KuCoding Medical and Billing, Ukuqeqeshwa Okufanele Kuyingqikithi Yokuphumelela
Imbonini yezokwelapha iyimbonini elawulwa kakhulu, ngesizathu esihle, njengoba izigidi zempilo zithinteka izinga lokunakekelwa kwezempilo olunikezwa iziguli ezweni lonke. Kodwa-ke, kungenzeka yini ukuthi imboni yezokwelapha ingalawulwa kakhulu ? Izingcindezi ezikhulayo zemiyalo emisha, izinqubo ezintsha, kanye neziqondiso eziqhubekayo ezinomthelela zithonya kanjani izigidi zabasebenzi bezempilo ezakha abasebenzi bezokwelapha?
Ucwaningo oluthile lubonakala lubonisa ukuthi imboni yezokunakekelwa kwezempilo ingahle ilawulwa ngokweqile, noma okungenani ilawulwa kakhulu kwabasebenzi abaningi bezempilo ukuze bahlale ngaphandle kwamazinga angadingekile okucindezeleka namaphutha. Ukwanda nokuguquka njalo emithethweni yokunakekelwa kwezempilo kuqhubeka njalo kwengeza izingxenye zehhovisi lobuholi, okubangela ukucindezeleka kwabasebenzi bezezempilo, kuze kube yilapho bezizwa bexoshwa futhi bexhunyiwe kubaqashi babo, okwenza bazizwe benganakekelwa ngokwanele ngokwanele ukuqeqeshwa kanye nezinsiza zokwenza imisebenzi yabo kahle . Eqinisweni, izibhedlela zase-United States zingase zibe sezingeni elibucayi, futhi amaphesenti angaba ngu-56 abasebenzi abasizwa ngaleyo ndlela, ngokusho kocwaningo luka-2017 lwe-CultureIQ, elinesihloko esithi "Ukuzibandakanya nokugcinwa kwabasebenzi bezempilo."
Ukuguqulwa kweCoding
Olunye ushintsho oluphawulekayo, futhi oluphawulekayo emithethweni yokunakekelwa kwezempilo okukhulunywe ngayo yilona uhlelo olusha lwekhodi ye -ICD-10, eyashintsha i-ICD-9 ngo-Okthoba ka-2015.
Uhlelo olusha lokubamba ikhodi luvame ukuphindwe kabili ivolumu yamakhodi okuxilonga kusuka ku-14,000 kuya kuma-68,000, kuyilapho amakhodi wenqubo awela ngaphezu kwamaphesenti angu-2,000, kusukela kumakhodi angu-4 000 kuya ku-87,000. Lokhu kuye kwabangela ukukhuphuka kwamaphesenti angu-69 esikhathini esithathwe ukucubungula izikweletu zezokwelapha zesiguli (imizuzu engu-17 ku-ICD-10, emaminithini angu-5 ngokukhipha ikhodi nge-ICD-9).
Okucacile kwamakhodi we- ICD-10 kuye kwaholela emibhalweni engaqondakali emsebenzini, okwenza amaphutha, ukusebenza ngokweqile, nesikhathi esinqunyiwe ukuqedela izinqubo zokukhokha . Lokhu kubangelwa ekunciphiseni ukubuyiswa kwemali, nokwenyuka kwezindleko zesikhathi esengeziwe, ukuchofoza odokotela ngokwezezimali, konke kuyilapho kunciphisa izinga lokunakekelwa kwesiguli, ngokusho kukaDavid Womack, umongameli kanye ne-CEO ye-Practice Management Institute (PMI), enikeza imfundo nokuqeqesha abasebenzi behhovisi lezokwelapha ezinkampanini zesibhedlela, izinhlangano zezokwelapha kanye nezikhungo zemfundo kuwo wonke amazwe.
Nakuba ukuqaliswa kwe-ICD-10 kwathembisa izinqubo ezihlehlisiwe, ukwanda okungazelelwe kwemininingwane emisha kungaba nemiphumela ehlukile , uMack add.
Ngokusho kokuhlangenwe nakho kwakhe emkhakheni wokuqeqeshwa kwabasebenzi bezempilo, uMomack uthi kubike ukuthi ukuxoshwa kwabasebenzi kuyingxenye yalomthetho wokulawula ngokweqile, kuhlangene nokuntuleka koqeqesho. Per Womack, ukwanda okukhulu kwedatha ngaphandle kokuqeqeshwa okuhambisana nakho kungahle kube inhlanganisela eyingozi embonini yezokunakekelwa kwezempilo- ingozi enkulu embonini esevele igcwele amaphutha okubhala .
Amaphutha ayabiza kakhulu kwiSikhungo Sezempilo
Amaphutha awashayi nje kuphela imboni, nabaqashi, imali eningi ekubuyiselweni okulahlekile.
Iphutha libuye lithengise isikhathi esibalulekile, futhi ikhwalithi-ngokuqondile ephazamisa impilo yesiguli.
Uma abasebenzi behlushwa izinto eziningi ngesikhathi esisodwa abaziqondi, bangena ekunganakwa futhi baphumele ngaphandle - okuholela ekuphusheni amaphutha, amaphutha, nokuntula okujwayelekile kokuqonda.
Amaphesenti angaba ngu-80 azo zonke izikweletu zezokwelapha aqukethe amaphutha, abiza u-R6 68 billion ekulahlekelweni kwempilo elahlekile . Ehlanganiswe nokuxiliswa kwedatha entsha, uMomack uthi ingozi yamaphutha ikhula kabili.
Kungani kunezinga eliphezulu kangaka lamaphutha okukhokha? "Ukubheka okukhona kuleyondawo," kusho uMomack. "Abakhokhi bodwa kanye nohulumeni bahlola ngokufanayo izimangalo zokunemba.
Uma izinkinga zitholakala, izimangalo ziphikisiwe, futhi imali ilahlekile. "
Iyini Isixazululo? Indlela Yokulungisa, Ukubamba Abasebenzi Ekuhambeni Kwezimiso Ezintsha
Imbonini yezempilo izoba yilapho ilawulwa kakhulu esikhathini esizayo. Ngakho-ke, ngokusho kwaMomack, izinga eliphakeme, ukuqeqeshwa kwabasebenzi okuqhubekayo kubaluleke kakhulu ukugcina iqembu elihlangene, elisebenzayo nokunciphisa amaphutha avinjelwe.
"Abasebenzi abasebenza ngokuzikhandla abasebenzi abasebenza kahle," kusho uMomack. "Abasebenzi be-Coding and reimbursement ngokuqeqeshwa okufanele bafaka isandla esixazululweni ngendlela ehlanzekile, esebenzayo [umshuwalense wezempilo]."
Ucwaningo lubonisa ukuthi izinhlangano zezempilo ezisebenza nabasebenzi abasebenza kakhulu benza ngokuphumelelayo kakhudlwana ngokuphepha, ikhwalithi, kanye nezindlela zokubhekana nesiguli, okuthonya kakhulu imiphumela yemali.
U-Womack wanezela ukuthi izinkampani ezihlinzeka ngesitifiketi sezobuchwepheshe ekwenzeni i-coding yezokwelapha, ukukhokhiswa kweqembu lesithathu, ukuphathwa kwehhovisi, kanye nokuhambisana, zisiza ukubeka izinga eliphakeme emisebenzini ngokunikeza ulwazi olusesikhathini sokufunda nokuhlolwa okuqinisekisa ukuqonda okuphelele komfakisicelo. Umphumela uba ukuthi odokotela bangagxila ekunakekelweni ngesineke kuphela, ukuhumusha ekuhlangenwe nakho okungcono kwesiguli, konke kuyilapho kuqinisekiswa ukuthi umkhuba uyaqhubeka uphumelele.
Ngaphezu kwalokho, uMomack uxwayisa ngokuqasha amakhodi wezokwelapha angaqeqeshwanga nama-billers. "Enye yezingozi ezinkulu zokusebenzisa amakhodi angaqeqeshiwe afika lapho abacwaningi bezempilo bezithola izinkinga ezibangelwa ukubuyiswa kwemali emikhulu yezinto ezifana nokukhokhwa kwezinsizakalo ezingakhishwa, ukuchithwa, ukukhishwa kwesikweletu, njll. Ekugcineni, udokotela unesibopho sokusayina zonke izimangalo, kodwa abasebenzi bangabelana ngokuzibophezela ngemikhuba yokukhokha engalungile, uma bewazi ukufaka izimanga zamanga. "
Ingabe ukukhokhwa okufanele nokukhokhwa ngokomlando kuyinselele emikhubeni yezokwelapha? Yebo, kusho uMackack. "Inkimbinkimbi yenqubo yokubuyiselwa imali iyisiqiniseko sobuhlungu, uMnack uthi. "Ukulwa namadola [okweleta] kulo mkhuba ngezinye izikhathi kungabaluleka ngaphezu kokwelashwa kwezimo zezokwelapha ekunqumeni ukusimama komuthi wezokwelapha. Ama-coders abangenalo ukuqeqeshwa okufanele afaka umlilo, "esho.
Akukhona nje ukuthi ukungabi nokuqeqeshwa kwamakhodi wezokwelapha kanye namakhokhisi angathinta i-back office yezokwelapha, kungase kuthinte nomkhiqizo jikelele womkhuba wonke. "Amakhodi aqeqeshelwa kahle nama-billers angathuthukisa inzuzo yonke yalo mkhuba ngokuthola amathuba angenayo yokuthola imali nokuhambisa izimangalo ze-dollar yonke efanele. Izisebenzi eziqeqeshwe kahle ziholela ekusebenzeni okuhle komsebenzi, amaphutha ambalwa kanye nokwaneliseka komsebenzi wonke [okukhulu]. "
> Imithombo:
> "Ukuzibandakanya nokugcinwa kwabasebenzi bezempilo." I-CultureIQ. Kuyini Amasiko? I-CultureIQ., Nd
> "I-ICD-10 Implementation Pros and Cons." I-MedLink. Np, 20 Jan. 2016
> "I-Coding Yezokwelapha Engalungile Iphazamisa Idatha Eyinkimbinkimbi Esetshenziswa Ngokwezinsiza Zokunakekelwa KwezeMpilo, Imiphumela Engenabuhlungu Kuyo yonke Imisebenzi Yokwengamela Impilo." I-Integrated Healthcare Executive. Np, nj
> Jensen D, Ward E no-Starbuck L. "Unyaka Kamuva: Impumelelo ye-ICD-10 Impumelelo Yokuphathwa Kwama-Cycle Revenue." Ukuphathwa Kwempilo. Np, 21 Dec. 2016.
> "Isihluthulelo Sokubaluleka Okuphezulu, Izindleko Zokusebenza Kwezezimali Emisebenzini Yokusebenza, Cindezela Imiboniso Yokucwaninga Ganey." Izindaba zezeMpilo zezeMpilo. Np, nj