Dzidza Pamusoro peZviviso Zvokurapa Mazano
Mazano Okutsigirwa (RA) ibhuku rakapiwa neinishuwarenzi iyo inopa chiziviso uye kutsanangurwa kwezvikonzero zvekubhadhara, kugadziriswa, kukanganisa uye / kana kuzarura mhosva dzezvokurapa. Inowanzoenda neMedare uye Medicaid . Kazhinji inonzi inotsanangurwa yekubhadhara (EOB) nevamwe vanobhadhara inshuwarisi.
Mhando dzeZvipo zvekuregererwa
- Mazano Ekudzoswa Kwemagetsi (ERA): RA iyo inoparadzirwa mumagetsi
- Mazano Ekuregererwa Kwemazana (SRA): RA iyo inotumirwa mumapepa mapepa
Vakawanda vanobhadhara inishuwarenzi vakashandisa kushandiswa kweERA. Zvikomborero zvinosanganisira kukwanisa kubhadhara mari yekubhadhara zvinyorwa uye nekukurumidza kuona kusakirwa kunoitwa panguva yekubhadhara kwokutanga kuita zvigadziriso zvinodiwa.
I ANSI 835 ndiyo yekubhadhara magetsi uye kubhadhara mazano maitiro akaenzana emitemo yezvoutano. Mitemo yeHIPAA inoshandiswa kushandiswa kwe835 semitemo yemitemo yekushandura pepa EOB apo vanopa rubatsiro rwehutano vanowana mari yezvemagetsi.
Chii Chinosanganiswa Pamusana pekugamuchira Remittance
Chipo chekudzorera Inofanirwa kusanganisira zvimwe kana kuti zveruzivo rwekutevera:
- Muchibhadharo Inobhadharwa Nhamba: dhora rinodhadharwa nemubhadhari
- Mari Yakagamuchirwa: mari yakagamuchirwa yakaenzana nemari yekutora kwese kwakagamuchirwa nemubhadhari
- Kubvumirwa Nhamba: iyo yakabvumirwa yakaenzana yakaenzana nemari yekutora kwese kwakabvumirwa nemubhadhari
- Mwoyo Murefu Mutengo: mari yemari ndiyo mutoro wemurwere unomirira murwere wevarwere, coinsurance , uye zvinokonzerwa nemari
- Zvakavharwa: Mari yakavharidzirwa yakaenzana nemari yekutora kwese kwakange kwakafukidzwa nemubhadhari
- Mari Yakagadziriswa: kukosha kwemadhora emutengo mukuru wekubhadhara kana kushandiswa kwekambani
- Kupiwa mutongo musi: zuva raitongwa rakatemerwa uye / kana kuti rakabhadharwa
Zano rekuregererwa rinogona kuratidzawo vatengi vari mukati rekutonga nhamba (ICN), chengorora nhamba, nheyo dzebasa, tsanangudzo yemabasa, kukanganisa mafungiro emitemo, uye kutsanangura tsanangudzo.
Mazano Ekutumira Magetsi (ERA)
Kushandisa mazano ekubhadhara magetsi (ERA) inzira inokurumidza uye yakajeka yekuisa mari yako pamwe chete nekugadzirisa nekuramba. ERA, zvisinei, haisi kubudirira kunze kwekubhadhara mari yemagetsi (EFT). EFT ichasimbisa kuti kubhadhara kwako kuchapinza zvakananga kubhengi yako yebhangi kuratidza ERA yako. Iwe unogona kunyora mabhizinesi aya zvakananga kana kuburikidza nekunatsa. Iyo nzira ichashanda yakafanana neyemagetsi yekubhadhara.
Muenzaniso: Muenzaniso Wokutumira Remangwana
Iyi mienzaniso yekuregererwa mazano inoratidza ruzivo rwemashoko, mazita eboka uye mamwe mashoko angave akasiyana maererano neinishuwarenzi.
ABC INSURANCE COMPANY
ZITA REPATIATI: JOHN DOE
PATIENT ACCT: 123123123
MEMBER ID NO: 554554554
PAYER ICN CHA: 123456789XYZ
DATE SVC: 01/01/2012
KUDZIDZA KUDZIDZA: 01/15/2012
BASA ROKUDZIDZA: BHURI KENDA
TOTAL CHIKAMU: $ 100.00
KUDZIDZIRWA KWAMATA: $ 80.00
KUDZA MWARI: $ 20.00
COPAY: $ 20.00
KANZI: $ 8.00 (10%)
PATIENT RESPONSIBILITY: $ 28.00
PAID AMOUNT: $ 52.00
MASHOKO
KUDZIDZWA KWAKAPERIDZWA KUVIMBIRWA NECHITATU
Mamwe mazwi akaenzana neRewittance Advice anosanganisira:
- Nhamba Nhamba: nhamba yakagoverwa kumurwere mumwe nomumwe anoshanya kuti azive zvikwereti uye kubhadharwa kwakagadzirwa kwezuva rimwe chete rebasa.
- Coinsurance: inoratidza kuti anishuwarenzi uye bhizimisi vanoparadzanisa sei mari yebhadharo rezvechipatara mushure mokunge deductible yakasangana. Kana imwe nguva kunze kwehomwe yepamusoro yakasvikiswa iyo inshurensi inotora mutoro we 100 muzana yemari ipi zvayo.
- Copayment: Chimwe chemari yakasarudzwa nehutano hwehutano yehushuwarisi yemurwere kubhadhara basa rinotsanangurwa, kazhinji chiyero chakareruka.
- Deductible : ndiyo chikamu chemhosva chero ipi zvayo isina kuvharwa neinishuwarenzi uye inofanirwa kubhadharwa nehu inshumberi zvisati zvaitwa nemutemo zvinogona kushanda.