Nzira yekucherechedza Mirayiridzo inoshanda sei
Utano hwehutano makambani, Medicare , uye zvipatara nguva dzose zvinotsvaka nzira dzokuchengetedza mari. Kukupa iwe kutarisa maonero uchishandisa maitiro ekucherechedza anovachengetedza mari, asi zvinogona kuguma kukudhura iwe zvakawanda.
Paunenge waiswa muchipatara, kuziva kana iwe wakabvumirwa sechirwere chepfungwa kana kuisa pfupa rekucherechedza zvakakosha kwauri iwe mari.
Heino chikonzero nei zvichikosha, uye chii chaunofanira kuita.
Chinonzi Observation Status?
Paunenge waiswa muchipatara, iwe unopiwa chirwere chepfungwa kana chekucherechedza. Iwe unopiwa chirwere chemukati chepatient kana iwe une zvinetso zvakakomba zvinoda zvikuru teknolojia, kuchengetedza unyanzvi.
Iwe unogoverwa maitiro ekucherechedza kana iwe usingarwarwi zvakakwana kuti uwane kubvuma kupinda muchipatara, asi uri kurwara zvikuru kuti uwane kutarisira kwako pahofisi yechiremba wako. Kana kuti, iwe unogona kugoverwa kunzvimbo yekucherechedza apo vanachiremba havana chokwadi chaizvo kuti uri kurwara sei. Vanogona kukuchengetedza muchipatara uye kukuita iwe mucheche kana iwe ukava murwere, kana kuti iwe uende kumba kana iwe uchinaka.
Ndingaziva sei kana ini ndakatarirwa kuongorora kuchengetedza mamiriro kana chirwere chemukati?
Sezvo varwere vanocherechedza vari rudzi rwechirwere chepanyama, dzimwe zvipatara zvine nzvimbo yakananga yekucherechedza kana mapiro echipatara nekuda kwevarwere avo vanoona. Asi, zvipatara zvakawanda zvinoisa varwere vanocherechedza mumakamuri akafanana nevanorwara.
Izvi zvinokuomera kuti iwe utaure kana iwe uri murwere kana mucheche wekucherechedza. Iwe haugoni kufungidzira izvozvo, nokuti iwe uri muimba yezvipatara nguva dzose, kana uri muhope yezvipatara pane pane gurney, iwe uri murwere.
Uyewo haungagoni kufunga kubva iwe wave uri muchipatara kwemazuva mashomanana iwe uri murwere.
Kunyange zvazvo kucherechedza kunotarisirwa kwenguva pfupi, haisi nguva dzose kushanda nenzira iyo.
Nzira chete yekuziva ndeyokubvunza .
Ndekupi Kuona Kwangu kana Chirwere Chekushaya Chirwere Chinopiwa?
Zvipatara uye vanachiremba havakwanisi kukupai imwe nzvimbo kana imwe nokuti vanofunga sezviri, nokuti imwe nzvimbo inoratidzika zviri nani, kana kuti nokuti iwe unokumbira kugoverwa pane imwe nzvimbo. Panzvimbo pacho, pane mazano emarudzi akabudiswa muBhuku reMagare Rebatsiro reMagadziro rekuona kuti ndiani anopiwa chirwere chekushaya chirwere, uye ndiani anopiwa basa rekucherechedza.
Aya mazano haana kujeka asi akaoma uye anogona kuchinja gore negore, saka zvipatara uye makambani einishuwarenzi anoshandisa basa rinoparidzidza zvido zvekuvabatsira kushandisa mazano kune mumwe murwere. Zvimwe zvemashoko anozivikanwa zvikuru ndeye McKesson's InterQual Criteria uye Milliman Care Guidelines.
Izvozvi zvirwere uye zvirongwa zvekucherechedza zvinowanzobata marudzi maviri akasiyana emitemo. Mutsara wokutanga ukuru hwehutano hwako: uri kurwara zvakakwana here kuti unoda kubhabhatidzwa?
Chikonzero chechipiri ukuru hwemashumiro aunoda: ndiyo kurapa iwe unoda zvakakwana zvakakwana kana kuti zvakaoma zvokuti chipatara ndiyo nzvimbo chete iwe unogona kugamuchira zvakakwana kurapwa?
Chirevo chega chega chega chinouraya zvachose zvikamu zvekuongorora zvinogona kusanganisira zvinhu zvakadai semigumisiro yekutsvaga ropa , zvitsva zve X-ray , kuongororwa kwepanyama, uye mhando dzemishonga yawakagadzirirwa.
Paunopinda muchipatara, chiremba wechipatara chechipatara kana mukoti wekudzokorora kushandiswa achaongorora nyaya yako, achienzanidza zvakawanikwa nachiremba wako, kuongororwa kwako, zvinobva pakuedza kwako uye zvidzidzo, uye kurapa kwako kwakatemwa nemitemo. Iye zvino achashandisa iyo mirayiridzo kubatsira chiremba wako kukupa iwe kana maonero ekucherechedza, kana kuti chirwere chepfungwa.
Sei Kufanira Kuona Chimiro kana Chirwere Chekushaya Chirwere Chinokosha kwandiri?
Kana iwe uri mucheche, asi Medicare kana kambani yehutano inshuwarano inofunga kuti iwe unofanirwa kugoverwa maitiro ekucherechedza, inogona kuramba kubhadhara yese yechipatara inpatient kugara.
Iwe pachako haugoni kuwana izvi kusvikira chipatara ichiendesa kudai uye chakange chakarambidzwa nekambani ye inshuwarisi mavhiki kana mwedzi mushure mekunge iwe wakarapwa.
Zvechokwadi, Centers for Medicare neMedicaid Services inopinda makambani kutsvaga Medicare varwere vechirwere chekuchengetedza varwere mukuedza kutsvaga varwere vachipikisa avo vangadai vakagadziriswa mumamiriro ekucherechedza. Izvi zvinoitika mwedzi kana kunyange makore shure-i-chokwadi. Zvadaro, Medicare inotora mari yose yakabhadhara kuchipatara ichi.
Zvipatara vanoedza kutevera mirayiridzo iripo kubva panguva iyoyo iyo iri nyore uye yakawanda pasi rose inogamuchirwa nzira yekururamisira kuti sei vakakupa iwe iyo nzvimbo chaiyo. Semuenzaniso, kana kambani yehutano yehutano yehutano kana Medicare inoramba kubvuma kwako nokuti yakaronga kuti iwe unofanira kunge uri mune zvekucherechedza chimiro panzvimbo yekusagadzikana, chipatara chicharwisana nekuramba uku nokuratidza kuti wakasangana neInterQual kana Milliman mirayiridzo yehuwandu hwawakapiwa . Kana chipatara chisingatevedzeri mirayiridzo iri pedyo, inokanganisa kuda kuramba.
Asi, kana iwe wakagoverwa kuongororwa kwepamusoro panzvimbo yekusagadzikana, kunyange zvazvo zvisingasviki wako mubhadhari wako acharamba kubvuma kwako kose, iwe unogona kutora mari inogumburwa. Kazhinji, chikamu chako chemari yevashandi vepachipatara chakakura kupfuura chikamu chako chemari yevanopinda muchipatara.
Sezvo kuongorora varwere rudzi rwechirwere chepfungwa, mabhiriro avo akafukidzwa pasi peMedarereti B , kana kuti kunze kwevashandi chikamu chehutano hwavo hwehutano inshuwarano, panzvimbo peMurengeti weAAA kana kuti muchipatara chikamu chemishonga yehutano yehutano. Kunze kwekugoverwa kunogona kuva nepamusoro kwekubhadharwa kwehuwandu hwehuwandu hwehuwandu hwehuwandu hwehutachiona (izvi zvinonyanya kuitika kana iwe uri paMedare, sezvo Chikamu B chine chekuvharidzirwa pasina chekuvhara chikwata kunze kwekuti iwe une chirongwa cheMedigap kana Medicare Advantage ). Saka, unogona kugumisa kubhadhara chikamu chikuru chechibhadharo chekucherechedza mazano pane iwe ungadai wakabhadharwa nehutano hwevarwere.
Kana iwe uri paMedarere, chiitiko chekucherechedza chichapedza kukupa mari zhinji kana iwe uchida kuenda kumba yekuchengetedza vakwegura yekuvandudza mushure mekugara kwechipatara. Medicare kazhinji inobhadhara mabasa ehutano hwepanyama mumuzinda wevanotarisira kwenguva pfupi. Asi, iwe chete unokodzera rubatsiro urwu kana iwe uine chirwere chemazuva matatu. Kana iwe uri mumamiriro ekucherechedza kwemazuva matatu, haugoni kukodzera.
Izvi zvinoreva kuti iwe unofanira kubhadhara mari yose yeimba yevanamukoti uye maitiro ayo ekudzorera iwe pachako. Iwe unogona kutarisira iri bhiri kuti rive zviuru zvuru zvemadhora.
Maviri-Pakati peusiku Mutongi
Muna 2013, Centers for Medicare neMedicaid Services (CMS) yakapa hutungamiri hunoti "huviri-pakati peusiku hutongi" hunotibatsira kuwedzera kuziva kuti varwere vanofanirwa kubvumirwa sevana varwere uye vakafukidzirwa pasi peMurengeti weAA (hospitali) panzvimbo yeChikamu B (kunze kwepakati ). Mutemo unotaura kuti kana chiremba achibvuma kuti chirwere chinoda kuva muchipatara kwekanguva chinotarisa pamaminitsi maviri, kuchengetwa kwaizove kuripo pasi peMederalare Part A.
Muna 2015, CMS yakarongedza hutatu-pakati peusiku hutongi hunoita kuti pave nemafungiro ezvinyorwa-by-case determinations. Aya mazano matsva anowanzoshevedza kugara kwechipatara izvo zvinotora midzi miviri miviri pamberi peMedareti A A inoshanda, asi vanosiyawo imwe nzvimbo yegadziriro yekuziva chiremba. Kana chiremba achidavira kuti murwere ane chirongwa chekurapa muchipatara kunyange apo chirwere chipatara chinotarisirwa kuva nenguva yepakati pemaminitsi maviri, chiremba anokwanisa kusarudza kubvuma murwere sechiremba.
Ndinofanira Kurwisana Nokuda Kwechirwere Chepfungwa, kana Kuronga Chiitiko Chekucherechedza?
Kunyange zvazvo zvichinyadzisa, haisi nyaya yakawanda yekugadzirisa maitiro ekucherechedza kana kurwisana nechirwere chekushaya chirwere sezvo chiri nyaya yekuve nechokwadi kuti uri mumamiriro akakodzera uye unonzwisisa zvinorevei kubhadharo yako.
Unoda kuti iwe udzoke zvakare kune chiremera chechipatara kana iwe uchikwanisa kukwanisa kuongorora mamiriro ezvinhu angaita sekuti inogona kukuchengetedza mari kana mari yako yekutengeserana ichikwirira kune yekunze kwekutarisira (kutarisa mamiriro ezvinhu), uye zvinonyatsobatsirika kugoverwa kutarisirwa kwepfungwa kana uri paMedare uye iwe uchange uchida kuchengetwa shure mushure mekurapa unyanzvi unyanzvi. Asi, yeuka, kambani yako yveshuwarhu yehutano inogona kuramba kubhadhara chikwereti chechipatara kana ikatarisa kuti iwe zvisina kururama wakapiwa chirwere chekushaya chirwere. Iwe iwe kana chipatara hazvizobudiriri mukurwisana kudai kubvuma sezvo iwe usina kukodzera mitemo yehupombwe.
Izvozvo zvakati, kuchenjera kubvunza kuti ndeapi mitemo yakashandiswa kugadzirisa kuti iwe unofanira kunge uri mumamiriro ekucherechedza panzvimbo yekusava nemamiriro ekusaziva. Iwe unogonawo kubvunza kuti ndedzipi mishonga yemishonga, mitsva yekuedza, kana zviratidzo zvingadai zvakakwanisa iwe kuti uve nechirwere chekushaya chirwere chechipatara pamwe chete ichi chinorwara. Uyezve, funga kubvunza kuti utaure nemumwe munhu kubva kuhofisi yekubhadhara uyo anokwanisa kuenzanisa yako kunze kwepodha mari kana iwe uri mune zvekucherechedza kana kuti iwe uri mucheche.
Kana iwe uri kurwara zvikuru kuti uzviite izvi iwe pachako, unogona kupa mvumo yekuva nhengo yemhuri yaunovimba nayo, shamwari, kana murwere mubatsiri kukumbira mibvunzo iyi kwauri, uye kutevera pane mhinduro.
Sources:
Nzvimbo dzeMedare uye Medicaid Services, Fact Sheet: Two-Mid Midnight Rule, 10-30-2015.