Shuruudaha Cashuur Bixinta iyo Bixinta

Heemaal Staff Ogosto 29, 2022 in Gudiga Xaashida by James Eng

CHPW waxay jeceshahay inay xasuusiso dhammaan rugaha caafimaadka iyo bixiyeyaasha sheegashada sheeganaya in lagu soo dallaco lambarro ansax ah oo ku habboon canshuur bixiyaha iyo, marka ay khuseyso, adeeg bixiyaha.

Guriga nadiifinta ee CHPW waxa uu diiday wixii sheegasho ah ee la soo gudbiyay iyada oo aan la bixin biilasha saxda ah iyo/ama bixinta codesyada cashuuraha iyo sheegashooyinkaas aan loo gudbin CHPW.

Sheegashada adeeg bixiye keli ah ayaa looga baahan yahay oo kaliya in lagu soo dallaco NPI / taxonomy heerka qaan-sheegashada sida bixiyaha biilasha iyo bixiyaha bixintu ay isku mid yihiin. Haddii magacaaga bixiyaha biilasha uu ka duwan yahay magacaaga bixiyaha bixiye, markaa NPIs gaar ah iyo madax-bannaan ayaa loo baahan yahay; xaaladdan oo kale, biil bixinta iyo bixinta ma noqon karto isku lambar taxonomy.

Bixinta Elektaroonigga ah ee Taxonomy

• Taxonomy-ka Biilasha (Billing Taxonomy) wuxuu galayaa Loop 2000A, PRV * BI Qaybta (sheegashada waraaqda: Sanduuqa 33b)
• Biilasha NPI waxay aadeysaa Loop 2010AA, NM1 * 85 Qaybta (Sanduuqa 33a)
• Lambarka Aqoonsiga Canshuurta Biilasha (TIN) wuxuu galayaa Loop 2010AA, REF * EI Segment (Sanduuqa 25)
• Bixinta NPI waxay aadeysaa Loop 2310B, NM1 * 82 Qaybta (Sanduuqa 24j - hoose)
• FQHC -yada, haddii bixiyaha bixiyaha uu ka duwan yahay kan loop 2310B, geli taxonomy ee loop 2420A.
• Raadinta Taxonomy waxay tagtaa Loop 2310B, Qaybta PRV * PE (Sanduuqa 24j - sare)

Fiiri “Tusaalaha Sheegashada Elektarooniga” iyo “Tusaalaha Sheegashada Waraaqaha” ee dhammaadka wargeyskan si aad u hesho wakiilo muuqaal ah.

Fadlan sii wad akhrinta si aad u hesho macluumaad dheeraad ah oo ku saabsan koodka cashuurta ama arag NUCC's Habraaca Xeerka Cashuuraha Bixiyaha Daryeelka Caafimaadka si loo helo madax-bannaani kale oo laga yaabo in lagu dabaqi karo.

Bixiyeyaal Qabiil

Bixiyeyaasha qabaa'ilku waa inay biil ku bixiyaan canshuurta ku habboon ee biilka ah iyo Hindida Mareykanka / Dhaladka Alaska (AI / AN) ee ku habboon ee loo xilsaaray ama beddele qabiileedka aan ahayn AI / AN.

Canshuuraha la Aqbali karo ee Bixiyeyaasha Qabiilka

• Sheegashada caafimaadka: 208D00000X, 225100000X, 225X00000X, 235Z00000X, 152W00000X, 171M00000X, iyo 174400000X
• Sheegashooyinka caafimaadka maskaxda: 2083P0901X
• Sheegashooyinka khalkhalka isticmaalka maandooriyaha: 261QR0405X
  • Haddii koodka biilasha H0020, waa inaad sidoo kale biil 261QM2800X bixiye/adeeg bixiye ahaan; tixraac Maamulka Daryeelka Caafimaadka Gobolka Washington (HCA) Tilmaamaha Biilasha Isticmaalka Walaxda (SUD). Wixii macluumaad dheeraad ah
• Goobaha daawaynta dadka deegaanka: 324500000x ama 3245S0500x

Fadlan tixraac HCA Tilmaamaha Biilinta Caafimaadka Qabiilka wixii faahfaahin ah.

Adeegyada Caafimaadka Habdhaqanka

Wixii loogu talagalay CHPW Adeegyada Caafimaadka Dhaqanka Keliya (BHSO) qorshaha/xubnaha (Ururka Adeegyada Maamulka Caafimaadka Dhaqanka (BH-ASO) macaamiisha), HCA waxay mas'uul ka tahay bixinta adeegyada loo arko daryeelka miyir-beelka hoose. Sheegashooyinka caafimaadka habdhaqanka xirfadeed ee adeegyadan waa in lagu soo gudbiyaa ProviderOne. HCA waxay go'aamin doontaa lacag bixinta shuruudaha soo socda:

1. Haddi bixiyaha uu yahay Community Mental Health Centre, Taxonomies 251S00000X ama 261QM0801X, lacag celinta waxaa mas'uul ka ah ururka daryeelka la maareeyo (MCO) waxaana diidi doonta HCA iyadoo ku wargelinaysa bixiyaha inuu biil u diro MCO/BH-ASO.
2. Cashuuraha biilasha soo socdaa waxay muujinayaan adeegyada caafimaadka dabeecadda waxayna mas'uul ka yihiin MCO/BH-ASO: 261QR0405X, 261QM2800X, 324500000X, 3245S0500X, 261QM3000X, 2083QM0901X, 261P0850M X, iyo 320800000P323X.
3. Taxonomy 283Q00000X ee cisbitaalka dhimirka waa in lagu dalacaa MCO/BH-ASO.
4. CHPW waxay diidi doontaa sheegashooyinka cashuuraha biilasha ee aan ahayn kuwa ku taxan #1-#3 ee sare. HCA waxay u tixgelisaa canshuuraha kale inay yihiin adeegyada miyir-qabka hoose waxayna ka baaraandegi doontaa oo ay bixin doontaa dacwad caafimaad ahaan, oo ka soo horjeeda sheegashada caafimaadka dabeecadda, iyadoon loo eegin ogaanshaha. HCA kaliya waxay eegtaa cashuurta biilasha.
5. HCA waxay bixin doontaa oo keliya adeegyada lagu bixiyo khidmadda ujrada ah; Adeegyada aan kujirin khidmadda adeegga waa in si toos ah loogu soo diraa MCO, iyadoon loo eegin taxonomy.
6. Fadlan eeg HCA Tilmaamaha Biilasha Adeegyada Caafimaadka Maskaxda ku saabsan biilasha habboon iyo isticmaalka cashuuraha.
7. HCA waxay sare uqaadi doontaa wixii khalad ah ee xaga biil ee mustaqbalka ah ee ay soosaaraan bixiyeyaasha shaqaalaha HCA ee barnaamijka Integrity.

Dhammaan adeegyada caafimaadka habdhaqanka waa in lagu soo dallacaa canshuuraha ku habboon ee biilashada, oo ay ku jiraan laakiin aan daruuri ku koobnayn, kuwa hoos ku taxan.

• Xarumaha Caafimaadka Maskaxda Bulshada: 251S00000X ama 261QM0801X
• Wakaaladaha caafimaadka hab dhaqanka (bixiyaha biilasha): 261QR0405X, 261QM2800X, 324500000X, ama 3245S0500X
• Baxnaaninta (dhaqancelinta) cilladda isticmaalka maandooriyaha (SUD): 261QR0405X
• Bukaanka / xarunta Methadone: 261QM2800X
• Xarunta dib u soo kabashada SUD: 324500000X
• Xarunta dhaqan celinta caruurta ee SUD: 3245S0500X

Rugaha Caafimaadka Reer Miyiga (RHC)

Adeegyada RHC waa in lagu dallaco cashuurta RHC si loo helo xoojinta adeegga ku salaysan (SBE). Sida ku qeexan HCA's Rural Health Clinics Billing Guide:

Sideen ugu dallacaa koodka taxonomy ee RHCs?

• • Marka lacag bixinta adeegyada uqalma bixinta lacag bixinta, HCA waxay ubaahantahay RHCs inay adeegsadaan taxonomy taxonomy 261QR1300X heerka sheegashada.
  • Canshuur -bixinta adeegga ayaa sidoo kale loo baahan yahay.
  • Haddii macmiilka ama adeegu uusan u qalmin la kulanka RHC, RHCs waxay si joogto ah biil ahaan ugu soo dallacayaan sida non-RHC oo aan lahayn HCPCS T1015 sheegashada.

Fadlan tixraac HCA Rural Health Clinics (RHC) Tilmaamaha biilasha Wixii macluumaad dheeraad ah.

Xarumaha Caafimaadka ee u Qalma Federaalka (FQHC)

Sida dhaqanka ugu wanaagsan, CHPW waxay raacdaa shuruudaha biilasha ee HCA ee FQHCs. Sida ku qeexan HCA's Faderally Qualified Health Centers (FQHC) Tilmaamaha biilasha:

Sideen ugu dallacaa koodka taxonomy FQHCs?

• Marka qaan -sheegashada adeegyada u -qalma lacag -bixinta kulanka, HCA waxay u baahan tahay FQHCs inay adeegsadaan cashuur -bixinta qaan -sheegga 261QF0400X heerka sheegashada.
• Canshuur -bixinta adeegga ayaa sidoo kale loo baahan yahay.

Fadlan eeg qaybta "Bilinta Elektrooniga ah ee Taxonomy" ee mawduucan (kor) ama tixraac HCA Tilmaamaha Biilida ee Xarumaha Caafimaadka ee Faderaalka ah (FQHC) Wixii macluumaad dheeraad ah.

Falanqaynta Dhaqanka ee la dabaqay (ABA) Taxonomy

Bixiyeyaasha Falanqaynta Dhaqanka ee Codsan (ABA) waa inay isticmaalaan lambarka cashuurta 103K00000X biilasha adeegyada daawaynta ABA si loo hubiyo in sheegashooyinka si habboon loo bixiyo. Kani waa ka kaliya ee lagu dabaqi karo, cashuurta la bixin karo ee codes ABA CPT. Bixiyeyaasha waa in ay geliyaan code-ka-taxonomy-ga labadaba biilasha iyo adeegga goobaha canshuuraha ee foomka CMS-1500 (HCFA).

Fadlan eeg NUCC's Habraaca Xeerka Cashuuraha Bixiyaha Daryeelka Caafimaadka Wixii macluumaad dheeraad ah.

Tusaalaha Sheegashada Elektaroonigga

Bixiyaha shakhsi ahaaneed tusaale sheegashada elegtarooniga ah ee hoose:

• Qaybta PRV*BI waa canshuur bixiyaha biilasha
Qaybta NM1*85 waa bixiyaha biilasha NPI
Qaybta REF*EI waa bixiyaha biilasha aqoonsiga cashuurta
Qaybta NM1*82 waa bixiyaha NPI
• Qaybta PRV*PE waa cashuur-bixinta bixiyaha

Tusaalaha Sheegashada Waraaqaha

Tusaalaha warqada sheegashada bixiyaha shakhsi ahaaneed ee hoose:

• • • • Sanduuqa 24j - kore waa taxonomy bixiyaha bixiyaha
      • Sanduuqa 24j - hoosta waa bixiyaha bixiyaha NPI
      • Sanduuqa 25 waa bixiyaha biilka biilinaya Aqoonsiga Canshuurta
      • Sanduuqa 33a waa bixiyaha biilka NPI
      • Sanduuqa 33b waa taxonomy bixiyaha biilka

Tilmaamaha Biilka

Fadlan eeg HCA Tilmaamaha Biilka canshuuraha saxda ah iyo macluumaad dheeri ah, oo ay ku jiraan Tusaha Biilasha Caafimaadka Qabiilka, Xarumaha Caafimaadka ee Federaalka Takhasuska leh (FQHC) Tilmaamaha biilasha, Tilmaamaha biilasha Caafimaadka Rural Health Clinics, iyo in ka badan.

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