Zonke izinkokhelo zezokwelapha ezibuyiswayo zenziwa kubahlinzeki ngokusekelwe kumakhodi we-CPT , amakhodi wamanje wezobuchwepheshe. Ikhodi ngayinye imelela isevisi ethize, umsebenzi, umkhiqizo, noma inqubo ehlinzekwa isiguli okungaba khona, bese ikhokhelwe ukwenza ngemshwalense noma abanye abakhokha.
Ngezinye izikhathi izinsizakalo kufanele zihambe ndawonye njalo futhi zenzeni futhi zikhokhiswa ndawonye ndawonye, zingahle zifakwe kwikhodi eyodwa.
Indlela Ukuqoqa Ukusebenza Kanjani
Nasi isibonelo esingesizokwelapha kodwa sizokusiza ukuthi uqonde ukuthi kungani ukukhishwa kwesikweletu kwenziwa.
Udinga ibhotela le-peanut kanye ne-jelly sandwich. Ukuze sikunike ibhotela le-peanut kanye ne-jelly sandwich, sidinga ukuhlanganisa isinkwa, ibhotela le-jelly; uwabeke epulangwe; futhi akunike i-napkin iphepha. Beka ndawonye, sikunikeze ngenkonzo yokwenza nokuhambisa i-PB noJ.
Uma omunye umuntu esikhokha ukuthi senze futhi asilethe leso sandwich kuwe, kuzodingeka akhokhe ngayinye yalezi zakhi: ibhotela le-peanut, i-jelly, isinkwa, isikhumba sephepha, ukusebenzisa ipuleti, nesikhathi. Noma, esikhundleni sokubhala amasheke esakhiweni ngasinye, bangase baqoqe zonke lezo zinto ndawonye ngokukhokha okunye-ukukhokhelwa kwe-PBJ. Isebenza kahle, futhi ukukhokha kungenziwa ngokushesha.
Amakhodi Ezokwelapha Ezihlanganisiwe
Imikhiqizo yezokwelapha kanye nezinsizakalo zingase zithathwe ngendlela efanayo ngendlela yokudala ikhodi eyodwa yokukhokha, kungenzeka kube lula kubo bobabili umhlinzeki nomkhokheli ukuphatha izinkokhelo.
Izingxenye zomuntu ngamunye zingatholakala kunani elingenamkhawulo lamakhodi esitolo. Isibonelo, ikhodi ye-CPT yokunikeza umjovo ikhodi eyodwa. Yini ejojowe kuyoba enye ikhodi. Isizathu sokuthi sijojowe sisodwa ikhodi. Ngakho ikhodi yokujova, noma ikhodi yezinto ezibonakalayo, ingabhalwa ngaphakathi kwezinqwaba eziningi, kuye ngokuthi into ejojelwayo, ukuthi ijojwe kanjani, noma ingabe ijojowe (umuthi wokugoma ulwa nomjovo we-cortisone emadolweni, isibonelo).
Esikhathini esiningi, ukuthi izinkokhelo zikhokhelwa noma cha zingathinti ukunakekelwa noma ukukhokhelwa kwesiguli (ama-copays, co- ins, noma ama- deductibles ).
Izinkinga Ngezikhombisi Zezokwelapha Eziningi
Izinkinga ziphakama lapho isiguli sidinga okuthile okungeziwe okungahlanganiswa nokukhokha okukhokhelwayo. Abakhokhi bangase bangabuyiselwa imali engaphandle kwesikhwama. Lokho kungenza umhlinzeki anganqikazi ukuhlinzeka ngensizakalo uma engakwazi ukubuyiselwa yona. Bangase bakhokhe ngisho nesiguli esengeziwe, ngentengo ephelele, ukuhlinzeka ngensizakalo. Iziguli zidinga ukubuka lolu hlobo lokukhokhisa okungaphezulu ngoba lungabangela ukukhokhiswa kwe-balance noma ukukhishwa kwesikweletu , kokubili okungekho emthethweni .
Uma uthola ikhodi ye-CPT kwisitatimende sakho se- Explaation of Benefits (EOB), futhi sinoku-B eceleni kwalo, okubonisa ukuthi sekuxhunyiwe. Noma kunjalo, akuwona wonke amakhodi athengiswayo angafaka i-B.
Ungabheka amakhodi we-CPT aqoqwe njengoba nje ungathanda ikhodi ngayinye ye-CPT.
Amakhodi we-HCPCS amakhodi wokukhokha e-Medicare, ngokusekelwe kumakhodi we-CPT, futhi angase abe nesibopho. Ungabheka amakhodi we-HCPCS amakhokhwe noma amancane .