I-National Health Care Anti-Fraud Association ithi u-3% wezingaphezu kwamaRandi 2 trillion asetshenziselwe ukunakekelwa kwezempilo ngo-2007 ulahlekelwa umsebenzi wokukhwabanisa. Ezinye izinhlangano zilinganisela ukukhwabanisa ku-akhawunti kuze kufike ku-10% yazo zonke izindleko. Ubugebengu beMedare buyingqayizivele futhi isikhathi esiningi sihamba singatholakali, kubakhokhisa abakhokhi bentela izigidigidi zamaRandi ngonyaka ngamunye.
Ukukhwabanisa kwezeMpilo kwenzeka ngezindlela eziningana, kubahlinzeki abaningi ekunakekelweni kwezempilo, okungenzeka ukuthi:
- Umthethosivivinywa ngezinsizakalo abanganikezanga.
- " Ikhodi ye-Upcode ," okusho ukuthi inikeze isevisi, kodwa ikhokhelwe izinga eliphakeme laleyo nsizakalo efanayo. Isibonelo, ungase ube nezimpawu zomkhuhlane. Kodwa udokotela wakho angase akhokhe imali ye-pneumonia, noma ngabe konke onayo ngempela kubanda.
- Nikeza izinsizakalo ezingadingekile. Ungathola i-EKG ehhovisi likadokotela, noma ngabe awudingi. Lezi zinsizakalo zihlale zenziwa ehhovisi lelo dokotela, nje ngokuba nekhono lokukhokhisa okuthile okungeziwe, hhayi ngoba udinga isevisi.
- Umthethosivivinywa wezinsizakalo okungezona zomshuwalense ezingabhekwa, futhi zingase zakhiwe kabusha ukuze zikhokhiswe. Isibonelo, ukuhlinzekwa kwepulasitiki "umsebenzi wempumu" ongahlanganiswa yomshuwalense kungabizwa ngokuthi i-septum ephukile, okuyinto inqubo ekhokhwayo.
- "Vula" isevisi. Ngezinqubo ezidinga izinyathelo eziningana futhi zingakhokhiswa ngesamba esisodwa, umhlinzeki angase abeke ukuzithengisa ngabanye ngakho-ke angeza kuze kube nokunye ukubuyisela.
- Iziguli zeBill ezingaphezu kwama-copay azo ezinsizakalo. Lokhu kubizwa ngokuthi " ukukhokhisa ibhalansi ." Njengoba nje ukukhwabanisa ukukhokhisa isiguli esengeziwe uma amasevisi esekhokhisiwe kakade.
- Yamukela imali yokudlulisela kwabanye abahlinzeki.
Eqinisweni, ukukhwabanisa kwezempilo kungaba yingozi kokubili ezempilo iziguli kanye nezikhwama zabo.
Ngaphandle kokuthi kuthatha imali eningi emaphaketheni ethu, ikakhulukazi ama-Medicare noMedicaid ukukhwabanisa okukhipha imali yethu yokukhokha intela, le miisebenzi yokukhwabanisa ibhalwe kumarekhodi ethu wezokwelapha . Ekugcineni, lezi zimfundiso ezingalungile zingaholela ekwelapheni okungalungile, amaphutha kumarekhodi ethu e- Medical Information Bureau , ngisho nokwebiwa kwezokwelapha .
Iziguli ezihlakaniphile zizobuyekeza amarekhodi azokwelapha ngamaphutha , kufaka phakathi ukulinganiswa komshuwalense wezinzuzo, futhi zenze izilungiso kunoma yimaphi amaphutha abathola.
- Uma ubukeza amarekhodi akho bese uthola amaphutha athinta ukuthi umhlinzeki wakho ukhokhelwe kangakanani, bese ubika ukuphazamiseka kumshwalense wakho.
- Uma lowo okhokhwayo ekhokhwa yi-Medicare, i-Medicare inikeza inqubo yokwenza umbiko.
- Ngokufanayo, uma inkinga ihilela isimangalo se-Medicaid, kunenqubo yokubika ukukhwabanisa kweMedicaid, futhi.
Ngenxa yokuthi ukukhwabanisa kwezempilo sekuvame kakhulu futhi kubiza, ngokuvamile kubhekwa njengengxenye yengxoxo yokuguqulwa kwezempilo e-United States.