Txhawm rau dhau los ua kws kho mob hauv xeev California, koj yuav tsum ua daim ntawv thov online ntawm lub vev xaib rau Tebchaws Meskas Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Tib Neeg. Cov txheej txheem thov online yog hu ua Tus Zov Me Nyuam Sau Npe, Chain, thiab Cov Tswv Cuab (PECOS) thiab tam sim no yog tib txoj hauv kev los thov kom dhau los ua kws kho mob hauv Tebchaws Meskas. Koj daim ntawv thov rau npe nkag yog tom qab tshuaj xyuas thiab ua tiav los ntawm California Medicare Tus Kws Lij Choj Tswj (MAC), uas yuav ceeb toom rau koj txog koj li xwm txheej ua tus kws kho mob Medicare, feem ntau tsis pub dhau 60 hnub tom qab xa daim ntawv thov. Cov txheej txheem siv sijhawm, tab sis kev saib xyuas koj muab cov neeg mob uas yog Medicare tau txais txiaj ntsig yog qhov tseem ceeb los ua California thiab nws cov neeg nyob hauv kev noj qab haus huv, zoo siab, thiab muaj txiaj ntsig zoo rau pej xeem.
Cov kauj ruam
Txoj Kev 1 ntawm 3: Txheeb Xyuas Koj Li Kev Tsim Nyog Ua Tus Kws Kho Mob
Kauj Ruam 1. Kawm paub hom Medicare
Ib tus kws kho mob lossis kws kho mob tsis yog kws kho mob lossis tus muab kev pabcuam uas muab cov kev pabcuam lossis khoom tsim nyog rau kev noj qab haus huv ntawm lub cev thiab lub hlwb ntawm cov uas tau txais kev pabcuam Medicare muaj feem tsim nyog thov ua tus muab kev pabcuam. Nyob ntawm seb yam khoom lossis kev pabcuam twg koj muab, txheej txheem thov suav nrog ntau cov kauj ruam txhawm rau kom ntseeg tau tias tsim nyog. Nws yog ib qho tseem ceeb los tshuaj xyuas ntau hom kev pab them nqi kho mob Medicare thiab yuav ua li cas koj lub tsev kho mob, xyaum ua, tsev kho mob, noj qab haus huv hauv tsev, lossis cov khoom siv kho mob haum rau txhua qhov.
- Ntu A, lossis tsev kho mob Medicare, suav nrog kev kho mob hauv tsev kho mob, cov chaw tu neeg mus sij hawm ntev, kev noj qab haus huv hauv tsev, thiab tsev kho mob.
- Ntu B, lossis kev kho mob kho mob Medicare, suav nrog kev pabcuam kws kho mob, kev saib xyuas tiv thaiv, khoom siv kho mob, ib qho txheej txheem kho mob sab nrauv, kuaj sim, xoo hluav taws xob, kho mob thiab kho mob sab nrauv cov kev pabcuam kev mob hlwb, thiab lwm yam kev kho zoo ib yam.
- Ntu C yog Medicare kev pab them nqi uas muab los ntawm cov kws pov hwm ntiag tug. Cov uas tsim nyog tau txais Medicare tuaj yeem xaiv rau Ntu C txoj kev npaj thiab them nqi them ntxiv, yog tias lawv xav nthuav cov kev pabcuam thiab cov muab kev pabcuam suav nrog hauv lawv cov phiaj xwm kho mob.
- Ntu D npog cov tshuaj raws li daim ntawv yuav tshuaj.
Kauj Ruam 2. Ua tiav cov ntaub ntawv ntxiv rau kev saib xyuas tshwj xeeb lossis cov chaw muag khoom
Cov Khoom Siv Kho Mob Durable Prosthetics/Orthotics, thiab Cov Khoom Siv (DMEPOS) cov chaw muag khoom thiab Cov Tsev Kho Mob Hauv Tsev thiab Tsev Kho Mob yuav tsum tau muab cov ntaub ntawv ntxiv lossis thov los ntawm cov koom haum sib txawv dua li lwm qhov chaw hauv Medicare. Ua ntej xa koj daim ntawv thov, xyuas kom tseeb tias koj tsis muab ib qho ntawm cov kev pabcuam uas yuav suav nrog hauv ob thaj chaw no.
- Cov neeg muab khoom DMEPOS yuav tsum ua kom tiav cov txheej txheem ntxiv los txiav txim siab ua raws li Kev Kho Kho Kev Kho Mob Hauv Tsev Kho Mob (CLIA) txhawm rau txhawm rau tsim nyog tau txais daim nqi Medicare rau cov khoom lag luam muab.
- Cov kws kho mob hauv Tsev thiab Tsev Kho Mob yuav xav tau ua kom tiav cov ntawv thiab ntaub ntawv ntxiv rau tsheb thiab lwm yam khoom. Cov no yuav raug ntxiv rau daim ntawv thov PECOS, thaum koj txheeb xyuas tias yog Tsev Kho Mob lossis Tsev Kho Mob.
- Ib qho ntxiv, Lub Tsev Saib Xyuas Kev Noj Qab Haus Huv Hauv Tsev thiab Tsev Kho Mob yuav tau txais kev pom zoo los ntawm Medicare los ntawm cov txheej txheem MACs sib txawv dua li cov uas npog lwm qhov ntawm Medicare.
Kauj Ruam 3. Tsim koj li kev tsim nyog tau txais kev khomob hauv Medicare
Medicare lees paub ntau yam ntawm cov kws kho mob thiab cov muab khoom lag luam raws li qhov tsim nyog kom tau raws li kev noj qab haus huv xav tau ntawm nws cov neeg tau txais txiaj ntsig. Medicare vam khom lub xeev cov cai tso cai siv tshuaj los txiav txim kev tsim nyog. Txhawm rau kom tau txais kev pom zoo los ua tus muab kev pabcuam Medicare lossis tus xa khoom, koj yuav tsum ua kom tau raws li cov cai tso cai thiab kev tso cai raug cai los xyaum ua hauv xeev California, koj lub nroog, nroog, thiab lwm lub zos
- Yog tias koj ua haujlwm ib feem ntawm chaw kho mob lossis tsev kho mob, koj lub chaw yuav tsum tau txais kev pom zoo los ntawm Medicare ua ntej koj daim ntawv thov kom txais Medicare ib tus zuj zus.
- Koj yuav tsum tau ntawv tso cai xyaum tshuaj thiab ua tau raws li txhua lub xeev thiab hauv cheeb tsam cov ntawv pov thawj kev kho mob raws li tus kheej thiab koom haum.
Txoj Kev 2 ntawm 3: Thov ua Tus Kws Kho Mob Hauv Tebchaws
Kauj Ruam 1. Sau npe nrog National Plan & Provider Enumeration System (NPPES)
Koj yuav tsum tau tsim tus lej siv uas yuav siv los tau txais koj Tus Neeg Muab Kev Pabcuam Hauv Tebchaws, thiab cov ntaub ntawv qub hauv no yuav raug siv los nkag mus rau Tus Zov Me Nyuam Sau Npe, Chain, thiab Cov Tswv Cuab (PECOS) lub vev xaib uas koj yuav thov rau dhau los ua tus kws kho mob Medicare. Cov txheej txheem yog yooj yim, tab sis thaum koj tau xaiv tus neeg siv ID, nws tsis tuaj yeem hloov pauv. Ua tib zoo ntsuas cov ntaub ntawv ua ntej ua tiav.
Kauj Ruam 2. Tau txais koj Daim Ntawv Qhia Tus Kheej Hauv Tebchaws (NPI)
Thaum koj lub npe siv tau teeb tsa hauv NPPES system, koj yuav tsum tau thov tus lej muab kev pabcuam no. Nyob ntawm hom kev kho mob uas koj muab, koj yuav tsum tau txais tus kheej, koom haum, lossis ob hom NPI ua ntej koj tuaj yeem thov ua tus kws kho mob.
- Hom 1 NPIs xav tau rau cov tib neeg thov kom lees txais Medicare kev pov hwm.
- Hom 2 NPIs yog qhov tsim nyog rau cov koom haum, thiab cov no yuav tsum tau txais ua ntej rau ib tus neeg muab kev pab twg uas tau txais kev pom zoo los ua tswv cuab ntawm lub koom haum.
- Ob hom NPI yog qhov tsim nyog yog tias koj yog tus tswv ntawm ib lub tsev kho mob nkaus xwb.
Kauj Ruam 3. Thov online los ntawm Tus Zov Me Nyuam Sau Npe, Chain, thiab Cov Tswv Cuab (PECOS)
Koj yuav tsum yog tsoomfwv pom zoo muab kev kho mob Medicare thiaj li tau txais kev pom zoo los lees txais Medicare kev them nyiaj hauv xeev California. Cov txheej txheem tau teeb tsa raws li cov lus nug tau piav qhia meej thiab teb daim ntawv thov. Koj kuj tseem tuaj yeem nrhiav cov npe txheeb xyuas rau txhua hom Medicare tus muab kev pabcuam thiab tus muab khoom muab los ntawm Lub Chaw rau Medicare & Medicaid Services (CMS). Yog tias koj muaj lus nug thoob plaws hauv txheej txheem thov, CMS tus sawv cev tuaj yeem hu rau muab kev pab ntawm email lossis xov tooj.
Kauj Ruam 4. Suav tag nrho cov ntaub ntawv tsim nyog
Nco ntsoov tias koj tau suav tag nrho cov ntaub ntawv tsim nyog kom ntseeg tau tias koj daim ntawv thov ua tiav sai. Cov txheej txheem thov Medicare tuaj yeem siv peb lub hlis lossis ntev dua, thiab txhua lub sijhawm koj xav tau xa cov ntaub ntawv ntxiv, lub sijhawm ua haujlwm rov pib dua. Hmoov zoo, PECOS system yuav coj koj hla txhua kauj ruam ntawm cov txheej txheem thiab cov ntaub ntawv thiab cov ntaub ntawv twg xav tau rau txhua tus.
- Sau ntawv lees paub los ntawm Internal Revenue Service uas muab koj tus lej ID ua se thiab lub npe lag luam raug cai. Rau cov tsis muaj txiaj ntsig, yuav tsum muaj tsab ntawv txiav txim los ntawm IRS. Yog tias koj tau tsim Lub Tuam Txhab Tsis Txaus Siab (LLC) koj yuav xav tau tsab ntawv IRS lees paub tias kev lag luam tsis raug txiav txim siab cais los ntawm tus neeg rau lub hom phiaj ua se.
- Txhua qhov ntaub ntawv tsis txaus siab zaum kawg los ntawm cov ntaub ntawv raug cai tawm tsam koj lossis kev coj ua uas koj ua haujlwm rau.
- Suav nrog cov ntaub ntawv hauv tuam txhab nyiaj txiag raws li qhov tsim nyog yog tias koj muaj kev pom zoo nrog lub txhab nyiaj kom them rau cov kev them nqi Medicare uas tseem tshuav.
- Cov ntawv theej ntawm Kev Txhim Kho Kev Kho Mob Hauv Tsev Kho Mob thiab Tsoom Fwv Saib Xyuas Tshuaj Yeeb Tshuaj daim ntawv pov thawj thiab cov ntaub ntawv pom zoo rau txhua qhov chaw, tus muab kev pabcuam, thiab tus muag khoom, suav nrog Tus Thawj Saib Xyuas Tshuaj Tiv Thaiv tus lej thaum tsim nyog.
Kauj Ruam 5. Teb sai rau qhov thov kom muaj ntaub ntawv ntxiv
Yog tias koj ua qee yam tsis raug, koj yuav raug hu los ntawm CMS. Xa cov ntaub ntawv ntxiv kom sai li sai tau kom ntseeg tau tias koj cov txheej txheem thov ua tiav hauv lub sijhawm tsim nyog. Koj yuav tsum tau txais email ncaj qha, yog xav tau cov ntaub ntawv ntxiv, tab sis koj tseem tuaj yeem tshawb xyuas qhov xwm txheej ntawm koj daim ntawv thov online hauv PECOS system.
Kauj Ruam 6. Them tus nqi koom nrog
Ua ntej tawm ntawm PECOS system, koj yuav tsum tau them tus nqi thov. Raws li xyoo 2017, tus nqi yog $ 560, tab sis tus nqi raug kho txhua xyoo. Cov peev nyiaj los ntawm daim ntawv thov siv los ntawm Medicare txhawm rau txhawm rau txhim kho kev txhim kho txuas ntxiv kom ntseeg tau tias muaj kev ncaj ncees ntawm Medicare system rau cov neeg tau txais txiaj ntsig.
Kauj Ruam 7. Ua Cov Ntaub Ntawv Hauv Cov Ntaub Ntawv Sib Txuas (EDI)
Raws li Txoj Cai Tswj Xyuas Kev Ua Yeeb Yam Yooj Yim Yooj Yim (ASCA), Medicare cov lus thov yuav tsum yuav luag txhua zaus xa hauv tshuab hluav taws xob. Qee tus kws kho mob tau txais kev zam, tab sis qhov no tshwm sim tsis tshua muaj tshwm sim. EDI yog cov txheej txheem uas cov kws kho mob hauv Medicare tuaj yeem xa ncaj qha mus thov. Ua ntej tau txais kev pom zoo los ntawm xeev California Medicare Cov Kws Saib Xyuas Kev Noj Qab Haus Huv, koj yuav tsum tau ua tiav cov txheej txheem sau npe nrog EDI.
Txoj Kev 3 ntawm 3: Tau Txais Kev Pom Zoo ua Tus Kws Kho Mob hauv California
Kauj Ruam 1. Ua kom ntseeg tau tias PECOS cov ntaub ntawv raug xa mus rau qhov tsim nyog tau txais kev pab hauv California Medicare Administrative Contractor (MAC)
Txhawm rau ua kom nrawm rau txheej txheem kev tso npe rau Medicare, CMS tau tso cai txiav txim siab ntawm lawv cov kws kho mob hauv ib cheeb tsam tshwj xeeb rau ntau tus neeg tuav pov hwm kho mob ntiag tug. Thaum koj daim ntawv thov Medicare tau pom zoo los ntawm CMS, lawv yuav tsum xa cov ntaub ntawv ncaj qha mus rau koj li MAC. Koj tseem tuaj yeem tshawb xyuas koj qhov kev nce qib ntawm PECOS system. Hauv California, Noridian thiab Kev Pabcuam Hauv Tebchaws yog MACs uas yuav pom zoo rau koj daim ntawv thov.
- Noridian muab kev pom zoo rau cov muab kev pab ntawm Medicare Tshooj A thiab Tshooj B nrog rau DMEPOS cov neeg muab khoom hauv lub xeev California.
- Tsoom Fwv Teb Chaws Cov Kev Pabcuam yog lub koomhaum uas saib xyuas cov ntawv thov no rau Kev Noj Qab Haus Huv Tsev thiab Hospice cov chaw nyob hauv xeev California.
Kauj Ruam 2. Xa cov ntaub ntawv txhawb nqa mus rau California MAC
Koj yuav raug hais kom luam tawm daim ntawv pov thawj pom zoo hauv PECOS daim ntawv thov online, thiab koj yuav tsum tau kos npe thiab xa nqe lus nrog rau daim ntawv theej ntawm koj daim ntawv tso cai kho mob California mus rau qhov tsim nyog MAC. Koj yuav tsum xa cov ntaub ntawv mus rau California MAC tsis pub dhau 7 hnub tom qab ua tiav daim ntawv thov PECOS txhawm rau txiav txim siab pom zoo ua tus kws kho mob.
Kauj Ruam 3. Teb rau cov lus thov rau cov ntaub ntawv ntxiv
Txawm hais tias CMS twb tau xa koj daim ntawv thov kev pom zoo rau kev pom zoo, koj li MAC yuav xav tau cov ntaub ntawv ntxiv lossis cov ntaub ntawv txhawm rau ua kom tiav daim ntawv thov. Raws li yog cov ntaub ntawv thov los ntawm CMS, sai dua koj tuaj yeem teb cov lus thov no, sai npaum li cas koj cov txheej txheem thov yuav txuas ntxiv. Koj yuav raug thov kom xa IRS cov ntaub ntawv, pov thawj ntawm tus kheej, daim ntawv tso cai, lossis lwm yam ntaub ntawv pom tias tsim nyog los ntawm MAC los txiav txim siab koj li kev tsim nyog.
Kauj Ruam 4. Hla qhov chaw mus ntsib raws li xav tau
Yog tias koj tab tom thov ua Medicare tus kws kho mob sawv cev rau lub tsev kho mob, tsev kho mob, kev saib xyuas mus sij hawm ntev lossis lwm qhov chaw kho mob, lossis yog tus tswv ib leeg xwb, yuav tsum mus ntsib tus kws kho mob. Kev mus ntsib ntawm qhov chaw yog ua los ntawm Tus Kws Saib Xyuas Qhov Chaw Hauv Tebchaws. Txhua tus neeg tshuaj xyuas qhov chaw rau Medicare cov kws muab kev pabcuam hauv Asmeskas yuav ua haujlwm los ntawm MSM Kev Pabcuam Ruaj Ntseg, LLC lossis lawv cov chaw pabcuam Khoos phis tawj Pov Thawj Tshwj Xeeb, LLC thiab Kev Ncaj Ncees Kev Noj Qab Haus Huv, LLC.
- Cov kws tshuaj xyuas qhov chaw yuav nthuav qhia tus lej siv tau los ntawm ib ntawm peb lub tuam txhab no thaum lub sijhawm tshuaj xyuas.
- Kev tsis koom tes nrog cov kws tshuaj xyuas qhov chaw tuaj yeem ua rau raug tsis pom zoo lossis raug tshem tawm ntawm Medicare cov chaw muab kev pabcuam.
- Kev mus ntsib qhov chaw tsis tas yuav tsum tau rau DMEPOS tus neeg xa khoom vim tias lawv twb tau ntsib dua qhov tsim nyog CLIA ntxiv lawm.
Kauj Ruam 5. Tos koj MAC xa koj daim ntawv pom zoo
Hauv 45 txog 90 hnub, koj yuav tau txais ntawv pov thawj hluav taws xob los ntawm MAC tsim nyog qhia rau koj paub tias koj daim ntawv thov raug lees txais lossis tsis lees txais. Yog tias koj tau txais kev pom zoo ua tus muab kev pab cuam Medicare, koj yuav tau txais Tus Zov Me Nyuam Tus Kheej Tus Naj Npawb Naj Npawb (PTAN). Koj tus kheej PTAN yuav cuam tshuam nrog koj tus lej NPI, thiab tso cai rau koj nkag mus rau cov ntaub ntawv rau npe nkag thiab lwm yam pov thawj koj tus kheej hauv Medicare system.
Kauj Ruam 6. Sau npe hauv Electronic Fund Transfer (EFT) rau Medicare
Ntxiv rau qhov xav tau cov ntaub ntawv thov xa hauv tshuab hluav taws xob, ASCA tseem them tawm Medicare cov ntawv thov hauv tshuab hluav taws xob. Thaum koj tau txais kev pom zoo los ua Tus Kws Kho Mob los ntawm koj li MAC, ua kom tiav daim ntawv EFT suav nrog hauv lawv pob ntawv. Yog tias koj tsis tau txais daim ntawv EFT, hu rau koj MAC tam sim ntawd.
