Hagaajinta hannaankaaga Medicare-ka iyo kahortaga khaladaadka leh talooyinkan
Bixinta Medicare uma baahna inay keento in badan oo diidmo ah iyo diidmo haddii aad haysato aqoonta saxda ah ee nidaamka loo yaqaan Medicare billing. Macluumaadka hoos ku qoran ayaa ah qaar ka mid ah waxqabadka iyo ma'aha kuwaas oo inta badan loo yaqaan si looga hortago khaladaadka biilasha.
Ha ilaawin inaad booqatid bogga internetka ee CMS si aad u hesho talefoono qalab ah, tilmaamo, iyo daabacaadyo kuwaas oo faa'iido u yeelan kara biilasha Medicare ee saxda ah.
Waxa la samaynayo Bixinta Caafimaadka
Qodbada codsigu maaha mid ku saleysan adeegyada, imtixaannada, iyo nidaamyada la qabtay.
Ma diiwaangelinayaan diiwaanka caafimaadka si tifaftiran oo ku saabsan dhammaan adeegyada, tijaabooyinka, iyo hababka sida loo fuliyey iyo si ku filan faahfaahsan ula socdo calaamadaha bukaanka, cabashooyinka, xaaladaha, jirooyinka, iyo dhaawacyada.
Usheega nidaamka CPT / HCPCS ee Medicare in ay si gaar ah ugu dhigmaan dukumeentiyada diiwaanada caafimaadka.
Xulo oo soo sheegaan isbadellada ku habboon CPT / HCPCS codsiyada ku saabsan codsiga iyadoo la raacayo tilmaamaha Medicare.
Ku dar dhererka waqtiga, inta jeer ee daaweynta, ama tirada unugyada ku jira diiwaanka caafimaadka si sax ah warbixinta sheegashada.
U soo sheeg calaamadaha lagu ogaanayo ICD-9 in ay gaaraan heerka ugu sarreeya ee gaarka ah ee u dhigma calaamadaha bukaanka, cabashooyinka, xaaladaha, jirooyinka iyo dhaawacyada faahfaahsan ee ku jira diiwaanka bukaan-socodka bukaanka.
U sheeg dacwooyinka dacwada hal sano gudaheed laga bilaabo taariikhda adeegga loogu talagalay sheegashada daaweynta aasaasiga ah ee Medicare iyo MSP.
Ka warbixi qaybaha adeegga ee ku saleysan Mashruuca Qaran ee Codsiga Qaran (NCCI) iyo Edifications of Medical Non-Edgy (MUEs) si looga hortago warbixinta adeegyo badan ama habraac aan loo baahnayn in lagu wada buuxiyo sababtoo ah hal adeeg ama nidaam laga yaabo inay ka mid yihiin kuwa kale ama sababtoo ah caafimaad ahaan uma badna in lagu sameeyo isla bukaanka isla maalintaas.
Waxaad haysataa Ogeysiis Horudhac ah Horumarineed (Abnormal Beneficiary) (ABN) faylka si sax ah u caddeeyaan adeegyo aan la daboolin oo ku habboon beddelka habboon, tusaale ahaan GA ama GZ, kaas oo tilmaami doona adeegyada lagu biilin karo ama aan loo dirin bukaanka.
Saxeex ka soo qaado bukaanka u oggolaanaya bixinta faa'iidooyinka, u oggolaanaya bixiyaha inuu helo oggolaansho, iyo inuu bixiyo daryeel.
U hubso xaq u yeelashada bukaanka oo ah Foomka Iskaashiga Guud (CWF) ka hor inta aan la soo dallacin sheegashada si loo hubiyo in macluumaadka bukaanku aanu isbeddelin.
Maxuu Sameynin Bixinta Medicare Bixinta
Ha bixin biilka adeega, imtixaanka, ama qaabka la fuliyay marka aysan jirin wax caddayn ah calaamadaha, cabashooyinka, xaaladaha, jirooyinka, iyo dhaawacyada bixiya caddaynta haddii aan la isticmaalin koodhka baaritaanka.
Ha u soo sheegin lambarrada habka loo yaqaan "CPT / HCPCS" ee nidaamka CPT / HCPCS ee la heli karo.
Ha si toos ah ugu darin beddelayaasha dhammaan CPT / HCPCS marka diiwaanka caafimaad uusan taageereynin isticmaalka.
Ha biilin adeegyada, tijaabooyinka ama qawaaniinta si gooni gooni ah loo xiro si wada jir ah sababtoo ah waxaa loo tixgeliyaa qeybaha isku midka ah adeegga, imtixaanka ama habka.
Ha bixin biilasha daawooyinka loo isticmaalo loona lumo. Tirada qashinka ah waa in lagu soo dallacaa khad gaar ah oo lagu tilmaamaa isbeddel JW.
Ha u gudbinin sheegashooyinka Medicare lacag bixinta haddii uu bukaanku ku jiro caymiska Daryeelka Caafimaadka ee Medicare.
Ha ku soo dallacin kharashyada Venipunctures (36415) ku qoran codsiga Medicare Qeybta B. Tani waxa kaliya lagu soo dallici karaa qayb ka mid ah sheegashada isbitaalka.
Ha u soo dirin baasaboorka caadiga ah ee jir ahaaneed haddii aadan ku qanacsanayn inaad hesho diidmo. Haddii biilka diidmada, hubi inaad ku darto GY wax laga beddelo xeerka habka CPT / HCPCS ku habboon.
Ha bixin biilka adeegyada Medicare Qeybta B marka bukaanku doorto bukaansocodka daaweynta iyo maareynta cudurka jirran.
Ha dalbanin waraaqo qoraal ah waxkasta oo aan ahayn habka, casaanka iyo cad CMS-1500 ama foomamka UB-04.