Indlela I-Biller Yezokwelapha Ezisebenza Ngayo Izimo Ezihlukene Zikaphakathi
Uma ubheka umsebenzi wokukhokha kwezokwelapha, kubalulekile ukuqonda uhlobo lomsebenzi ezinhlobonhlobo zezakhiwo. Izinkokhelo eziningi zezokwelapha zizokutshela ukuthi kukhona ukungafani okuphawulekayo ekucubungulweni kwezimangalo zezokwelapha kuzo zonke izici ezahlukeneyo nezinhlobo zezikhungo. Kukhona umehluko omkhulu ekukhokhiseni phakathi kokunakekelwa kwezempilo nezinye izimboni. Ekukhokheni kwezokwelapha, kunezinhlobo ezimbili ezihlukene zokukhokhisa-ukukhokhelwa kochwepheshe kanye nokukhokhiswa kwezikhungo.
Kuyini Ukukhokhwa Kwezenhlalakahle Zomsebenzi Wezokwelapha?
Ngenkathi iningi leminye imisebenzi eyenziwa yihhovisi lezokwelapha lifanayo kulo lonke uhlobo lwezokwelapha, ukukhokhiswa kwezokwelapha akuyona. Ihhovisi lezokwelapha lilawula imisebenzi yokuphatha yezokwelapha, kuhlanganise neziguli zokubingelela, ukuhlela ukuqashwa, ukuhlola nokubhalisa, ukuqoqa imali, neminye imisebenzi eminingi kubandakanya ukukhokhiswa kwezokwelapha.
Ukukhokhwa komsebenzi kunesibopho sokukhokhwa kwezimangalo ezenzelwe umsebenzi ezenziwa odokotela, abahlinzeki, nabanye abahlinzeki abangenazikhungo zombili iziguli neziguli zokwelapha.
Amafomu asetshenzisiwe : Izindleko zobuchwepheshe zikhokhiswa kwifomu ye- CMS-1500 . I-CMS-1500 iyifomu elibomvu le-in-red-in-white-fomu yokufunwa ejwayelekile elisetshenziswe odokotela nabahlinzeki ngezinkokhelo zokumangala.
Nakuba izimangalo ezithile okwamanje zikhokhwa ephepheni, i-Medicare, i-Medicaid, nezinye izinkampanini eziningi zomshuwalense zamukela izimangalo zika-elektroniki njengendlela yokuqala yokukhokha. Inguqulo ye-elektroniki ye-CMS-1500 ibizwa ngokuthi i-837-P, i-P imele ifomethi yobuchwepheshe.
Umsebenzi wezokwelapha UJobe Imisebenzi Kule Ukubeka: Abadayisi bezokwelapha abaqeqeshiwe bavame ukuba nemisebenzi eminingi ehlukile kunezikhwama zezokwelapha zezikhungo. Abadayisi bezokwelapha abaqeqeshiwe ngokuvamile bavame ukwazi ukuthi kokubili ukukhokhela nokukhokha. Izinhlelo eziningi zokuqeqesha zokukhokha zinikeza ukukhokhelwa kwezokwelapha kanye nokuqoqa ndawonye. Iningi lalezi zinhlelo zokuqeqesha zivame ukufundisa ngaphezulu ikhodi yokukhokha kunokukhokhisa. Kodwa-ke, abakhokhisi bezokwelapha bangathola ukuqeqeshwa okusemthethweni ekukhokhiseni kodwa imikhuba eminingi idinga ukuthi abakhokhisi babe nesitifiketi sokubhala ikhodi. Ama-Billers angase abe nesibopho sokungena nokukhokhwa kwezinkokhelo ezivela kubanini-mbopha kanye neziguli.
Kuyini Ukukhokhwa Kwemisebenzi Yezokwelapha?
Ukukhokhiswa kwezikhungo kubhekene nokukhokhwa kwezimangalo ezenzelwe umsebenzi ezenziwa izibhedlela, izikhungo zokuhlengikaza abanekhono , nezinye izikhungo zezinsizakalo zokugula neziguli , kuhlanganise nokusetshenziswa kwemishini kanye nempahla, izinsizakalo zelabhoratri, izinsizakalo ze-radiology nezinye izinkokhelo.
Amafomu asetshenzisiwe: Izindleko zezikhungo zikhokhiswa ku- UB-04 . I-UB-04 yi-inkino ebomvu ephepheni elimhlophe lefomu lokufaka isicelo elimhlophe elisetshenziswe ngabahlinzeki bezikhungo ekukhokheni imali. Inguqulo ye-elektroniki ye-UB-04 ibizwa ngokuthi i-837-Mina, mina ngimela ifomethi yesakhiwo.
Umsebenzi wezokwelapha Umsebenzi we-Medical Institutional kule Mithetho: Ngezinye izikhathi izinkokhelo zezikhungo zinemisebenzi ehlukile kunezikhwama zezimali. Ama-billers asezikoleni cishe kuphela anesibopho sokukhokhisa noma enze kokubili ukukhokha nokuqoqa. Ukubhaliswa kwezibhedlela kunzima kakhulu kunokwedluliswa kwamakhodi, ngakho-ke ukubhalwa kwezimangalo zezikhungo kwenziwa kuphela ngamakhodi.
Imisebenzi Nemisebenzi Yamakhono Ezokwelapha
Kungakhathaliseki ukuthi ukukhokhwa kwezisebenzi noma izikhungo, izikhwama zezokwelapha zinomsebenzi obalulekile. Ukuze baphumelele bonke abakhokhisi kumele bafunde ngezindawo eziyisihlanu eziyinhloko:
- Ukuze uthumele izimangalo zezokwelapha ngokuphumelelayo, izikhwama zezokwelapha zidinga ukwazi noma ukuthola ulwazi oluningi kwinkampani yomshuwalense ngamunye.
- Abasebenzi bokukhokha kwezokwelapha banokufinyelela kolwazi oluyimfihlo nolwazi oluyimfihlo lwesiguli futhi kufanele baziswe ngezindlela zokugwema ukwephula imithetho ye-HIPAA yobumfihlo nemithetho yokuphepha.
- Ukujwayela ngokuhlobo lwesofthiwe yokukhokha esetshenziselwa kuzosindisa isikhathi, ukunciphisa amaphutha, nokuvimbela eziningi zezinsizwa. Abadayisi bezokwelapha kufanele basebenzise ngokunenzuzo ukuqeqeshwa ukuthi abahlinzeki be-software banikele futhi uma kunesidingo, xhumana nabo njengoba kudingeka uma kuphakama izinkinga.
- Ukuqonda ukuhlanganiswa kolwazi lokuhlomula kusho ukuqonda indlela yokukhokhisa izimangalo ngendlela efanele ukuvimbela ukubambezeleka kokukhokha.
- Ingxenye ngayinye yesimangalo sezokwelapha imelela imininingwane eqoqwe kusukela ngesikhathi isiguli sigqiba ukuqashwa kuze kube yilapho isiguli sithola izinsizakalo.