Ma'aikatar Kula da Lafiya na Coventry

Mahimmanci ga Ƙwararrun Masiha

Coventry Health Care, Inc. yana aiki da dama da tsare-tsaren kiwon lafiya, kamfanonin inshora, da kamfanoni na ma'aikata a dukkanin jihohi 50. Ma'aikata na likita zasu iya buƙatar sallamawa ga wannan kamfani. Suna samar da tashar yanar gizo masu dacewa don yin mafi yawan waɗannan ayyuka.

Akwai shirye-shiryen kiwon lafiya daban-daban da suka fada a karkashin yarjejeniyar Coventry, wanda ya fito ne daga Shirin Lafiya na Rundunar Jama'a ga Ƙungiyar Ma'aikata ta Amirka. Daga izinin izini, don yin amfani da amfanin, don gyara da'awar da kuma dawowa, menene ya kamata ka san game da Coventry kuma ta yaya zaka iya gano ainihin bayanin da kake bukata? Bari mu fara da magana game da abin da aka hada da tsare-tsaren, yadda za a sami cikakken bayani, da kuma inda za ka iya tsara takamaiman tambayoyi don samun amsoshin da kake bukata.

Idan kana neman bayanan janar don gudanar da tsarin inshora na likitanci, kasancewa ta hanyar duba bayanan kula da asibiti na kiwon lafiya .

1 -

Shirye-shiryen da aka kunshe a ƙarƙashin kula da lafiya na Coventry

Kamar yadda kamfanin kamfanonin inshora na yanzu ke da, Kamfanin Coventry Health Care ne babban kamfani wanda ya hada da ƙananan tsarin. Wasu (amma ba duka) daga cikinsu sun haɗa da:

• Cibiyar Kula da Kiwon Lafiya na Coventry
• Sabuwar Harkokin Kiwon Lafiya
• Ma'aikata Masu Amfani da Aikace-aikacen Saƙonni
• Altius
• Carelink
• Maganin lafiyar Coventry na Delaware, Florida, Georgia, Iowa, Kansas, Louisiana, Nebraska, Nevada
• Coventry Lafiya da Life na Oklahoma, Tennessee
• Coventry Missouri
• Shirin Lafiya na Rukuni
• HealthAmerica / HealthAssurance
• PersonalCare
• Kasuwancin Kiwon Lafiya
• Jami'ar Missouri
• WellPath
• Ƙungiyar Amfani da Ƙungiyar
• Shirin Amfani da Ƙasashen waje na Ƙasashen waje
• Yankin Gudanar da Ƙauyuka Masu Goma
• Binciken Kasashen waje, Inc
• Ƙungiyar Ma'aikata ta Amirka (APWU)
• Na farko Health Life & Lafiya Ins. Co.

2 -

Janar Bayani game da kula da lafiyar Coventry

Hanya mafi kyau don gano cikakken bayani game da lissafin kuɗin kiwon lafiya tare da Coventry, koma zuwa Grid Gidan da ke cikin Sashe na 6 na jagoran mai bada sabis.

Don Sha'idodin Kasuwanci don Allah a bincika Lambar Wayar Kasuwancin da aka lissafa a kowane katin ID na memba. Wannan Sashen za ta iya taimaka maka tare da batutuwan da aka lissafa a ƙasa da kuma sauran damuwa da yawa.

• Tambayoyin Shaƙaɗɗa
• Biyan ku] i
• Tsarawa mai yawa
• Tambayoyi na Adalci
• Adireshin EOB da RAs
• Bayanin izini
• Bincike da Sake Gida
• Amfanin Amfani da Abubuwan Memba
• Kira na Biyan kuɗi na farko
• New Provider Inquiries
• Provider Manual Requests
• Ƙungiyar Yan Ta'idar Ba ta Kira ba
• NPI Tambayoyi

Don tambayoyin Abokin ciniki na Kasuwancin Coventry suna kiran lambar wayar da ke bayan bayanan katin ID na memba.

3 -

Yanayi, Amfani da Yanayi Magana

Idan kana mamaki idan an rufe wani tsari ko mai bada sabis (cancanta), adadin ɗaukar hoto (amfanin), ko kuma sha'awar koyo cewa matsayin da'awar (halin da'awar), akwai hanyoyi uku don samun wannan bayani.

1. Tuntuɓi lambar wayar da aka jera a katin katin ID na memba.
2. Ta hanyar hanyar kula da lafiyar Coventry ta hanyar samar da layi na yanar gizo a www.directprovider.com.
3. Ta hanyar Ofishin Emdeon.

4 -

Ba da izni ba

Ayyukan da ake buƙatar samun izini sun hada da kula da asibitoci ko kulawa da ido, aikin tiyata wanda ya fi dacewa (ko da kuwa irin saitin), haɗin ƙidayar rediyo (kamar CT, MRI, IMRT, Done / Density, Whole Body or PET Scans), DME / Prosthetics / Orthotics, Gidan Kulawa, Gudanar da Ra'ayin Gwiwwalwa, Saukewa (Cardiac / Pulmonary / PT / OT / Speech), Nazarin barci, da kuma ayyuka da suka danganci rashin amfani ko Transplants.

Yadda za a Sauko da Neman Tambaya

Ana buƙatar buƙatun ba da izinin shiga ta hanyar kula da lafiyar Coventry ta hanyar samar da intanet a www.directprovider.com.

Don takamaiman tambayoyi, tuntuɓi lambar ba da izinin da aka jera a katin ID na memba.

5 -

Bayanin Biyan Kuɗi

Akwai hanyoyi guda uku wadanda za a iya sanya takardar kudi:

1. Ana iya ƙaddamar da ƙirar lantarki ta hanyar hanyar kula da yanar gizo mai kula da lafiyar Coventry a www.directprovider.com.
2. Za'a iya ƙaddamar da ikirarin lantarki ta hanyar tsararren Emdeon.
3. Takarda takarda za a iya shigar da su ga adireshin imel na Coventry na Kulawa da Lafiya a jerin katin ID na memba.

Ƙidaya na biyu za a iya aikawa ta hanyar haka:

• Sanya lantarki.
• Takarda takarda za a iya sanyawa tare da EOB mai biyan bashi.
• Ƙara yawan daidaituwa a matakin duka da matakin layin sabis (idan akwai).
• Ƙara dalilai na daidaitawa kamar su wajan kwangila, deductible, coinsurance, ko wasu. Yi amfani da lambobin da aka ba da kyautar mai biyan bashin.
• Farashin biyan biyan bashi a duk matakin da ake da'a da matakin layin sabis (idan akwai).

6 -

Samun bukatun lokaci

An tsara iyakokin ƙayyadaddun lokaci a cikin yarjejeniyar bada.

Tun da wannan bayanin zai iya canja tare da lokaci ko ya bambanta tare da kamfanin na musamman, tabbatar da duba ta hanyar yarjejeniyar mai badawa don bukatun kwanan nan.

7 -

Sharuɗɗan Shari'ar

Lokacin yin canje-canje ga biyan kuɗin da aka rigaya, ƙaddamar da ƙwararriyar ƙirar ta hanyar sadarwa.

Ƙaddamar da Dokar Sakamakon Bayanai tare da:
7 = Sauyawa na da'awar da aka rigaya.
8 = Maɓallin / soke wani da'awar da ta gabata.

8 -

Refunds

Idan kana buƙatar kula da asibiti na inshorar lafiya , sallama da'awar gyara. Maganin Kula da Lafiya na Coventry zai sake farfadowa / sake kuɗin da za a ruwaito a kan ERA tare da sauyawar adjudication da ba daidai ba, sa'annan bin umarnin gyara da aka yi.

Za a iya mayar da kuɗi saboda asusun bashi na yanzu:

Dubi Cogenry's Grid Grid da ke cikin Sashe na 6 na jagorar mai bada sabis.

9 -

Bayyana Bayani

Don buƙata ya ƙaryata game da maganin likita da'awar wannan ikirarin za a iya sake dawowa ta hanyar hanyar yanar gizon Coventry Health Care kyauta a www.directprovider.com ko tuntuɓar lambar waya a katin ID ɗin memba don bayani.

Ka je wa sashen Mai Gudanarwa na Yanar Gizo Coventry, karkashin Electronic Solutions, don duba rubutun EDI da sauran bayanan da za su iya samuwa a gare ku.

> Source:

> Sanadin lafiyar Coventry. http://www.coventryhealthcare.com/