Medicare Chee-For-Service (FFS) inoshandisa mazuva-e-kushanda kana mazuva-ekudururwa musi kana musi waApril 1, 2013, ichaenderera mberi kuunza 2 muzana kuderedzwa kweMitambo yeMedare kusvikira pane chiziviso. Izvi zvinoramba zvichiitika muna 2017. Kusina kushandurwa, kukohwa hakuzoperi kusvikira 2021.
Sangano rehurumende rezvemari rakagadziriswa rinoshandiswa pakuita kuti Medicare zviitike zvakatanga kushanda musi waApril Fools Day, asi yakanga isiri nyaya inoseka.
Zvinosanganisa chirongwa cheMedricare Fee For Service (FFS), chinonziwo Medicare HMO (Chikamu C) zvirevo uye Zvigadzirwa Zvokurapa Zvisingagumi, Prosthetics, Orthotics, uye Zvimwewo (DMEPOS).
Kuverenga Mishonga Yekurapa neMari Yokugadzirisa Sequestration
Izvo zvikamu zviviri kubva muzana kuderedza mubhadharo zvinotariswa mushure mekunge mutengi wacho akadzikinurwa, coinsurance, uye copay zvakabviswa kubva pachiyero chakabvumirwa.
Pamberi paEpril 1, 2013, Payment Medicare yakaverengwa nenzira iyi
KUDZIDZIRWA KWEMWE - KUTAURA KWEMPATI (kunosanganisira deductible, coinsurance, uye copay) = MARIYA YA MEDICARE
Mushure meEpril 1, 2013, Medicare payments iko zvino yakaverengwa nenzira iyi
KUVARIRWA KWAKAITIKA - KUPINDA KWEMPATI (kunosanganisira deductible, coinsurance, uye copay) = KUPARIDZA KWEMEDICARE X 98% = NYAYA YOKUTANGA MEMEDICARE
Kutaura Kugadziriswa Reason Codes
Iro remagetsi ekubhadhara mazano (ERA) inonyora kushandurwa kwekutsvaga kugadziriswa kwekodzero dzemashandisi ekushandura kudai. Zvimwe zvacho zvinosanganisira zvinotevera:
Kutaura Kugadziriswa Reason Codes
- CO 45
- PR 1
- PR 2
- PR 3
- PR 96
Kutaura Kururamisa Tsanangudzo
- CO Kushanda Kugadziriswa
- PR Murefu Mutoro
- 1 Deductible Amount
- 2 Coinsurance Amount
- 3 Copay Nhamba
- 45 Mutero unodarika mheteti yemari / yepamusoro yakagamuchirwa kana chechibvumirano / chemutemo chekugadzirisa urongwa
- 96 Mhosva isina kuvharwa (s)
Kuti utsanangure zvikamu zviviri kubva muzana kuderedzwa pamusoro peERA, imwe nhamba yekugadzirisa inoshandiswa.
CO 253: Kusarudzwa - kuderedza mubhadharo yezvemagariro.
Nokuti iyo 253 inofambidzana neCOC, murwere haakwanisi kubhadhara mari iyi. Iko kunyorwa kwekupa. Uku kuderedzwa kunongoguma kune mupiki, ndicho chikonzero kuderedzwa kunoverengerwa mushure mokunge mutoro wekutarisira uchitarirwa.
Somuenzaniso, pane kudai kune $ 50.00 kubhadhara kubva kuMedare munguva yakapfuura kwaizove iko $ 49.00 kubhadhara ne $ 1.00 yakapiwa CO 253 kuti inomiririra mazana maviri ekuderedza.
Chirwere cheMedare Kuchengetedzwa Kwekurapa paIri Medical Office
Kuti ugone kunyatsogadzirisa zvinhu zvezvemari zvehofisi yezvokurapa, zvakakosha kuvandudza mitsara yako kuratidzira kuchinja kubhadhara yako. Izvi zvinounzawo nyaya pamusoro pemitemo yakawanda inogona kunge isina kukuvadza inokonzerwa nekucheka uku. Vamwe vanachiremba vari kusarudza kupedza nhamba yeMedare varwere vanorapa kana kuti vanorega kurapwa navanaMedare varwere zvachose. Zvinosuruvarisa, izvi zvinokonzera dambudziko kuvarwere, avo vane zvishoma zvingasarudzwa kuti vatarise zvinodiwa nehutano hwavo hwemazuva ano uye hwemangwana.
Kusapinda kwechipatara kweVirwere veMedare kunoreva zvinowanikwa mune zvekukurumidzira mumba, kuwedzera zvirwere, nekuwedzera mari inogadzirwa mune imwe shandhu kutsva nzira dzekuderedza mari.
Pane imwe nzira yekushandura Medicare varwere, vazhinji vavo vane makore anopfuura makumi matanhatu nemashanu uye / kana muviri kana mupfungwa dzakagadzikana. Vatapi vezvechiremba vanogona kutendeukira pane zvavanenge vachirasikirwa kubva kuMedare uye vashandise mazano ekugadzirisa kushanda kwemari kune dzimwe nzvimbo.
Kuita kuti mazana maviri anonzi Medicare aputswe, imwe nzvimbo iyo hofisi yako yezvehutano inogona kutarisa pane kupa nekubhadhara kubhadhara zvikwereti kuti unyengedze makambani ehurumende yveshuwarisi, vashandi vanobhadhara vatakuri uye vanozvibhadharira varwere kubhadhara mari yavo nokukurumidza. Kupa nokukurumidza kubhadhara zvikwereti kunoita kuti hofisi yako yezvechiremba inosangana nemitoro yezvemari, kuwedzera uye kukura nekuvandudza mararamiro ako ose anogamuchirwa.
> Kwakabva:
> C MS.gov MLN Inobatanidza Nekupa eNews, March 3, 2016.