Kana iwe uchimhanya kune imwe nguva yakabvumira chikamu pahutano hwako hwehutano inshumo yekubatsira , inogona kukonzera kumwe kuvhiringidzika. Ndiyo mari yakawanda yako yekambani yehutano inshuwarisi inofunga kuti mutano wako wehutano anofanirwa kubhadharwa nekuda kwekutarisira kwaakapa. Iko mari yakabvumidzwa inoshandiswa zvakasiyana kana iwe ukashandisa mu-network network kupa apo iwe unoshandisa kunze kwe-network .
Kubvumirwa Nhamba Iine In-Network Care
Kana wakashandisa mupiro ari mu-network neurongwa hwehutano hwako, mari yakabvumirwa ndiyo mutengo wakaderedzwa urongwa hwehutano hwehutano hwakarongedzwa hwakataurirwa mberi kwebasa iroro. Dzimwe nguva in-network network inobhadhara mari yakawanda kupfuura iyo yakabvumirwa, asi iye chete achabhadharwa chikwereti chakabvumirwa. Iwe haufaniri kuita misiyano pakati pemari yakabvumirwa uye mari chaiyo yakabhadharwa paunoshandisa in-network provider. Ndiyo imwe yezvidziviriro zvevatengi zvinouya nekushandisa in-network provider.
Zvisinei, izvi hazvirevi kuti hauzobhadhari chinhu. Iwe unobhadhara chikamu chemari yakabvumidzwa zvachose nenzira yekubhadhara , coinsurance , kana kubviswa . Mupiritsi wako wehutano anobhadhara chikamu chemari yakabvumirwa.
Zvose zvinotengeswa kumusoro nepamusoro zvinoregererwa mari hazvibvumirwi kutengesa. Mutapi wehutano haazobhadharwi. Kana EOB yako ine koromo yemari isingabvumirwi , izvi zvinomirira kubhadhara kambani yehutano yehutano inobvunzurudzwa nemupi wako.
Kubvumira Mutengo Nekunze kweNhepfenyuro Yekutarisira
Kana iwe wakashandisa kunze kwe-network, mvumo yakabvumirwa ndiyo mutengo wako kambani yveshuwarenzi yehutano yakasarudza ndiyo yakajairika, tsika yechikwereti uye inonzwisisika yebasa iroro. An out-of-network provider anogona kubhadhara chero mari yaanosarudza. Urongwa hwako hwehutano hauna kontrakiti neyekunze-we-network, saka hapana kutaurirana kunotsanangurwa.
Iko hurongwa hwehutano hwako huripo huchave hwakavakirwa pamutengo wakabvumirwa, kwete pamutengo wakabhadharwa.
Nekunze kwe-network, mutarisiri wako achaverenga mari yako yekubhadhara yakavakirwa pamutengo wakabvumirwa, kwete mari yakabhadharwa. Iwe uchabhadhara chero copay, coinsurance, kana kunze-kwe-network kubviswa kwakakodzera; wako wehutano wehutano achabhadhara zvakasara zvehuwandu hunotenderwa.
Izvozvo zvakabuda kunze kwe-network zvinogadzirisa chikamu chebhadhiro chiri kumusoro uye kunze kwechibvumirano chakabvumirwa chinogona kusiyana. Mune zvimwe zviitiko, kunyanya kana iwe uchikurukurirana mberi, mupiro acharega izvi zvakanyanyisa. Mune zvimwe zviitiko, mutapi wacho achakupa chikwereti pamusiyano pakati pemari yakabvumirwa uye zvimhosva zvepakutanga. Izvi zvinonzi kuenzanisa kubhadhara uye zvinogona kukudhura zvakawanda.
Sei vatsigiri vehutano vachipa chikwereti chakabvumirwa chekunze kwe-network? Ndiyo nzira yekugadzirisa dambudziko ravo rezvemari. Sezvo zvirongwa zvehutano hazvigoni kudzora kunze-kwe-network zvinodhura nezvikwereti zvisati zvamboitika, vanofanirwa kuzvidzora kuburikidza nekupa chikamu chepamusoro kumutemo.
Ngatiti chirongwa chako cheutano chinoda kuti iwe ubhadhe 50% coinsurance yekunze kwe-network. Pasina chibvumirano chisati chagadziriswa, an-out-of-network anokwanisa kukwereta $ 100,000 kuitira kushanya kwehofisi.
Kana hurongwa hwehutano hwako husina kupa chikwereti chakabvumirwa, chaizofanira kubhadhara $ 50,000 kuhofisi yehofisi iyo inogona kuwanzobhadhara $ 250. Urongwa hwako hwehutano hunozvidzivirira kubva pachinhu ichi kuburikidza kupa chibvumirano chakabvumirwa kune kunze kwe-network services.
Zvinosuruvarisa, mukuzvidzivirira pachako kubva pamhosva dzisinganzwisisiki, inoshandura mutoro wekutarisana nezvikwereti izvozvo zvisina musoro kwauri. Ichi chinhu chakaipa chakasiyana chekuita kunze kwe-network-kutarisira uye ndicho chikonzero iwe unofanirwa kutaurirana nguva dzose nezvemhosva yekunze-ye-network kutarisira mberi.