani amadijithi amahlanu abhalwe eceleni kwesevisi ngayinye.
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Amakhodi we-CPT Ahlelwe Ngomshini Wokuqokwa KwakhoUma usuqaphele izinsizakalo kanye nezinsizakalo zokulandelela ku-bill yakho, uzobona ukuthi ngamunye uhlanganiswe nekhodi edijithi amahlanu.
Lezi zibizwa ngokuthi amakhodi we-CPT. Yonke insizakalo eyodwa udokotela ozokunikeza yona ukuthi ulindele ukukhokhwa izohambisana nenye yalezi zimpawu ze- CPT .
Ama-CPT amakhodi abalulekile kudokotela wakho ngoba anquma ukuthi uzokhokhwa kangakanani ngokuvakashelwa kwakho. Kubalulekile kuwe ngoba ufuna ukuqinisekisa ukuthi uboniswa ngokunembile kumarekhodi akho. Amakhodi we-CPT angalungile angabangela umphumela wokuvuthwa ongase uphele ekuxilongweni okungalungile kuwe, ukwelashwa okungalungile, futhi kamuva, uma udinga ukushintsha umshwalense, kungabangela ukuphika umshuwalense ngezimo ezandulele.
Njengoba nje uhlolisise amagama amasevisi nezinsizakalo zokulandelela ezinikeziwe, uzofuna ukuqinisekisa ukuthi amakhodi we-CPT aqinisile, futhi. Qhathanisa amakhodi we-CPT kumasevisi awo .
Uma uthola ukungafani, kuzodingeka usebenze nehhovisi likadokotela wakho ukulungisa irekhodi lakho lezokwelapha .
Uma unezinsizakalo namakhodi we-CPT ehlanganisiwe, kuyoba yisikhathi sokubheka imininingwane yokuxilongwa.
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Ukuxilongwa kwakho kubhalwe ohlwini lokuqokwa kwakhoEsigabeni esahlukile kusuka kumasevisi nokuhlolwa, uzothola uhlu lokuxilongwa. Njengoba kushiwo ngaphambilini, lezi zifo zizotholakala ekamu lokunakekelwa kokuqala. Abanye ochwepheshe bazoba nokuxilongwa okuhlukile kumarisidi abo, kuye ngokuthi uhlelo lomzimba nezifo abasebenza nazo.
Ukuze ukhokhelwe ngumshwalense wakho, Medicare, noma omunye umkhokheli, udokotela kumele akhethe ukuxilongwa. Uma ubukeza ibhilikithi kadokotela wakho, uzoqonda ukubaluleka kokuqinisekisa ukuthi amasevisi enza uhlu oluhambisana nokuxilongwa okwenziwe. Lokhu kungaba inkinga ngezizathu ezimbili.
Isizathu sokuqala ukuthi kungenzeka ukuthi awukatholakali. Lokhu kusho ukuthi udokotela wakho uzothatha ukuqagela okufundisiwe kuleli phuzu. Ngeshwa, ukuthola okunzima kakhulu ukuhlonza izinkinga zezempilo, lokhu ukuqagela kungakhanyisa noma yikuphi ukubhekwa komunye wezinkinga zenkinga yangempela.
Okwesibili, lokhu kutholakala, ngisho noma kuqala, kuzorekhodwa kumarekhodi akho. Kungakhathaliseki ukuthi kulungile noma kungalungile, kungaba nomthelela ekwenzeni kwakho kwesikhathi esizayo ukuthola umshuwalense uma kubonisa ukuthi kungenzeka isimo esandulele.
Ngalezo zizathu, uzofuna ukuhlola kabili ukuthi ukuxilongwa kubhalwe ngokunembile ngangokunokwenzeka. Ungathola udokotela wakho engakaqapheli ukuxilongwa ohlwini; esikhundleni salokho, kungenzeka ukuthi uyibhale endaweni engenalutho kwenye indawo ngesikhathi sokuthola.
Uma uthola ukungafani, kuzodingeka usebenze nehhovisi likadokotela wakho ukulungisa irekhodi lakho lezokwelapha .
Uma usubonile amagama asetshenziselwa ukuchaza ukuxilongwa kwakho, uzofuna ukuhlola kabili ikhodi ye-ICD - yebo - odokotela bezinhlelo ezihlukile kakhulu zekhodi kumele babhekane nazo.
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Lungisa Amakhodi we-ICD-9 noma i-ICD-10 Kumbuyiselo Wokuqokwa Kwedokotela WakhoAmakhodi e-ICD - i-bane yokuphila kukadokotela wakho - yiwo amakhodi akhombisa ukuthi uyatholakala yini. Ungafunda kabanzi mayelana nokuthi bavelaphi, kungani kunezinhlobo ezimbili zazo (i- ICD 9 ne-ICD 10 ) nokuthi kungani zibaluleke kakhulu kudokotela wakho.
Amakhodi we-ICD anamahlamvu amane noma amahlanu futhi anephuzu eliyisimali. Uzothola eduze kwamagama okuxilongwa kwi-risiti yokuqokwa.
Njengama-CPT amakhodi, amagama okuhlolwa kwakho, futhi amakhodi okuxilongwa kwakho kufanele afane.
Uma ufanisa amakhodi we-ICD 9 noma i-ICD 10 emazwini udokotela wakho abhale futhi akhulume nawe futhi athola ukungafani, khona-ke uyishayele udokotela wakho ngokushesha bese ucela iphutha ukuze lilungiswe . Awukwazi ukukhokhela ukuthi lezi zimakhodi ziphindwe ezincwadini ezingathinta ikhono lakho lokunakekelwa okudingayo, noma umshuwalense oyidingayo esikhathini esizayo.
Manje ukuthi uyayiqonda imininingwane kule risiti yokuqokwa kwamasevisi okuqokwa, isinyathelo sakho esilandelayo sizoba ukuqhathanisa irisidi yokuqokwa kukadokotela wakho esikhwameni sakho sedokotela, futhi kamuva i-EOB (incazelo yezinzuzo) ezivela kumkhokhi wakho.