Me pēhea te Whiriwhiringi i te Pire Hōhipera: 6 Ātaahi hei Whakaheke 50%

Ko te whiriwhiringi i ngā utu pire hōhipera he pūkenga ka iti noa ngā Amerikana e ako ana. He pūrongo 2024 nā KFF e whakaatu ana, kotahi i te 12 pakeke te nui ake i te $1,000 te nama hauora, ā, $220 piriona ngā pire hauora kāore i utua kei runga i ngā pūrongo nama a ngā kaihoko. Ā, tata katoa o ēnei pire ka taea te whiriwhiri.

E whakamārama ana tēnei tuhinga i ngā mahi e whai hua ana ka whiwhi koe i tētahi pire hōhipera nui ake i tō e tatari ana, tae atu ki te kimi hapa i roto i tō pire, ngā mea hei pātai i ia ātaahi, me ngā mea hei kōrero. Ko ngā tohutohu kei roto i tēnei aratohu nā CFPB, CMS, me ngā rangahau kua arotakehia e ngā hoa, ehara i te pāpāho pāpori. Āwhina ēnei mahi i te nuinga o ngā tāngata ki te whakaheke i ā rātou pire kia 20% ki te 50%.

He aha ngā pire hōhipera e taea te whiriwhiri

Kāore ngā utu hōhipera e mārō. Ka rerekē i runga i te kaha o te inihua hauora a te tūroro, ngā kaupapa here a te hōhipera, me te nui o te utu a te tūroro ki waho o te pute. I tētahi rangahau tata nei mō ngā utu moni i te neke atu i te 2,000 hōhipera i whakaputaina ki JAMA Health Forum i te tau 2023 i kitea ai ngā utu mō tētahi ratonga kua tautuhia, neke atu i te 10x te teitei i roto i tētahi rohe waehere poutāpeta kotahi.

E mōhio ana hoki ngā hōhipera ka nui ake ā rātou moni ki te tuku whakahekenga, ā, ka utua wawe ngā pire. Nō reira ko te nuinga o ngā hōhipera o Amerika ka tuku kaupapa awhina ā-pūtea, whakahekenga mō te utu wawe, me ngā mahere utu (ahakoa ehara i te mea ka pānuitia tonu).

Ā, kei reira ngā hapa o te utu. I kitea e tētahi rangahau nā te Medical Billing Advocates of America, 80% o ngā pire hōhipera katoa kei reira ngā hapa, tae atu ki ngā utu takatika me ngā waehere tikanga hē.

Me pēhea te whiriwhiringi i tētahi pire hōhipera i roto i ngā ātaahi e 6

Ko te whiriwhiringi i tētahi pire hōhipera ka tino pai ka takatika te tukanga. Ko ngā ātaahi e ono kei raro nei e kapi ana i ngā mea hei pātai, me tō rātou raupapa. Ko te nuinga o ngā whiriwhiringi ka 2 ki te 4 wiki mai te timatanga ki te mutunga.

Tīmata mā te waea atu ki te tari utu. Pātai atu me te ngāwari, tuhia ngā tuhinga (rā, ingoa o te mangai, tāna i kōrero), ā, whai mai i ngā mea katoa mā te tuhituhi.

Ka taea e tētahi taputapu kore utu pēnei i te August AI Bill Analyser te āwhina i a koe ki te tuku i tō pire hōhipera taipitopito me te tirotiro i ngā utu takatika, ngā tikanga hē te waehere, me ngā tūemi i runga ake i te utu paerewa a Medicare, e hoatu ana ki a koe ngā tūemi motuhake hei whakahē i te waea.

Me pēhea te whiriwhiringi i ngā pire hauora: ngā tohutohu whiriwhiringi pire hōhipera

Ko te angitu o te whiriwhiringi i ngā pire hauora ka puta mai i te whakarite. Ko ngā tohutohu whiriwhiringi pire hōhipera kei raro nei nā ngā aratohu a te kaihoko a CFPB me ngā rangahau a te hunga kaitautoko tūroro.

• Tono tonu he pire taipitopito i te tuatahi. Ko ngā ture a te kāwanatanga i raro i te No Surprises Act e whakahau ana kia tukuna e ngā hōhipera tētahi i roto i te wā tika

• Whakatairitehia āu waehere ki ngā paerewa utu a Medicare i CMS.gov's Procedure Price Lookup

• Tono tautoko ā-pūtea mā te tuhituhi. Me tuku tautoko ā-pūtea e ngā hōhipera kore-hua i raro i te Wāhanga 501(r) a IRS

• Whakamahia te rerenga kupu "Kei te hiahia au ki te whakaoti i tēnei kaute i tēnei rā" ka tono ana he whakahekenga mō te moni

• Kaua rawa e hoatu ngā mōhiohio o te kāri nama kia oti ra ano ngā tikanga kua whakamanatia mā te tuhituhi

• Tāwhai noa i muri i te otinga o ngā ratonga engari i mua i te tukunga o te pire ki ngā kohinga (ka rite ki te 90 ki te 120 ra mai i te tukunga pire)

Ki te nui rawa tō pire hōhipera i muri i te inihua, kāore rānei koe e whai inihua, whakahuahia tika. E kii ana te CFPB, he ngāwari ake ngā hōhipera ki ngā tūroro utu-whaiaro nā te mea ka iti ake ta rātou kohinga mai i ngā pire utu-katoa.

Tauira whiriwhiringi pire hauora: tā te tangata hei kōrero

Ka whai hua noa te tauira whiriwhiringi pire hauora mehemea ka mōhio koe ki ngā utu hei whakahē. He iti noa ngā tūroro e mōhio ana, ā, kāore te tari utu hōhipera e kōrero atu ki a koe ngā mea kē. Ko te wāhanga uaua rawa o te whiriwhiringi ehara i te waea tonu. Ko te mōhio ki ngā raru o te pire me te whiriwhiri i te tautohetohe.

Koia te wāhi ka āwhina ai te August AI Bill Analyser. Ka whakapirihia e koe te pire hōhipera taipitopito me te rorohiko ka āta tirotiro i ia raina mō ngā takatika, ngā tikanga hē te waehere, ngā tūemi i utua i runga ake i te reiti Medicare, me ngā tūemi ka hipokina e ngā kaupapa āwhina ā-pūtea a te hōhipera. Ka hangaia e ia tētahi reta ki te hōhipera e whakaatu ana i ngā raruraru kua kitea, me ngā waehere CPT me ngā reiti Medicare tika, kia taea ai e koe te tuku pera tonu, te whakarerekē rānei. Ka torutoru meneti te katoa o te tukanga, ā, ka whakakapi i te raruraru pepa pango ki tētahi mea pono ka taea e koe te mahi.

Ka oti te tātaritanga me te tauira reta, ka taea e koe te:

• Tukuna te reta mō ngā tautohetohe taipitopito (ngā utu takatika, ngā waehere hē, ngā ratonga kāore i whiwhi)

• Whakamahia hei rārangi tinihanga waea me ngā tūemi raina motuhake me ngā paerewa Medicare kua reri hei tohutoro

• Tāpirihia ki tētahi tono tautoko ā-pūtea hei tautoko i tō take mō te atawhai atawhai, he whakahekenga rānei

E ai ki tētahi tātāritanga a Health Affairs, ko te hunga e whiriwhiringi ana me ngā taunakitanga motuhake me tētahi puka tuhituhi ka whiwhi whakahekenga i te 60% o te wā, ka whakaritea ki te reiti angitu iti ake mō ngā waea e whakahē ana i tētahi pire kāore he taipitopito.

Ka taea e koe te whiriwhiri pire hauora kua tukuna ki ngā kohinga?

Āe, ka taea e koe te whiriwhiri pire hauora kua tukuna ki ngā kohinga, i etahi wā ka kaha ake i mua. Ka hokona te nama ki tētahi tari kohinga, ka rite ki te 5 ki te 10 pene i te taara te utu, ko te tikanga kei a rātou te wāhi nui ki te whakaoti.

Hei whakaheke i ngā pire hauora kua tukuna ki ngā kohinga:

• Tono kia tētahi sSkkōrero "utu-mō-te-muku" (mā te tuhituhi) ka mukua e te tari te kaute i tō pūrongo nama i te wā kua utua

• Tukuna tētahi whakaritenga nama kotahi o te 25% ki te 50% o te nui taketake

• Kaua rawa e tautuhi anō i te wā tattū o te nama mā te utu iti me te kore he whakaritenga tuhituhi

• Tautohetohe te nama ki ngā tari nama mena ka whakapono koe he hē te pire (he tika kore utu tēnei i raro i te FCRA)

Kia mōhio ko raro i ngā ture hou a te CFPB, ko ngā nama hauora i raro i te $500 kāore e taea te puta ki ngā pūrongo nama a ngā kaihoko, ā, ko te nuinga o ngā nama hauora he wā whakaputa poto ake i ētahi atu nama.

Ngā Pātai Auau

Ka taea e koe te whiriwhiri pire hauora ki te whai koe i te inihua?

Āe. Ka rite te whai hua o te whiriwhiringi me te kore te inihua. Arotahi ki te wahanga kawenga a te tūroro (ngā tangohanga, ngā moni tiritiri, ngā utu kāore i roto i te whatunga) kaua ki te wahanga i utua e te inihua. Ko ngā wikitoria noa ko te whakaheke i ngā utu kāore i tataria, te whakakore i ngā tūemi takatika, me te whakawhiti i ngā pire toenga ki ngā reiti i roto i te whatunga i raro i te No Surprises Act.

E hia te nui ka taea te whakaora i tētahi pire hōhipera?

Ko te nuinga o ngā whiriwhiringi angitu ka whakaheke i te pire kia 20% ki te 50%, e ai ki ngā rangahau a Health Affairs. Ko ngā whakaritenga moni ka taea te whakaheke i ngā pire kia 60% te nui ake rānei. Ko ngā pire kua tukuna ki ngā kohinga ka rite te whakaoti ki te 25% ki te 50% o te nui taketake. Ko ngā whakaora nui rawa ka puta ka whakakotahi koe i te whakapai hapa, te tautoko ā-pūtea, me tētahi whakahekenga utu wawe.

Mehemea ka whakakahore te hōhipera ki te whiriwhiri?

Tono kia piki ake. Tono kia tētahi kaitohutohu pūtea, kaitautoko tūroro rānei, ehara i te kaituku pire anake. Ki te whakakahore tonu te hōhipera, tuku amuamu ki te tari tiaki kaihoko a tō heamana o te kawanatanga, me te CFPB. Ka mate te mana ā-taake o ngā hōhipera kore-hua ki te kore e whai i ngā ture tautoko ā-pūtea a te Wāhanga 501(r) a IRS.