Nheyo dzeMari yekurapa

Zvamunoda Kuziva Pakutsvaga Basa reMutapi Bhipi

Vashandi vezvechiremba vane basa rekutumira panguva yakakodzera yezvigadzirwa zvemishonga kana zvehutano zvemakambani emishuwarenzi kusanganisira mahofisi echiremba, zvipatara, misha yevanamukoti, kana zvimwe zvivako zvehutano. Munzvimbo yezvipatara , mabhizimisi ezvokurapa anoita mabasa akasiyana pane vashandi vezvokurapa vanoshanda kune dzimwe nzvimbo.

Kana iwe uchida kuva chiremba wezvechiremba, hezvino zvakakosha pamusoro pekugadzirisa kwekurapa kwechiremba, vatengi vakuru, uye kuti yakaitwa sei.

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The Basics of Health Insurance Plans

Kunzwisisa zvidzidzo zvehutano hwehutano hunoita kuti vashandi vemahofisi ezvokurapa vataure zvakanaka nevarwere maererano nehutano hwavo hwehutano inshuwarano uye kurukurai nezvemagariro ehutano nezvevashandi nevanomiririra vekambani.

Kuva neruzivo rwekutanga rwemhando imwe neimwe ye inshuwarisi ichaderedza zvinetso zvekutumira zvirevo uye kubhadhara mari. Kune miviri miviri mikuru yehutano hwehutano inshuwarheni:

1. Indemnity Inishuwarenzi: mitero-ye-mapurogiramu
2. Kutarisirwa Kuchengetedza Zvirongwa
   • Health Maintenance Organizations (HMOs)
   • Zvipo Zvokupa Zvokuda (PPOs)
   • Exclusive Provider Organizations (EPOs)
   • Point-of-Service (POS) Zvirongwa

Zvimwe

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Hurumende Yehutano Hwezvirongwa

Me dicare : Medicare ndiyo chirongwa chehurumende chinopa hutano hwehutano hwemamiriyoni makumi mana eAmerica anosanganisira:

• vakwegura vanopfuura makore makumi matanhatu nemashanu
• vakwegura zvachose vanhu vakuru pasi pemakore makumi matanhatu nemashanu
• vanhu vanotambura kubva pakupedzisira-Stage Renal Disease (ESRD) iyo inogara isingagoneki kushaya mafungiro ekuda dialysis kana kupora kwepvo

Medicaid : Zvakakosha kuchengeta mupfungwa kuti Medicaid haisi inshuwarisi. Medicaid chirongwa chinoita kuti kurapwa kwechiremba kuvepo kune uyo anogamuchira.

Kana chikwereti chechitatu chiripo, ipapo Medicaid inogara iri mubhadharo wekupedzisira. Izvi zvinongoreva kuti Medicaid inobhadhara nguva yekupedzisira kune imwe inshuwarisi iripo.

TRICARE: TRICARE, chikamu cheMasoja Health System chinoshandiswa neDhipatimendi Rekuchengetedza (DoD), chirongwa chekuchengetedza kwehutano kune nhengo dzekushanda, dzakasimuka uye dzevarindi / Reserve uye mhuri dzavo.

CHAMPVA: Kunyange zvazvo yakafanana ne TRICARE, CHAMPVA inotarisirwa neDhipatimendi reVeterans Affairs, uye kana nhengo yakakodzera TRICARE havagoni kukodzera naCAMPVA. Zvose TRICARE naCAMPVA vanogara vachienda kune dzimwe zvirongwa zvehutano hwehutano kunze kwekuwedzera zvirongwa uye Medicaid.

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Mushonga wekurapa

Kurapa kwevarwere: Pakati pevarwere chekuongorora, muongorori wevanhu vane huwandu hwevanhu vane huwandu hwehutano hwakapinda huri kusanganisira bhujhuseti yebhadharo, nhamba yehurongwa, uye mamwe mashoko anodiwa kuti agadzirise kudai kwakachena.

Inishuwarenzi kubvumirwa uye kuvimbiswa: Nokuti ruzivo rwehushuwarisi runogona kuchinja chero nguva, kunyange kune varwere nguva dzose, zvakakosha kuti mupiki ave nechokwadi chekufanirwa kwemuteveri nguva dzose nguva dzose. Ichi chiito chegadziriro yacho zvakare chinodiwa kuti uwane ruzivo uye ruzivo ruzivo.

Mutero Wokupinda: Mutero wokupinda ndiyo kuiswa kwezvikwereti zvebasa zvakagamuchirwa nemurwere uye zvinosanganisira kuwirirana kwakakodzera kwehutano hwezvehutano kumabasa uye nzira dzinoshandiswa apo murwere achishanyira.

Kuchengetedza maitiro ekuongorora, maitiro, uye kuchinja : Mitsara yekodhi yakarurama inobvumira mubhadhadzi wehushuga kuziva chirwere kana kukuvadzwa kwemurwere uye nzira yekurapa.

Kukumbirira kwemhosva: Mushure mekunge kubvunzwa kwapera, kudai kunotumirwa kubhadhara kumubhadhara weinishuwarenzi. Kuti vaise mvumo yezvokurapa nenzira yakajeka, vatengesi vezvemishonga vanoda kuziva kana kuwana ruzivo rwakawanda rwekambani imwe ye inshuwarisi.

Kubhadhara kusuma: Kubhadhara kunyoresa kunosanganisira kutumira uye kuisa mabasa uye kuyananiswa kwekutumira mabasa nemari.

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Professional Billing uye Institutional Billing

Mukubhadhara kwechiremba, pane maviri ezvinyorwa zvakasiyana-siyana zvebhadharo - unyanzvi hwekubhadhara uye yekubhadhara masangano.

Kubhadhara Kwemhizha: Kudzidzira kubhadhara kunokonzera kubhadhara kwezvakaitwa zvakagadzirwa nebasa rinoitwa navanachiremba, vatengesi uye vamwe vasiri vemuzvikoro zvevamwe vose vari kunze uye vanorwara. Mhosva dzezvemhizha dzinobhadharwa paCMS-1500 fomu. ICMS-1500 ndiyo iyo yerineni yakachena pamashizha emhando yemhando yepamutemo inoshandiswa navanachiremba uye vatengesi nokuda kwekubhadhara mari.

Institutional Billing: Mahofisi ekubhadhara zvikoro anokonzerwa nekubhadhara kwezvikwereti zvinokonzerwa nebasa rinoitwa nezvipatara, mazviremba vane unyanzvi, uye mamwe masangano ekurapa uye kuberekwa kusanganisira kushandiswa kwezvigadzirwa uye zvigadzirwa, mabazi e laboratori, mabasa ehurology, nezvimwe zvikwereti. Zvikwereti zvemitambo zvinotengeswa paB-04. I-UB-04 ndiyo inowi yepepuru pamuvara wepepuru inotarirwa kudai inoshandiswa nevanopa zvipo zvekubhadhara mari.

Zvimwe

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Kudhinda Kwemagetsi uye Mapepa Ezvokupa Mapepa

Pepa yekubhadhara haisi yekutanga kusarudza zvikwereti zvekurapa asi dzimwe nguva basa rakafanira. Zvechokwadi, magetsi ekutsvaga maitiro ari nyore uye anokurumidza kufananidzwa nehuwandu hwebhuku rekubhadhara pepa.

Zvizhinji zvehushuwarisi hukuru huripo vanopa magwaro ekutumira kukumbira. Iwe une sarudzo yekubhadhara zvakananga kana kugadzirisa nhoroondo neyekuchenesa.

A refinghouse is a company that will accept all your claims and electronically forward them to the insurer insurer for processing. Ivo vakagadziridza munzvimbo kuti vaongorore zvikanganiso mubato renyu kuti vabatsire kudzivisa kunonoka mukubhadhara.

Kubatsira kukuru kwekubhadhara magetsi kana iwe uchishandisa chekuchenesa kana iwe kutora bhiri ndeyokuti iwe uchakurumidza kushandiswa kwekutaura kwako. Pepa yekubhadhara kunogona kutora mazuva makumi mashanu kusvika pakugadzirisa.

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Medical Office Terminology

Iwe unoda kuziva mazwi aya ane chokuita nehutano inshuwarhu, kubhadhara kwechiremba, coding yezvechiremba, teknolojia yekubhadhara, uye utano hwehutano hwehutano.

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Medical Claims Processing

Iwe uchadikanwa kunzwisisa mabhizimisi ekubhadhara magetsi nemagetsi ehuwandu hwemafomu, ayo anogamuchirwa neMurere, Medicaid, uye makambani akawanda emishuwarenzi. Zvisinei, mapepa ekubhadhara mapepa achiripo uye iwe unoda kuva akajairika mukugadzirisa.

Zvimwe

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Kurapa Kubhadhara kuMedare, Medicaid, uye Tricare

Vatengi vehurumende ndivo chikamu chakakosha chekubhadhara kwechiremba. Iwe unofanirwa kuve wakanyatsonzwisisa nemitemo yavo. Ongorora mumwe nomumwe zvakadzika, uyewo mamwe emakambani makuru emishuwarenzi ega ega.

Zvimwe