Ukuvakashela egumbini lezimo eziphuthumayo kungabiza kakhulu ngisho noma unomshwalensi. Ngaphandle komshwalensi, izindleko zingaba nzima kakhulu ukuzibikezela ngoba ibhili yokugcina incike esibhedlela, izinsizakalo ozitholayo, nokuthi udinga izivivinyo, ukuthwebula izithombe, izinqubo, noma ukunakekelwa kwezingcweti.
Ukuvakashela okuyisisekelo kwe-ER ngaphandle komshwalensi kungabiza cishe u-$1,000 kuya ku-$3,000 noma ngaphezulu. Ukunakekelwa okuyinkimbinkimbi kungafinyelela ngokushesha u-$5,000 kuya ku-$10,000 noma ngaphezulu.
Lokho akusho ukuthi kufanele ugweme i-ER lapho udinga ukunakekelwa okuphuthumayo. Uma izimpawu zakho zingaba yingozi empilweni, ukuthola ukwelashwa ngokushesha kubaluleke kakhulu kunebhili. Kodwa uma ubhekene nesimo esingesona esiphuthumayo futhi unquma phakathi kwe-ER, ukunakekelwa okungaphuthumayo, kanye ne-telehealth, ukuqonda umehluko wezindleko kungakusiza ukhethe indawo efanele.
TL;DR: Okubalulekile Okubalulekile
- Izindleko zokuvakashela i-ER ngaphandle komshwalensi ngokuvamile ziqala kusuka cishe ku-$1,000 kuya ku-$3,000 noma ngaphezulu kokuvakashela okuyisisekelo.
- Ukunakekelwa okuphuthumayo okuyinkimbinkimbi okubandakanya ukuthwebula izithombe, izinqubo, noma ukulaliswa esibhedlela kungabiza u-$5,000 kuya ku-$10,000 noma kakhulu kakhulu.
- Ukunakekelwa okungaphuthumayo ngaphandle komshwalensi ngokuvamile kubiza cishe u-$150 kuya ku-$280 ngokuvakashela okuyisisekelo, ngaphambi kwezivivinyo noma izinqubo ezengeziwe.
- Ama-ER azimele angase afane namaklinikhi okunakekelwa okungaphuthumayo kodwa ngokuvamile akhokhisa ngamanani egumbi lezimo eziphuthumayo.
- Umthetho kahulumeni we-No Surprises Act uvikela iziguli ezinkokhelweni eziningi ezingalindelekile zangaphandle kwenethiwekhi ezimeni eziphuthumayo nezinye izimo.
- I-Telehealth ngokuvamile iyinketho eshibhile yezimo ezingesona eziphuthumayo ezifanele, ngohambo lokukhokha ngemali oluvame ukubiza cishe u-$39 kuya ku-$100.
- Uma uthola ibhili ye-ER ongakwazi ukuyikhokhela, ungacela ibhili enemininingwane, izaphulelo zokukhokha wedwa, usizo lwezezimali, ukuxoxisana, nezinhlelo zokukhokha.
- Uma ubhekene nesimo esiphuthumayo sezokwelapha, ungabambisi ukwelashwa ngenxa yezindleko. Shayela ku-911 noma uye ku-ER eseduze.
Awulazi ukuthi izimpawu zakho zidinga i-ER, ukunakekelwa okungaphuthumayo, noma i-telehealth? Zama ukuhlola izimpawu kwamahhala kwe-August AI ukusiza ucabange ngohlobo luni lokunakekelwa olungaba lufanele. Uma unezimpawu ezinzima noma ucabanga ukuthi ubhekene nesimo esiphuthumayo sezokwelapha, ungasebenzisi ukuhlolwa ku-inthanethi.
Shayela ku-911 noma uye ku-ER eseduze ngokushesha. Ukuhlolwa kwe-AI akuyona ukuxilongwa. Ngokunakekelwa okungesona esiphuthumayo okungaphathwa kude, udokotela ogunyaziwe wase-US angabuyekeza izimpawu zakho futhi anikeze ukwelashwa lapho kufanele.
Yimalini ukuvakashela i-ER ngaphandle komshwalensi?
Akukho intengo eyodwa ejwayelekile yokuvakashela igumbi lezimo eziphuthumayo. Izindleko ziyahlukahluka ngesibhedlela, indawo, nohlobo lokunakekelwa oludingayo.
Ngokuvakashela okuyisisekelo kwe-ER ngaphandle komshwalensi, ungase ukhokhe cishe u-$1,000 kuya ku-$3,000. Uma usungeza ukuthwebula izithombe, ukuhlolwa kwelabhorethri, izinqubo, ukubonisana nezingcweti, noma ukulaliswa esibhedlela, isamba singafinyelela ku-$5,000 kuya ku-$10,000 noma ngaphezulu.
Ibhili yakho ingase ifake izinkokhelo eziningana ezihlukene, kufaka phakathi:
- Imali yokusetshenziswa kwesikhungo sokusebenzisa umnyango wezimo eziphuthumayo
- Imali kadokotela noma yesisebenzi sezokwelapha
- Izivivinyo zokuhlolwa kwelabhorethri
- Ama-X-ray, ama-CT scan, noma okunye ukuthwebula izithombe
- Imithi enikezwe ngesikhathi sokuvakashela
- Izinqubo
- Izimali zezingcweti
Ungathola izikweletu ezihlukene kusuka esibhedlela kanye nabasebenzi bezokwelapha ababandakanyeka ekunakekelweni kwakho. Ngokwesibonelo, umuntu ophethe ukuthwebula izithombe angase akhokhise ngokuhlukene kusuka egumbini lezimo eziphuthumayo.
Uma ungenamshwalensi, buza ukuthi ngabe isibhedlela sinikeza isaphulelo sokukhokha wedwa noma ukukhokha ngemali. Inani lokuqala ebhilini akusho ukuthi yilona mali yokugcina okufanele uyikhokhe.
Kubiza malini ukunakekelwa okungaphuthumayo ngaphandle komshwalensi?
Uma isimo sakho singesona esiphuthumayo kodwa udinga ukunakekelwa kwezokwelapha ngalolo suku, ukunakekelwa okungaphuthumayo ngokuvamile kubiza kakhulu kuno-ER.
Izindleko zokunakekelwa okungaphuthumayo ngaphandle komshwalensi ngokuvamile ziqala cishe ku-$150 kuya ku-$280 ngokuvakashela okuyisisekelo. Izinsizakalo ezengeziwe zingandisa isamba.
Ngokwesibonelo, ungase ukhokhe okwengeziwe:
- Ukuhlolwa kwelabhorethri
- Ama-X-ray
- Ukulungiswa kwenxeba
- Ukubopha
- Ezinye izinqubo
- Imithi
Ngakho-ke, ukuvakashela okuyisisekelo kokunakekelwa okungaphuthumayo kwisifo esincane noma ukulimala kungabiza amakhulu noma izinkulungwane zamadola ngaphansi kokuphothula i-ER.
Uma uzama ukukhetha phakathi kokubili, umhlahlandlela wethu ku-Ukunakekelwa Okungaphuthumayo noma i-ER: Unganquma Ngemizuzwana Engu-60 kungakusiza uqonde ukuthi iyiphi inketho engaba efanele kuwe.
I-ER ezimele ngokumelene nokunakekelwa okungaphuthumayo: yini umehluko?
Enye yezindlela ezilula zokuthola ibhili enkulu yezokwelapha ukudideka i-ER ezimele njengekliniki yokunakekelwa okungaphuthumayo.
Amagumbi ezimo eziphuthumayo azimele angase afane nezikhungo zokunakekelwa okungaphuthumayo. Angase atholakale ezikhungweni zezitolo noma ezakhiweni ezizimele futhi angase anikeze ukunakekelwa okungena ngaphandle kwesikhathi esiningi.
Umehluko obalulekile ukuthi i-ER ezimele iseyingumnyango wezimo eziphuthumayo. Ingakhokhisa ngamanani e-ER, angaba izikhathi eziningi kunezinga lawo ongawukhokha ekunakekelweni okungaphuthumayo.
Ngaphambi kokungena esikhungweni, hlola ukuthi ngabe sihlukaniswe njengegumbi lezimo eziphuthumayo noma isikhungo sokunakekelwa okungaphuthumayo. Uma ungazi, buza ukuthi hlobo luni lwesikhungo futhi ngabe linawo yini imali yesikhungo ehlukile.
Lo mehluko ubaluleke kakhulu lapho ubhekene nesimo esingesona esiphuthumayo futhi uqhathanisa izindleko.
Yimaphi amavikelo akhona ngokumelene nezikweletu zezokwelapha ezingalindelekile?
Umthetho kahulumeni we-No Surprises Act, oqala ukusebenza ngo-2022, unikeza ukuvikelwa ezinkokhelweni eziningi ezingalindelekile zezokwelapha zangaphandle kwenethiwekhi.
Ngokwesibonelo, izinsizakalo ezithile eziphuthumayo ezinikezwe izibhedlela noma odokotela abangaphandle kwenethiwekhi ngokuvamile azikwazi ukuholela ekukhokhiseni okungaphezu kokwabelana ngezindleko ezisebenza ngaphakathi kwenethiwekhi. Umthetho uphinde unikeze ukuvikelwa ezimweni ezithile ezingesona eziphuthumayo ezikhungweni ezingaphakathi kwenethiwekhi kanye nezinsizakalo ezithile zendiza ezinekhabethe.
Uma ungenamshwalensi noma ukhokha ngemali ngokunakekelwa okuhleliwe, i-CMS ihlinzeka ngolwazi mayelana neziQinisekiso Ezinhle Zokulungela Ukukhokha. Isiqinisekiso Esihle Sokulungela Ukukhokha sikunika intengo elindelekile ngaphambi kwezinsizakalo ezithile ezihleliwe.
Uma ibhili yakho yokugcina ingaphezu kwezigidi $400 kunokulinganiselwa, ungase ube nelungelo lokudicilela izinqikithi ngenqubo kahulumeni.
La mavikelo akuhlanganisi njalo ibhili yezokwelapha. Ngokwesibonelo, izinsizakalo zamaloli omhlaba ngokuvamile azihlanganiswa yi-No Surprises Act kahulumeni, noma ngabe imithetho yezifunda ingase inikeze ukuvikelwa okwengeziwe.
Yenzani uma ungakwazi ukukhokhela ibhili ye-ER?
Ukuthola ibhili ye-ER eyizinkulungwane zamadola kungaba ngumthwalo onzima, ikakhulukazi uma ungumshwalensi. Ngaphambi kokucabanga ukuthi kufanele ukhokhe yonke inani, buza esibhedlela mayelana nezinketho zakho.
Cela ibhili enemininingwane
Cela ukuhlukana okuningiliziwe, komugqa ngomugqa kwezinkokhelo. Buyekeza kuwo izinsizakalo eziphindaphindwe kabili, izinkokhelo ezingalungile, noma izinsizakalo ongaziboni.
Buza ngesaphulelo sokukhokha wedwa
Izibhedlela zingase zinikeze izaphulelo ezishwanteliswa ezigulini ezingenawo umshwalensi. Buza ngokuqondile ukuthi ngabe intengo yokukhokha wedwa noma yokukhokha ngemali iyatholakala.
Faka isicelo sosizo lwezezimali
Izibhedlela ezingenzi inzuzo eziningi zinezinhlelo zosizo lwezezimali noma zosizo lomusa ezizizukulwaneni ezifanelekile. Thinta umnyango wezibhedlela wokukhokhiswa kwezimali futhi ubuze ukuthi ungazifaka kanjani isicelo.
Xoxisana ngebhalansi
Ngokuya ngesibhedlela nezimo zakho, ungakwazi ukuxoxisana ngenani olikweletayo. Abanye abahlinzeki banikeza inani eliphansi uma ukwazi ukukhokha imali eyodwa.
Buza ngohlelo lokukhokha
Uma ungakwazi ukukhokha ibhili ngesikhathi esisodwa, buza ukuthi ngabe isibhedlela sinikeza uhlelo lokukhokha. Ukusabalala izinkokhelo ngokuhamba kwesikhathi kungenza ibhalansi enkulu ibe lula ukuphatha.
Sicela ummeli wesiguli
Abameli beziguli kanye nezinhlangano ezingenzi inzuzo bangakusiza uqonde, uphikise, noma uxoxisane ngezikweletu zezokwelapha.
Ungazishayeli indiva nje ibhili. Uma unenkinga yokukhokha, thinta umnyango wokukhokhiswa kwezimali futhi ubuze ngezinketho ezitholakalayo.
Nini i-telehealth noma ukunakekelwa okungaphuthumayo kungakonga imali yakho?
Akuwona wonke umjikelezo wezokwelapha ofuna i-ER.
Kwezimo ezingesona eziphuthumayo ezifanele, i-telehealth noma ukunakekelwa okungaphuthumayo kungabiza kakhulu.
Izimo ezingase ngezinye izikhathi zihlolwe ngaphandle kwe-ER zihlanganisa:
- Izimpawu zokubanda nokugula
- Izifo ezincane
- Ama-UTI angaxakile
- Iso elibomvu
- Ezinye izinsipho
- Imibuzo mayelana nemithi noma ukushintshwa kwayo
- Ukulimala okuncane okungadingi ukuthwebula izithombe eziphuthumayo
- Ezinye izindaba ezingesona eziphuthumayo
Ama-telehealth ahlinzekwa ngemali ngokuvamile abiza cishe u-$39 kuya ku-$100, kanti ukuvakashela okungaphuthumayo okungenawo umshwalensi kungabiza cishe u-$150 kuya ku-$280 ngaphambi kwezinsizakalo ezengeziwe.
Ngokuqhathanisa okuseduze kwezinketho, bona i-ukwelashwa okungaphuthumayo ngokumelene ne-telehealth: izindleko, isivinini, nokuthi yini ngayinye elapha.
Inketho eshibhe kakhulu ayisiye ngokuzenzakalelayo leyo efanele, kodwa-ke. Izimpawu zakho kufanele zinqume izinga lokunakekelwa oludingayo.
Nini ungakhonzi ukuzama ukonga imali ngokugwema i-ER?
Izindleko akufanele neze zibe yisici esinqumayo lapho ubhekene nesimo esingesona esiphuthumayo sezokwelapha.
Shayela ku-911 noma uye ku-ER ngezimpawu ezifana nalezi:
- Ubuhlungu esifubeni noma ukucindezela
- Ukuhluleka okukhulu ukuphefumula
- Izimpawu zokushaywa unhlanga, okuhlanganisa ukuwa kobuso, ubuthakathaka bezingalo, noma ubunzima bokukhuluma
- Ukopha okunzima noma okungalawulwa
- Ukulahlekelwa yisidina okungazelelwe noma ukudideka okukhulu
- Ukujulukwa
- Ukuphendula okukhulu komzimba okubucayi
- Ukulimala okukhulu kwenhloko
- Izimpawu ezibukeka zibi ngokushesha noma ezizwa njengeyingozi ngaso leso sikhathi
Ukuthola ukwelashwa okuphuthumayo ngokushesha kungavimbela ukulimala okungapheli. Izinkinga zezimali zingaxazululwa kamuva ngokusebenzisa usizo lwezimali lwesibhedlela, izinhlelo zokukhokha, ukuvikelwa komshwalensi, nezinye izinsiza.
Imibuzo Evame Ukubuzwa
Kungani i-ER ibiza kakhulu?
Iziyalo zezimo eziphuthumayo kumele zilungiselelwe ukwelapha izimo ezimbi kakhulu nganoma yisiphi isikhathi, okudinga abasebenzi abanekhono, imishini, nezingqalasizinda.
Izikweletu ze-ER zingase futhi zifake izindleko ezingaphezulu zesikhungo, udokotela, ingcweti, ilabhorethri, ukuthwebula izithombe, imithi, nezinkokhelo zezinqubo.
Ngokuvakashela okungesona esiphuthumayo, ukunakekelwa okungaphuthumayo noma i-telehealth kungabiza kakhulu ngoba lezi zindawo azinawo amandla afanayo okubhekana nezinjongo eziphuthumayo.
Ngingakwenqenqwa yini i-ER uma ngingenamshwalensi?
Ngokuvamile, cha.
Ngaphansi komthetho kahulumeni we-Emergency Medical Treatment and Labor Act (EMTALA), izibhedlela ezihlanganyela ne-Medicare ezineminyango yezimo eziphuthumayo kumele zinikeze ukuhlolwa kwezokwelapha nokwelashwa okuqinisekisa kubantu abafika nesimo esiphuthumayo, kungakhathaliseki isimo sabo somshwalensi noma amandla abo okukhokha.
Lokho akusho ukuthi ukunakekelwa okuphuthumayo kumahhala. Ungase usathola ibhili ngemuva kokwelashwa.
Yini imali yokusetshenziswa kwezikhungo ye-ER?
Imali yokusetshenziswa kwezikhungo iyinkokhelo yokusebenzisa izikhungo nemithombo yesibhedlela noma yomnyango wezimo eziphuthumayo. Inehlukile enkokhelweni ekhokhiswa ngudokotela okwelapha wena.
Izinkokhelo zezikhungo zingaba zimbi kakhulu futhi ziyisizathu esisodwa ibhili ye-ER ingaba ngaphezu kwalokho obekulindelekile, noma ngisho ungatholanga ukwelashwa okuningi.
Ngabe ukunakekelwa okungaphuthumayo kunikeza izinhlelo zokukhokha?
Kuya ngekliniki.
Amanye amaklinikhi okunakekelwa okungaphuthumayo anikeza izinhlelo zokukhokha, izaphulelo zokukhokha wedwa, noma ezinye izinketho zokukhokha, kanti amanye angase adinge ukukhokhelwa ngesikhathi sesevisi.
Uma ungenamshwalensi noma ukhokha ngemali, buza ngamanani eklinikhi nezinketho zokukhokha ngaphambi kokuthola ukunakekelwa lapho kungenzeka.
Yenzani uma ngithola ibhili yezokwelapha engaqondakali?
Qala ngokubuyekeza ibhili ngokucophelela.
Cela isitatimende esinemininingwane bese uqinisekisa ukuthi izinsizakalo ezibalwe zihambisana nokunakekelwa owatholayo. Uma ukholelwa ukuthi inkokhelo yokuphuthuma kwangaphandle kwenethiwekhi iphula i-No Surprises Act, ungaxhumana ne-Centers for Medicare & Medicaid Services noma isiphathimandla sakho sombuso.
Uma ibhili ilungile kodwa ingakhokheki, buza umhlinzeki ngosizo lwezezimali, izaphulelo zokukhokha wedwa, ukuxoxisana, nezinhlelo zokukhokha.
Isiphetho
Izindleko zokuvakashela i-ER ngaphandle komshwalensi zingaba zimbi, ngokuvakashela okuyisisekelo kwesibhedlela ngokuvamile kubiza u-$1,000 kuya ku-$3,000 noma ngaphezulu. Ukunakekelwa okuyinkimbinkimbi kungakhuphula isamba sibe ngaphezu kuka-$5,000.
Kwezimo ezingesona eziphuthumayo, ukunakekelwa okungaphuthumayo kanye ne-telehealth kungabiza kakhulu. Kodwa izindleko akufanele zinqume ukuthi ngabe udinga yini ukwelashwa okuphuthumayo lapho izimpawu zakho zingaba yingozi empilweni.
Uma uthola ibhili enkulu ye-ER, ungacabangi ukuthi kufanele ukhokhe inani eligcwele ngaso leso sikhathi. Buyekeza izinkokhelo ezinemininingwane, buza ngezaphulelo zokukhokha wedwa kanye nosizo lwezezimali, futhi uthole ukuthi ngabe uhlelo lokukhokha noma ukuxoxisana ngebhili kuyatholakala.
Futhi uma ubhekene nesimo esiphuthumayo sezokwelapha, ungabambisi ukwelashwa ngenxa yokwesaba izindleko. Shayela ku-911 noma uye ku-ER eseduze. Izinketho zakho zezimali zingaxazululwa ngemuva kokuthola ukunakekelwa okudingayo.
