Litlhahlobo tsa Litlhahlobo Tsa Bongaka

Haeba u thahasella ho ba moqapi oa bongaka, mona ke thuto ho phekoloang litlaleho tsa bongaka.

Sepheo sa Thuto

Sepheo sa 1: Lipolelo tsa litefiso tsa elektronike

• Hlalosa 837-P
• Hlalosa 837-I
• Khetholla likarolo tsa Sethathamo sa Transaction
• Hlalosa ntlo ea ho hloekisa

Sepheo sa 2: Litlhalo tsa Karolo ea ho Lefa

• Khetholla mefuta e sa tšoaneng ea likoloto tsa ho lefella
• Tlatsa foromo ea CMS-1500 kapa UB-04
• Tlhaloso e nepahetseng ea litlaleho tsa pampiri

1 -

Litlhalo tsa Elektronike tsa Lekhetho

Medicare , Medicaid , le lik'hamphani tse ling tse ngata tsa inshorense li amohela liqoso tsa elektronike e le mokhoa o ka sehloohong oa ho lefella. Phetolelo ea elektronike ea CMS-1500 e bitsoa 837-P, ea P e emetse mokhoa oa setsebi. Phetolelo ea elektronike ea UB-04 e bitsoa 837-I, eo ke emeng bakeng sa mofuta oa setsi.

E le hore u atlehe ho kenya liqoso tsa elektronike, likoloto tsa bongaka li tlameha ho utloisisa litlhoko tsa mefuta e sa tšoaneng ea insurers li fana ka lipolelo. Mongolo o mong le o mong oa 837 o romella faele ea data ho insurer e bitsoang Transaction Set. Transaction Set e robehile likarolo:

1. Transaction Header
2. Tlhaloso ea Mofani oa Litefiso
3. Boitsebiso ba batlisisi
4. Tlhaloso ea Mamello
5. Bolela Lintlha
6. Transaction Trailer

Le hoja ho sa hlokahale hore li-billers li utloisise li-transaction setsing, ke habohlokoa hore ntho e 'ngoe le e' ngoe e kenngoe tsamaisong ea ho lefa e latela mekhoa e nepahetseng ea ho thibela liphoso le ho hana lits'ebeletso.

Ntlo ea ho hloekisa ntlo ke k'hamphani e amohelang lipolelo tsohle tsa hau le ho li fetisetsa ho bafani ba inshorense bakeng sa ho sebetsa. Ba boetse ba fetohile sebakeng sa ho hlahloba liphoso ho seo u se batlang ho thusa ho qoba ho lieha ho lefella.

Molemo o ka sehloohong oa ho lefella k'homphieutha ho sa tsotellehe hore na u sebelisa ntlo ea ho hloekisa kapa u tsamaisa likoloto ke hore o tla potlakisa ho etsa lipolelo tsa hau. Ho lefella pampiri ho ka nka matsatsi a 45 ho sebetsa ha ho lefella ka elektroniki ho nka matsatsi a 7 ho isa ho a 21.

2 -

Litlhaloso tsa Karolo ea Lichelete

Ho lefella pampiri hase eona khetho ea pele ea litlaleho tsa bongaka empa ho na le mosebetsi o hlokahalang ka linako tse ling. Ha e le hantle, mokhoa oa ho ipelaetsa oa elektronike o bonolo ebile o potlakile ha o bapisoa le mokhoa oa tsamaiso oa ho lefella pampiri.

Nako le nako ha ho sebelisoa likopi, boloka tsena kelellong:

• Khetha foromo e nepahetseng ea ho lefella: Ke habohlokoa ho utloisisa le ho sebelisa foromo e tloaelehileng ea litlaleho tsa bongaka. Khetha pakeng tsa CMS-1500 le mefuta ea litlamorao tsa UB-04 .
• Etsa bonnete ba hore sebopeho se nepahetse: Lichelete tse ling li amohela liphetolelo tsa li-claim tsa bongaka tse ntšo le tse tšoeu, empa mokhoa o motle ke ho romella tlhahiso ea pele ea bofubelu le e tsoeu. Ho itšetlehile ka mofani, ha mochini oa pele oa boipiletso o sa sebelisoe, moqoqo o ka 'na oa se ke oa kenngoa tsamaisong ea bona ka mokhoa o nepahetseng ho baka ho lieha kapa ho hana ho lefa.
• Kenya data e nepahetseng sebakeng se nepahetseng: Sheba le mofani oa inshorense ka mong ho fumana hore na ho hlokahala eng. Etsa bonnete ba hore boitsebiso bohle bo kenngoa ka mokhoa o nepahetseng le ka nepo masimong a nepahetseng.
• Kenyeletsa mangolo a nepahetseng: Ka linako tse ling ho lefella pampiri ho hloka hore mangolo a nepahetseng a romeloe ka foromo ea mobu.

Hape

Thuto ea 4: Medicare, Medicaid, le Likoloto Tse Ling

Ho utloisisa lits'ebeletso tsa basebetsi ba Medicare, Medicaid, Tricare, le bahiri ba khoebo ba inshorense