Ungafunda kanjani izikweletu zakho zeDokotela noma ezinye izikweletu zezokwelapha

Kukhona ulwazi oluthe xaxa emalini wakho wezokwelapha

Uma unquma ukuthatha izinyathelo zokulawula izindleko zempilo yakho, ukwazi ukufunda izidakamizwa zakho odokotela kanye nezinye izikweletu zezokwelapha zizofika kahle.

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Zonke iziMithetho zezokwelapha zineziNqobo ezifanayo

Kukhona izingxenye ezintathu zephepha ozodinga ukuqhathanisa.

1. Uhlu lwezinsizakalo ezenziwe. Lokhu kunikelwa kuwe uma usuka ehhovisi likadokotela noma endaweni yokuhlola.
2. Umthethosivivinywa udokotela noma isikhungo sezempilo uyakuthumela. Yiluhlu lwamasevisi avela ku # 1 ngenhla, namacala enkonzo ngayinye. Lelo bhili libhekiswe kulesi sihloko.
3. Incazelo yezinzuzo - i-EOB - evela kumkhokheli wakho (umshwalense, Medicare noma omunye umkhokheli).

Phakathi kwezingxenye ezintathu zephepha, uzothola amagama namakhodi azokusiza ukuthi uqiniseke ukuthi ukhokhiswa kuphela ngezinsizakalo ezenziwa.

Sizoqala ngokubheka ibhilidi yezokwelapha eziyisisekelo, ongayithola kudokotela wakho noma omunye umhlinzeki.

Ibhilidi yakho yezokwelapha kungenzeka noma ingabonakali njengale, kodwa izoba nezinhlamvu ezifanayo zokwaziswa.

Uzobona konke kusuka ezinsukwini zesevisi kuya ezinsizakalweni ezinikezwe izindleko ku-bill yakho.

Kulo mthethosivivinywa, ikholomu ye "Pat #" kusho ukuthi yiziphi iziguli ku-akhawunti yami ezithole insizakalo. Njengoba ngangiyena umshuwalense, u-1 ubhekisela kimi.

"I-Prv #" isetshenziswe ngudokotela wami ukuze ngisho ukuthi yiyiphi i odokotela engibonile. # 51 ungudokotela wami.

Futhi i-B ngaphansi kwe "Msg" ibhekisela eqinisweni lokuthi bayikhokhisa umshwalense wami.

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Isinyathelo 2 - Thola uhlu lwezinsizakalo kuMthethosivivinywa wakho wezokwelapha

Isikhwama sakho sezidakamizwa sizobhala uhlu lwezinsizakalo ezinikezwe zona. Yini ongayifunda ngabo?

Amaningi alawa magama awajwayele!

Ukuze ufunde ukuthi isichazamazwi sisho ukuthini, sebenzisa isichazamazwi sezokwelapha noma uhlu lwezivivinyo zezokwelapha.

Esikhathini esingenhla, ngingabheka amagama afana nalokhu:

"Panel Panel" okubukeka sengathi iyisivivinyo samazinga ami e-cholesterol.

"Thyroxine Free" okubonakala sengathi iyilingo le-thyroid.

Isihluthulelo lapha sizoba ukuhlanganisa lezi zinsizakalo ngamaphepha owawunikezwe ngenkathi ushiya ihhovisi likadokotela futhi uqiniseke ukuthi ngempela uthole lezi zinsizakalo. Lokhu kuvame ukushiwo lula kunokuba kwenziwe.

Uma ngabe yiziphi izinsizakalo zibonakala zingavamile kuwe, noma uma ubuza ukuthi ngabe uzitholile, uxhumane nenombolo yocingo enikeziwe kumthethosivivinywa.

Kunezizathu ezimbili zokwenza lokhu:

1. Okokuqala, awufuni ukukhokha (noma awufuni umshwalense wakho akhokhe) nganoma yiziphi izinsizakalo ongazitholanga.
2. Okwesibili, ngoba amaphutha emithwalweni ebiza sonke imali. Kuyavunywa, kungenzeka ukuthi ube nezinsizakalo ezithunyelwe ku-akhawunti yakho ngephutha. Kungaba yinto engenacala kakhulu. Kodwa izigidigidi zamaRandi zikhokhiswa ngokweqile ku-Medicare nezinkampani zomshuwalense unyaka ngamunye. Kukhona kithi ngamunye ukuqinisekisa ukuthi abahlinzeki bethu abasikhokhisi ngobuqili .

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Isinyathelo 3 - Kabili Hlola Amakhodi we-CPT

Kulikhwalithi yakho kadokotela, uzobona ikhodi yamadijithi ayisihlanu emele ikhodi ye-CPT.

Uzokhumbula ukuthi amakhodi we-CPT afaka zonke izinsizakalo umhlinzeki wezokwelapha ongasinika zona. Uma ungaqiniseki ngokusetshenziswa kwawo, ungafunda kabanzi ngamakhodi we- CPT, lapho avela khona nokuthi kungani ebalulekile .

Kulikhwalithi yakho yezokwelapha, uzothola amakhodi we-CPT ahambisana nezinsizakalo. Kungakhathaliseki ukuthi isihloko sesevisi sizofana nani, uma kungenjalo ngokufanayo, njengegama le-AMA yalowo msebenzi.

Isikhumbuzo, futhi, ukuthi amakhodi we-HCPCS , iNqanaba I, afana namakhodi we-CPT.

Uma ufuna ukubuka amakhodi we-CPT ukuze uqiniseke ukuthi afana nokuhlunga kwezinsiza, ungakwenza kanjalo ngokusesha ikhodi ye-CPT .

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Isinyathelo 4 - Ukuhlola Amakhodi Wokuthola I-ICD kuMthethosivivinywa Wezokwelapha

Amakhodi Wokuthola, okubizwa nangokuthi amakhodi we-ICD-9 noma i-ICD-10, azophinde afakwe kuhlu ku-bill yakho yezokwelapha.

Udokotela wakho noma omunye umhlinzeki ngeke akhokhelwe yinkampani yakho yomshuwalense noma omunye umkhokheli wezempilo ngaphandle uma enika ikhodi yokuxilonga ukuze ahambisane nezinsizakalo. Isizathu ukuthi yizinsizakalo ezithile kuphela ezingenziwa ngezinkinga ezithile zokuxilonga. Isibonelo, udokotela wakho akakwazanga ukuhlola ukuhlolwa kwenhliziyo uma inkinga yakho yayiyi-rash emlenzeni wakho.

Lezo zifo zimelelwa amakhodi e-ICD (Ukuhlukaniswa Kwezifo Zamazwe Ezizwe), inguqulo 9 noma ingu-10. Iningi lokukhokhisa kwamanje libonisa amakhodi we-ICD-9 kodwa eminyakeni embalwa ezayo, bonke abahlinzeki bezokwelapha bazoshintshela ku-ICD-10. Ungase ufune ukufunda kabanzi mayelana nalezi zimakhodi zokuxilonga nokushintshela ezisha.

Kwezinye izimo, kuzoba khona amakhodi amaningi okuxilonga asetshenzisiwe, njengoba kulesi sibonelo. Lokhu kubonisa ukuthi udokotela akaqiniseki ngalokho okwenza isibonakaliso futhi ngokuvamile umelela izizathu zokuhlolwa okunikezwayo.

Ungase ube nesithakazelo ekubhekeni amakhodi we-ICD . Lo mthethosivivinywa uqukethe ikhodi ye-ICD-9 785.1, emele amaphilpitations enhliziyo, futhi 272.0 okuyinto ikhodi ye hypercholesterolemia ehlanzekile.

Kungani ungathanda ukubuka amakhodi we-ICD? Uma uvakashele udokotela wakho ngezimpawu futhi ungaqiniseki ngalokho ayekufunayo, ungase uthole ezinye izinkomba kusuka kulezi zimakhodi.

Uma amakhodi engenzi lutho kuwe, uma wazi ukuthi awunayo izinkinga ezibalwe, khona-ke kungenzeka ukuthi ukhombise imali ekhokhwayo, noma ukuthi ukukhwabanisa kubandakanyeka ngandlela-thile, kufaka phakathi kungenzeka ukweba . Xhumana nehhovisi lomhlinzeki wakho ngokushesha ukuze ucacise.

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Isinyathelo sesi-5 - Leyo Nkonzo Yezokwelapha Yabiza Kangakanani?

Izindleko zakho zezokwelapha ziyoba nenani udokotela wakho akhokhisa ngamasevisi akhe kumthethosivivinywa.

Yiqiniso, sonke isizathu sokuthi ibhilikhithi ithunyelwe kuwe kwakuyokwazi ukuthi udokotela wakho noma omunye umhlinzeki wezempilo uzovakashela kangakanani, akunjalo?

Abaningi bethu babheka kuphela izindleko ngoba siyazi ukuthi izindleko zizohlanganiswa umshwalense noma omunye umkhokheli. Njengoba abantu abambalwa bethola umshuwalense, noma njengoba abaningi bethu beya emiphakathini yomshuwalense wezempilo ephezulu, lokho kubiza kubaluleke kakhulu.

Kunento eyodwa esingayenza nalezi zinombolo, ngisho noma singalindelekile ukubhala isheke kubo. Singabheka phezulu ngensizakalo ukuze sibone ukuthi ngabe amanani aqondakalayo. Lokhu kungenziwa ngokusebenzisa ikhodi ye-CPT kanye newebhusayithi ye-AMA.

Ngokwenza ukucinga ikhodi ngayinye ye-CPT ohlwini, ungafunda ukuthi i-Medicare ibuyisela yini leyo nsizakalo. Iningi lezinkampani zomshuwalense zilandela amanani e-Medicare kahle kakhulu. Uma unomshuwalense wangasese, ungalindeli ukuthi izinombolo zizoba ngqo, kodwa zizobe zisondele.

Ngesikhathi ukhona, ungase ufune nokufunda ukuthi kungani kukhona umehluko phakathi kwalokho odokotela besikweletu kanye nalokho abakuthola khona yizinkampani ezizibuyisela.

Manje ukuthi uyaqonda ukuthi ungafunda kanjani ibhilidi lezokwelapha, ungase ufune ukubheka ezinye izingcezu ongazifanisa nazo: irisidi / uhlu lwezinsizakalo udokotela wakho akunika lona, ​​ne-EOB (incazelo yezinzuzo) ozithola kamuva kusuka kumkhokhi wakho.