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I-Health First Colorado kunye ne-CHP + zibuyela kwiinkqubo eziqhelekileyo zokuvuselela.
Jonga i-imeyile yakho, i-imeyile, kunye ne-PEAK ibhokisi lokungenayo. Thatha inyathelo xa ufumana imiyalezo esemthethweni. Ungawubona umhla wakho wokuhlaziya Apha nangaliphi ixesha. Ukuba ufumana ipakethe yokuhlaziya, qiniseka ukuba uyigcwalise. Qiniseka ukuba uyasisayina kwaye usibuyisele ngomhla omiselweyo.
Funda kabanzi apha

Izibheno

Indlela yokufaka isibheno kunye nento ongayilindela kwinkqubo.

Ilungelo lokuBhenela

Unelungelo lokubhena. Oku kuthetha ukuba unokucela ukuhlaziywa kwesenzo okanye isigqibo malunga neenkonzo ezifumanayo. Awuyi kulahlekelwa zibonelelo zakho xa ufaka isikhalazo. Unokufakela isibheno xa sikhanyela okanye sinciphise uhlobo lwenkonzo oyicelayo. Unokwenza isibheno xa sinciphisa okanye simisa inkonzo esiyivumile ngaphambili. Unokwenza isibheno ukuba asihlawuli nayiphi na inkonzo. Kukho ezinye izenzo onokubhena. Awuyi kulahlekelwa zibonelelo zakho xa wenza oku. Unokubonisa inkxalabo, ufake isikhalazo okanye isibheno. Umthetho.

Ukuba wena okanye ummeli wakho oqeshwe ngumxhasi (DCR) ucela isibheno, siya kuhlolisisa isigqibo. Umnikezeli wakho unokufaka isibheno kuwe okanye akuncede sakho isibheno njenge-DCR yakho. Ukuze i-DCR ifumane iirekhodi zakho zonyango ukwenza oku, wena okanye umgcini wakho womthetho kufuneka unike imvume ebhaliweyo kumnikezeli wakho. Awuyi kulahlekelwa zibonelelo zakho xa ufaka isikhalazo.

iinkonzo

Ukuba ufumana iinkonzo ebesizivumile ngaphambili, usenokukwazi ukuqhubeka uzifumana ezo nkonzo ngelixa ubhena. Oku kuphela kwi-Health First Colorado (iprogram ye-Colorado Medicaid) amalungu. Ayisebenzisi kumalungu e-CHP +. Ungakwenza oku ukuba:

  • Isibheno sakho sithunyelwe kuthi ngokwexesha elifunekayo nguwe okanye umboneleli wakho;
  • Umnikezeli we-Colorado Access ucele ukuba ufumane iinkonzo;
  • Ixesha lokuvuma (ukugunyazwa) kweenkonzo akupheli; kwaye
  • Ucela ngokuthe ngqo ukuba iinkonzo ziyaqhubeka.

Zonke ezi mfuno zingentla kufuneka zifezekiswe ukuze uqhubeke ufumana iinkonzo.

Kufuneka uhlawule iinkonzo ozifumanayo kwisibheno xa ulahlekelwa. Awuyi kuhlawulwa xa ufumana isikhalazo. Nceda usazise xa ucela isibheno ukuba ufuna ukuqhubeka ufumana iinkonzo zakho. Ukuba uqhubeka ufumana iinkonzo ezivunyiweyo, ziya kuqhubeka ixesha elithile.

iinkonzo

Iinkonzo ziya kuqhubeka de:

  • Uya kubuyisa isikhalazo sakho;
  • Iyonke idlule yeentsuku ze-10 emva kokuba sithumelele isaziso sokuqala kuwe esitshilo sathi samphika isikhalazo sakho. Ukuba ucela ukuBoniswa kweNkundla kaRhulumente phakathi kweentsuku ze-10, izibonelelo zakho ziya kuqhubeka. Baza kuqhubeka kude kube sekupheleni ukuva.
  • Iofisi ye-State Fair Hearing igqiba ukuba isibheno sakho sichithwa.
  • Ugunyaziso lweenkonzo luphela.

Imizekelo yezigqibo onokubhena ziquka:

  • Ukulahla iinkonzo eziqhubekayo, ezinjengezokwelapha ngokwenyama, oziva ukuba usadinga.

Kwenzeka ntoni ngesibheno:

  • Emva kokuba sifowune ifowuni yakho okanye ileta, uya kufumana ileta phakathi kweentsuku ezimbini zoshishino. Le leta iya kukuxelela ukuba sinesi sicelo sakho sesibheno.
  • Wena okanye i-DCR yakho ingasitshela ngomntu okanye ngokubhaliweyo kutheni ucinga ukuba kufuneka sitshintshe isigqibo sethu okanye isenzo. Wena okanye i-DCR yakho ingasinika naluphi na ulwazi ocinga ukuba luyakunceda sakho isibheno. Ezi zi nga rekhodi. Wena okanye i-DCR yakho inokubuza imibuzo. Unokuphinda ucele ulwazi esasilisebenzisa ukwenza isigqibo sethu. Wena okanye i-DCR yakho inokujonga kwiirekhodi zethu zezokwelapha eziphathelele kwisibheno sakho.
  • Ukuba ubhenela isigqibo okanye isenzo malunga nokukhanyela okanye utshintsho lwenkonzo, ugqirha uya kuhlaziya iirekhodi zakho zonyango. Ugqirha uya kuphinda ahlaziye ezinye iinkcukacha. Lo ugqirha akayi kuba ngudokotela ofanayo owenza isinqumo sokuqala.
  • Siza kwenza isigqibo kwaye sikuxelele kwiintsuku zeentsuku ze-10 ukususela ngosuku esifumana isicelo sakho. Sizakukuthumela ileta ekwazisa isigqibo. Ileta iya kukwazisa isizathu sesigqibo.
    Ukuba sidinga ixesha elingakumbi, siyakuthumela ileta ukuze sikuxelele. Okanye, wena okanye i-DCR yakho unokucela ixesha elide. Singakwazi ukwandisa ixesha ukuya kwiintsuku zekhalenda ze-14.

Indlela yokucela isibheno (esinye isiphononongo) sesigqibo okanye isenzo:

Ukuba isibheno sithetha ngesicelo esitsha seenkonzo, wena okanye i-DCR kufuneka ucele isibheno kwiintsuku zekhalenda ze-60 ukususela kumhla wencwadi esithetha into esithathileyo, okanye sicwangcise ukuthatha.

  • Ukuba ubhenela isenzo sokunciphisa, ukutshintsha okanye ukuyeka inkonzo egunyazisiweyo, kufuneka ufake ifowuni yakho kwisibheno. Ngexesha lithetha ngomhla okanye phambi kwexesha elilandelayo:
    • Kwiintsuku ze-10 ukusuka kumhla wokuposa weeNcwadi zeSaziso seNtsebenzo.
    • Umhla oza kuqalwa ngayo isenzo.
  • Wena okanye i-DCR yakho inokufownela iqela lethu lokubhenela ukuba iqalise isibheno sakho. Batsho ukuba ufuna ukubhenela isigqibo okanye isenzo. Ukuba ufowuna ukuqala isibheno sakho, wena okanye i-DCR kufuneka usithumelele ileta emva kwefowuni ngaphandle kokuba bacele isisombululo esiphuthumayo. Ileta kufuneka isayinwe nguwe okanye i-DCR yakho. Sinokukunceda ngeleta, ukuba ufuna uncedo.

Ileta kufuneka ithunyelwe ku-:
Access Colorado
KwiSebe le ziBheno
PO Box 17950
Denver, CO 80217-0950

• Wena okanye i-DCR yakho inokucela ukuba "ukukhawuleza" okanye isibheno esiphuthumayo ukuba usebhedlele, okanye uzive ukuba ukulinda isibheno rhoqo kunokusongela ubomi okanye impilo yakho. Icandelo elibizwa ngokuba yi "Expedited (" Rush ") Izibheno" zitsho kabanzi malunga nale ndlela yesibheno.
• Ukuba ufumana iinkonzo esele zivumile, unako ukuqhubeka ufumana ezo nkonzo ngelixa usibheno. Kufuneka uhlawule ezo nkonzo ozifumanayo kwisibheno xa ulahlekelwa. Awuyi kuhlawulwa xa ufumana isikhalazo. Ukuba ufuna ukuqhubeka nokufumana iinkonzo zakho, nceda usazise xa ucela isibheno.

Expedited ("Rush") Izibheno

Ukuba uvakalelwa kukuba ukulinda isibheno kunokuchaphazela kakhulu impilo okanye impilo yakho, unokufuna isigqibo esisheshayo esivela kuthi. Wena okanye i-DCR yakho inokucela ukuba isikhalazo "sokukhawuleza" sihambele.

Ukubhenela ngokukhawuleza, isigqibo siya kwenziwa kwiiyure ze-72, esikhundleni seentsuku ze-10 zeentsuku zokubhena. Siza kwenza isigqibo sethu kwisibheno esiphezulu kwiiyure ze-72. Oku kuthetha ukuba wena okanye i-DCR yakho inesixa esifutshane sokujonga iirekhodi zethu, kunye nexesha elincinci lokusinika ulwazi. Ungasinika ulwazi ngomntu okanye ngokubhaliweyo. Ngeli xesha, iinkonzo zakho ziya kuhlala zifana.

Ukuba siphika isicelo sakho sokubhena isikhalazo, siya kukubiza ngokukhawuleza njengoko sikwazi ukukuxelela. Sizakukuthumela neleta ngaphakathi kweentsuku ezimbini zoshishino. Emva koko siza kuhlolisisa isikhalazo sakho ngendlela eqhelekileyo. Uya kufumana ileta ekwazisa isigqibo sesibheno. Kuya kukwazisa isizathu.

Unokucela njani i-State Fair Fair

  • I-State Fair Hearing ithetha ukuba umgwebi wezomthetho wolawulo (ALJ) uza kuhlaziya isigqibo sethu okanye isenzo. Unokucela i-State Fair Hearing:
    • Emva kokuba ufumene isigqibo esivela kuthi ukuba awuvumelani,
    • Ukuba awuyivuyo nesigqibo sethu ngesibheno sakho. Isicelo soHlebe lweNkundla kaRhulumente kufuneka sibhalwe phantsi:
  • Ukuba isicelo sakho sithetha ngonyango esingazange siyivume ngaphambili, wena okanye i-DCR yakho kufuneka wenze isicelo kwiintsuku zekhalenda ze-120 ukususela kumhla wencwadi ekuxelela yona isenzo esiyithathileyo, okanye sicwangcise ukuthatha.
  • Ukuba isicelo sakho sithetha ngonyango esiyivumile ngaphambili, wena okanye i-DCR yakho kufuneka wenze isicelo phakathi kweentsuku zekhalenda ze-10 ukususela kumhla wencwadi ekuxelela yona isenzo esiyithathileyo, okanye sicwangcise ukuthatha, okanye ngaphambi komhla wokuqalisa lokutshintshwa okanye ukutshintshwa kwenkonzo kwenzeka, nayiphi na kamva.

Ukuba wena okanye i-DCR yakho ufuna ukucela ukuThetha kweNkundla kaRhulumente, wena okanye i-DCR yakho ungabiza okanye ubhale:

Ofisi yeeNkundla zoLawulo
I-633 Street yeshumi elinesibhozo - I-Suite 1300
Denver, CO 80202

Ifowuni: 303-866-2000 Ifeksi: 303-866-5909

Unokucela njani i-State Fair Fair

I-Ofisi yeeNkundla zoLawulo izakuthumela ileta ekwazisa inkqubo kwaye iya kubeka umhla wokuva.

Uyakwazi ukuthetha nawe kwi-State Fair Hearing okanye unakho ukuthetha nge-DCR. I-DCR ingaba igqwetha okanye isihlobo. Ingaba ngummeli okanye omnye umntu. Ijaji yomthetho wezolawulo liya kuhlaziya isigqibo sethu okanye isenzo. Emva koko baya kwenza isigqibo. Isigqibo sejaji siphelile.

Ukuba ungathanda ukufaka isibheno, kufuneka uqale uyifake ne-Colorado Access. Ukuba awuyivuyo nesigqibo sethu, unokucela ukuvalelwa ngokusemthethweni. Le ntetho iya kwenzeka kunye nejaji yomthetho wezolawulo (ALJ). Ulwazi loqhagamshelwano lwe-ALJ lubhalwe apha ngasentla. Kumele wenze isicelo sakho se-ALJ esikulo ngokubhaliweyo. Kumele usayine isicelo sakho.

Ukuba ufumana iinkonzo esele zivumile, unokukwazi ukuqhuba ezo nkonzo ngelixa ulinde isigqibo sejaji. Kodwa ukuba ulahlekelwa kwi-State Fair Hearing, kunokufuneka uhlawule iinkonzo ozifumanayo ngexesha lesibheno sakho. Ngeke uhlawule xa uphumelela.

Ukuba ufuna uncedo nangayiphi na inxalenye yenkqubo yokubhena, nceda uqhagamshelane nathi. Sinokukunceda nangayiphi na imibuzo enayo. Sinokukunceda ukuba ufake ifowuni.