Maererano neCMS, zvinodarika mabhiriyoni mashanu ezvemari zvinotumirwa kutengeswa gore negore. Kodhadhikodhi yakakosha yakakosha kuti ivimbise kuti izvi zvinodavirwa zvinoshandiswa nenzira isiri. Makambani eInishuwarenzi, vateresi vatatu, uye mitemo yehurumende uye yehurumende yakaratidza kuwedzera kunetseka pamusoro pekukosha kwekodhi yekodzero yevashandi vepachipatara.
Apo vateresi vanokundikana kuita maererano nekodhi zvinodikanwa izvo zvinodiwa pakubhadhara kunze kwekugadzirisa nzira, mukana wokubhadhara kusina kukodzera unowedzerwa.
Medicare inoshandisa PPS (Prospective Payment System) uye purogiramu yekubhadhara inoshandisa nzira yekubhadhara yakavakirwa pamutengo wakatarwa. Kune pepa PPSs uye mahedheni ekubhadhara zvichienderana nehutano hwakapiwa.
Zvichida Kubhadhara Systems
- Zvipatara zvakanyanya muzvipatara
- Misha yehutano masangano
- Hospice
- Chipatara chiri kunze
- Inpatient psychiatric facilities
- Inpatient rehabilitation facilities
- Zvirwere zvekugara kwenguva refu
- Vanachiremba vane unyanzvi
Fee Schedules
- Physicians
- Ambulance services
- Clinical laboratory services
- Imishonga inogara kwenguva refu yemishonga, prosthetics, orthotics, uye zvinhu
Pasi pePPS uye Purogiramu Yebhadharo, mumwe nomumwe anopa mubhadharo anodzorerwa mari yakatarwa yakatarwa maererano nenheyo yenzira yakataurwa. Kunyora zvinyorwa zvisina kukodzera kunogona kukonzera kukundikana kutevera coding zvinoda.
Kune nzvimbo gumi dzinobatanidzwa neipi isina kukodzera kunze kwekuita coding.
- Kurondedzera zvisiri izvo zvikamu zvebasa
- Kubhadhara kusina kukodzera kwekucherechedza mabasa
- Kutaura mhosva dzisina kukodzera nekuda kwekudengenyeka kwenhepfenyuro yejaja
- Kuisa mumiriri wemhosva kana kukundikana kutevera NCCI (National Correct Coding Initiative) mirayiridzo ye Medicare neMedicaid
- Inappropriate reporting yenzira code code modifiers
- Zvisingakwanisi E / M (Kuongorora uye Kutungamira) kusarudzwa kwekodhi
- Kurondedzera "chirwere chekushaya chirwere" chete pamusana pekuda kurapwa
- Kuendesa zvirevo zvemishonga pasina mishonga
- Kukundikana kutevera maitiro akawanda ekuderedza mitemo
- Nheyo dzakagadzirwa nemudzidzi, anogara kana imwe nyanzvi ine unhu husina kubvumirwa pasina mutariri wechiremba anodiwa
Kukanganisa kwekodhi kunogona kuonekwa kune zvimwe zvinhu.
- Zvinetso zvepanguva uye / kana kudzivisa
- Zvinokanganisa
- Kushaikwa kwechiitiko chekunyora
- Kukanganisa kwevanhu
- Kutadza kukurukurirana
- Vakapedzisira varwere vanosangana mafomu
Zvinhu izvi zvinowanzove zvisina kuita nemaune asi apo kukanganisa kwekodhi kunoitika pane zvisingagumi, vatapi vanogona kuonekwa sevanopesana neMutemo Wezvokureva Mhosva nokuda kwekubhadhara maitiro ekubhadhara. Kunyengera dzimwe nguva kunokanganiswa nekushungurudzwa. Kushungurudzwa ndeyebhadharo isingatarisiri yezvinhu kana mabasa asina kupiwa. Nzvimbo ina dzinowanzowanikwa dzinozivikanwa seUkubiridzira kana kushungurudzwa ndezvekuti:
- Kubhadhara Kwemishonga Yezvokurapa Haimbopi Yakapiwa
Nzvimbo inowanikwa yakawanda yekurapa kweMedare ndeyekubhadhara Kwezvokurapa Zvimwe Zvokurapa (DME). DME inoreva chero mishonga yezvokurapa inodiwa kumurwere wehutano kana muviri. Inosanganisira maguruvhesi, mabhedha echipatara, uye zvimwe zvigadzirwa zvechimiro ichocho. Mupiki achabhadhara Medicare pamidziyo iyo murwere asina kumbobvumirwa. Kufamba kwevadzidzi vanove vachinyanyozivikanwa nokuda kwezvirongwa zvekubiridzira zveMedare.
- Kubhadhara Kwemabasa Kusamboitwa
Muchiitiko ichi, mupiro wemupiro wekuongororwa, kurapwa kana nzira dzisina kumboitwa. Izvi zvinogona kuwedzerwa kune urongwa hwekuedzwa murwere akawana zvechokwadi uye akarega kuonekwa. Mupiki anganganisawo kuongorora zvirongwa kuitira kuti awedzere pazviedzo zvisingakoshi kana mabasa.
- Zvokubhadhara Mhosva
Kunyoresa huwandu hwebasa kana nzira inogadzirirwa kuitira kuti uwane mari yakawanda kana kugamuchira chikwata chepamusoro chekubhadhara chinonzi kubvunzurudzwa. Kukwidziridzwa kunowanikwawo kana basa rinoitwa risati rakafukidzwa neMedare asi mabhizimisi anopa mvumo basa rinovharidzirwa panzvimbo yayo.
- Zvikwereti Zvisingabatsiri
Mamwe maitiro anobatwa seanobatanidzwa. Kusunungura kubhadhara kune nzira dzakasiyana zvakasiyana-siyana dzinowanzobhadharwa semhosva imwe chete. Somuenzaniso, mvumo yekupa mvumo yekudzivirirwa kwemamwe maviri ekudzivirira kuongorora mammograms, panzvimbo yekubhadhara ku 1 mairi ekuongorora mammogram.
Kunyora kwekodhi kunonyatsobvumira mubhadharo wehushuwarisi kuziva zviratidzo, kurwara kana kukuvara kwemurwere uye nzira yekurapa yakaitwa nachiremba. Kuchengetedza kukanganisa kunoitika apo iyo inowanikwa inoiswa kune kambani ye inshuwarisi ine kusakanganiswa kwakaipa kana chirongwa chekodzero pamusoro pemhosva. Kunyora coding zvisina kururama kunogona kutungamirira kune dzakawanda zvinokonzera zvakaipa. Zvinotarisirwa kuti hofisi yezvokurapa inokura nzira yekuteerera iyo inogona kudzivirira kuputsa kwezvido zvekurapa zvinodhaka.