Kusiyanisa Pakati Pekubatana uye Vasingatori Vachipatara Vanopindira
Dzidza nezvekusiyanisa pakati pevatori vechikamu (par) uye vasina-participating (kwete-par). Mumwe mupi wehutano angasarudza kupinda muzvibvumirano nemakambani einishuwarenzi nevamwe vanobhadhara kana kwete, asi kune zvipo uye zvinetso zvebhizimisi ravo nevarwere vavo.
Kubatanidzwa (Par) Vatengesi
"Par kana avo vanotora chikamu ndivo vanochiremba kana vamwe vanopa hutano vane chibvumirano nemumwe mubhadharo wehushuwarani. Izvi zvibvumirano zvinotsanangurira mitemo nemamiriro ekubatanidzwa kune vose mubhadhari uye mutapi.
Pane zvinoreva zvishoma kune avo vanotora chikamu vanoita chibvumirano kana chibvumirano nevasimari vanobhadhara. Chinonyanya kukosha, vateresi vanofanira kugara nemimwe mitemo nemirairo yakarongwa nemunhu aripo:
Patient Care Care Services
Chikamu chekuchengeta rubatsiro rwevarwere chechibvumirano pakati pomubatsiri uye mubhadhari chinosanganisira mashoko pamusoro pezvokurapa zvinoda uye kushandiswa kwekushandisa. Mumwe nomumwe anokwereta angave ane tsanangudzo yake yezvechiremba zvinodiwa kubva pane tsanangudzo yakazara: "Kunyanya kutaura nezvemasangano, kurapwa, zvinhu, kana zviitiko zvakabatana zvakakosha uye zvakakodzera zvichienderana neuchapupu hwezvehutano uye mararamiro ekurapa kuti aongorore uye / kana kubata kurwara kana kukuvara kana; kurapa, mabasa, kana mabasa achaita kuti hutano huwedzere hutano kana kuti kusavapo kwakadaro kuchakuvadza murwere. "
Kushandiswa kwekushandisa zvinodiwa kunoratidza mirayiridzo yekutora pre-certification, pre-authorization, kana zvimwe zvinodiwa zvakasarudzwa kuitira chinangwa chekuchengeta hutano hwehutano uye kutengesa mari.
Mwoyo Murefu
Vose vanobhadhara vanoda kuti murwere ave nemhosva yevamwe chikamu chezvikwereti zvemishonga. Uyu mutoro wemwoyo murefu unomiririrwa ne deductible, kubhadharwa, uye coinsurance yakawanda. Chibvumirano pakati pomubhadhara uye mupiro anopawo chikamu chinoratidzawo kuti mupiki anodiwa kuti aite zvose zvaanoedza kutora mutoro wevarwere.
Zvinoda Kubhadhara
Kubhadhara zvinodiwa zvinogona kusiyana zvichienderana nemupi uye nemitemo inotsanangurwa muchibvumirano chekupa rubatsiro. Izvi zvinotsanangurwa tsanangudzo pamusoro pekodzero yekodhi, kugadziriswa kwezvikwereti, kubvunza fomu yehuwandu, kuiswa panguva yakakodzera, zvinyorwa zvezvechiremba uye zvinyorwa, mirayiridzo yekutsvaga, uye kubhadhara.
Kusarudza kuti kana kuti kwete kuva mupiro wekugovera zvinotarisirwa kune mubhadhari uye kuti zvichave zvakakosha sei pakuzadzisa zvinangwa zvesangano.
Vasingatori Nhengo (Kwete-Par) Vaperekedzi
Vasiri-Par kana vasiri vatsigiri vezvekurapa ndivo vanachiremba kana vamwe vatapi vezvehutano vasina kubvumirana kupinda muchibvumirano nemumwe mubhadhari wehushuwarisi, kusiyana nevatapi vemubatanidzwa. Vanogonawo kudanwa kunze kwe-network providers .
Mhedzisiro huru pakati pevatori vechikamu uye vasingabatsiri ndeye kusava nechokwadi. Vapiro vanosarudza kusava nekutora vasina chivimbiso chokuti vachazobhadhara kubva kumubhadhara weinishuwarenzi.
Kuva nechiratidzo Chirwere Chigadziro cheZvibatsiro Fomu
Basa rekubhadhara mafomu ndiyo fomu inobvumira kambani yehutano inshuwarhu yehutano kubhadhara zvakananga kune chiremba, chiremba kana chipatara chekurapwa kwakagamuchirwa.
Kunyange zvazvo kupiwa kwebatsiro haisi chivimbo chokuti mubhadhadzi achabhadhara munhu asiri nemupi webasa, mutapi angakodzero yekugamuchira kubhadhara kwezvikwereti zvacho. Vatsigiri vasiri vatsigiri havatomanikidzi kugadzirisa kana kubvisa chero chikamu chezvikwereti zvose sezvo vasati vabvumirana.
Panogona kunge pane zvimwe zvisiri izvo kune vasiri-par providers vanosarudza kubvuma basa reMedare varwere. Medicare inoda kuti avo vasiri-vapeji vanobvuma kugamuchira vanobvuma kusingabvumirwi sekubhadhara zvakakwana.
Chimwe chinhu chakaipa chekusava-par par provider ndechokuti varwere vanokurudzirwa nekambani yavo yveshuwarenzi kuti vashandise vatori vechikamu chete. Izvi zvingave zvichigadzirisa kune mupiki nekuda kwenhamba inokwanisa yevarwere iyo vangave vachirasikirwa nevatapi vanobatana.