Ukusetshenziswa kweSaziso se-Medicare Advance Beneficiary ku-Medical Office

Isaziso Sokuhlomula Ngokwemvelo Sokungenzi Inzuzo (i-ABN) isaziso seMediare sidinga abahlinzeki bezempilo ukuthi bakhiphe iziguli ze-Medicare ukuze zibaqaphele ukuthi uM Medicare angeke akhokhe izinsizakalo ezithile noma izivivinyo ngaphambi kokuzenza ukuba zilungiselelwe iziguli. Lokhu kuvumela isiguli ukuba senze isinqumo esinolwazi mayelana nokuthi bafuna ukuthola yini izinsizakalo futhi bamukele umthwalo wemali ophelele uma uM Medicare engakhokhi.

I-ABN ayidingekile ezintweni noma ezinsizakalweni uM Medicare azifihla. Isibonelo, amazinyo, ama-acupuncture, ukuhlinzeka ngezimonyo, izinsiza zokuzwa, nokunakekelwa kwezinyawo ezivamile akudingi i-ABN ngoba ayifakwe ngaphansi kwe- Medicare Part A ne- Part B.

IFomu CMS-R-131 yokusebenzisa imali yokusebenza ye-ABN itholakala kuwebhusayithi ye-CMS.gov ngesiNgisi nangesiSpanishi.

Abahlinzeki Kumele Baphumele i-ABN noma Abakwazanga ukukhokhela uMsebenzi ongatholakali

Ngokomhlahlandlela we-Medicare, umhlinzeki kumele anikeze isiguli se-Medicare i-ABN noma ngeke sikwazi ukukhokhela isiguli ngensizakalo engaziwa. Uma i-ABN ikhishwa futhi isayinwe yisiguli, umhlinzeki angakwazi ukukhokha ngokukhululekile isiguli ngezinkokhelo ezingekho. Lapho i-ABN ingakhishwa, umhlinzeki ngeke akwazi ukukhokhela izinsizakalo ezingakaziwe emgqeni.

Izizathu ze-Medicare Ngamanje angangena i-Item noma Isevisi evame ukuvuthwa

Abanikezeli kumele banikeze i-ABN uma bekholwa ukuthi uM Medicare angeke akhokhele into noma isevisi ngokuvamile ehlanganiswa ne-Medicare.

Isizathu esijwayelekile ukuthi akusilo ukufaneleka kwempilo nokudingekayo, kufaka phakathi izinto zokuphenya, lezo ezingabhekwa njengokuphephile noma eziphumelelayo, lezo ezingaboniswa ukuxilongwa kwesiguli, noma uma inani lezinsizakalo lidlula labo abavunyelwe yi-Medicare esikhathini esithile ukuxilongwa kwesiguli.

Imishini yezokwelapha kanye nempahla inganqatshwa ngoba umphakeli akanayo inombolo yomhlinzeki noma benza ucingo olungacelwa.

Ukuqeda i-ABN

Kunezinsimu ezigunyaziwe okufanele zigcwaliswe ku-ABN ukuze zibhekwe njengezivumelekile. Ifomu kufanele libe likhasi elilodwa kuphela futhi liphrintiwe ngohlobo olwanele futhi lanyatheliswa ngokungafani okwanele ukuze lifunde kalula. Amafomu kusuka ku-CMS.gov angenziwa ngezifiso ezithile. I-ABN ye-electronic ingasayinwa, kepha inguqulo yephepha kufanele inikezwe ngesicelo. I-ABN inganikezwa nge-imeyili, i-mail, noma ifeksi evikelekile uma nje ilandela inqubomgomo ye-HIPAA. I-ABN esayinwe kufanele igcinwe iminyaka emihlanu kusukela ngosuku lokunakekelwa, kuhlanganise nalapho isiguli esenqaba khona ukusayina noma ukunqaba ukunakekelwa.

A. Igama lomhlinzeki wezempilo, ikheli kanye nenombolo yocingo

B. Igama lesiguli

C. Inombolo Yokukhomba

D. Incazelo yezinsizakalo ezikholelwa ukuthi azitholakali

E. Isizathu sokuthi amasevisi angeke ahlanganiswe yi-Medicare

F. Izindleko ezilinganisiwe zezinsizakalo

G. Amabhokisi amathathu okukhethwa kukho, isiguli kumele sikhethe eyodwa kuphela.

Ulwazi olungeziwe (aludingeki)

I. Isignesha yesiguli noma isiguli esibamele

UJ Date

Kuthiwani Uma Isiguli Senqaba Ukubonisa I-ABN?

Uma isiguli senqaba ukusayine i-ABN, qiniseka ukuthi ubhala phansi i-ABN ngale lwazi. Ngaphandle kokuba isevisi ibaluleke kakhulu empilweni nasekuphepheni kwesiguli, kungase kube umqondo omuhle ukungenzi inkonzo.