Kuphikisana
Indlela yokufaka isikhalazo nokuthi yini ongayilindela kusuka enkambisweni.
Ilungelo Lokudlulisa
Unelungelo lokukhalaza. Lokhu kusho ukuthi ungacela ukubuyekezwa kwesenzo noma isinqumo mayelana nokuthi yiziphi izinsizakalo ozitholayo. Ngeke ulahlekelwe izinzuzo zakho uma ufaka isikhalazo. Ungafaka isikhalazo uma siphika noma sinciphisa uhlobo lwenkonzo oyicelayo. Ungabhena uma sinciphisa noma simisa isevisi esiyivumile ngaphambili. Ungafaka isikhalazo uma singakhokhi nganoma iyiphi ingxenye yesevisi. Kunezinye izenzo ongazibhena. Ngeke ulahlekelwe izinzuzo zakho uma wenza lokhu. Ungakwazi ukuveza ukukhathazeka, ukufaka isikhalazo noma isikhalazo. Umthetho.
Uma wena noma ummeleli wakho oqokiwe (DCR) ecela isikhalazo, sizobuyekeza lesi sinqumo. Umhlinzeki wakho angakufaka isikhalazo kuwe noma akusize ngesiphakamiso sakho njenge-DCR yakho. Ukuze i-DCR ithole amarekhodi akho ezokwelapha ukwenza lokhu, wena noma umnakekeli wakho wezomthetho kufanele unikeze imvume ebhaliwe kumhlinzeki wakho. Ngeke ulahlekelwe izinzuzo zakho uma ufaka isikhalazo.
Imisebenzi
Uma uthola amasevisi esiwagunyaze ngaphambilini, ungakwazi ukuqhubeka nokuthola lawo masevisi ngenkathi ufaka isikhalazo. Lokhu kungokwamalungu e-Health First Colorado (uhlelo lwe-Colorado Medicaid). Ayisebenzi kumalungu e-CHP+. Ungakwenza lokhu uma:
- Isikhalazo sakho sithunyelwe kithi esikhathini esibekiwe nguwe noma umhlinzeki wakho;
- Umhlinzeki we-Colorado Access Access ucele ukuthi uthola amasevisi;
- Isikhathi lapho imvume (imvume) yamasevisi ingapheli; futhi
- Ucela ngokuqondile ukuthi amasevisi aqhubeke.
Zonke izimfuneko ezingenhla kufanele zihlangatshezwe ukuze uqhubeke nokuthola izinsiza.
Kungadingeka ukhokhele izinsizakalo ozitholayo ngesikhathi sikhalazo uma ulahlekelwa. Ngeke udingeke ukhokhe uma uphola isikhalazo. Sicela usazise uma ucela isikhalazo uma ufuna ukuqhubeka nokuthola amasevisi wakho. Uma uqhubeka nokuthola amasevisi avunyelwe, azoqhubeka isikhathi esithile.
Imisebenzi
Izinsizakalo zizoqhubeka kuze kufike:
- Ubuyisela isikhalazo sakho;
- Isilinganiso sezinsuku ze-10 ngemuva kokuthumela isaziso sokuqala kuwe esithi siphikile isikhalazo sakho. Uma ucela ukuzwa kwe-State Fair phakathi kwalezo zinsuku ze-10, izinzuzo zakho zizoqhubeka. Bazoqhubeka kuze kube sekupheleni.
- Ihhovisi lika-State Fair Hearing likhetha ukuthi isikhalazo sakho sinqatshelwe.
- Ukugunyazwa kwezinsizakalo kuphelile.
Izibonelo zezinqumo ongabhena zihlanganisa:
- Ukwenqaba izinkonzo eziqhubekayo, ezifana nokwelashwa ngokomzimba, ukuthi uzizwa usadinga.
Kwenzekani ngesikhalazo:
- Ngemva kokuthola ucingo lwakho noma incwadi, uzothola incwadi ezinsukwini ezimbili zebhizinisi. Le ncwadi izokutshela ukuthi sithole isicelo sakho sokukhalaza.
- Wena noma i-DCR yakho ingasitshela ngomuntu noma ngokubhala ukuthi kungani ucabanga ukuthi kufanele sishintshe isinqumo noma isenzo sethu. Wena noma i-DCR yakho ingasinika futhi noma yiluphi ulwazi olucabanga ukuthi luzosiza isikhalazo sakho. Lezi kungaba amarekhodi. Wena noma i-DCR yakho ingabuza imibuzo. Ungabuye ubuze ulwazi esasilisebenzise ukwenza isinqumo sethu. Wena noma i-DCR yakho ungabheka amarekhodi ethu wezokwelapha ahlobene nesiphakamiso sakho.
- Uma ukhala isinqumo noma isenzo mayelana nokuphika noma ukuguqulwa kwenkonzo, udokotela uzobuyekeza amarekhodi akho ezokwelapha. Udokotela uzophinde abukeze olunye ulwazi. Lo dokotela ngeke abe ngudokotela ofanayo owenze isinqumo sokuqala.
- Sizokwenza isinqumo futhi sikukwazise ezinsukwini zebhizinisi ze-10 kusukela ngosuku esithola isicelo sakho. Sizokuthumelela incwadi ekutshela isinqumo. Le ncwadi izobuye ikutshele isizathu sesinqumo.
Uma sidinga isikhathi esengeziwe, sizokuthumelela incwadi ukukutshela. Noma, wena noma i-DCR yakho ungacela isikhathi esengeziwe. Singazandisa kuphela isikhathi sezinsuku zekhalenda ye-14.
Indlela yokucela isikhalazo (esinye isibuyekezo) sesinqumo noma isenzo:
Uma isikhalazo sibhekene nesicelo esisha sezinsizakalo, wena noma i-DCR yakho kumele ucele isikhalazo ngaphakathi kwezinsuku zekhalenda ze-60 kusukela ngosuku olubhalwa ngalo ukuthi uthini isinyathelo esisithathile, noma uhlele ukuthatha.
- Uma unxusa isenzo ukwehlisa, ukushintsha, noma ukumisa isevisi egunyaziwe, kumele ufake i-appeal yakho ngesikhathi. Ngokuhamba kwesikhathi kusho noma ngaphambi kokulandelayo kokulandelayo:
- Ngaphakathi kwezinsuku ze-10 kusukela ngosuku lokuthumela lwe-Notice of Action letter.
- Usuku oluzoqala ngalo isenzo.
- Wena noma i-DCR yakho ingashayela ithimba lethu lokucela ukuqala isikhalazo sakho. Batshele ukuthi ufuna ukukhalaza isinqumo noma isenzo. Uma ufonela ukuqala isikhalazo sakho, wena noma i-DCR yakho kufanele usithumelele incwadi ngemuva kokushaya ucingo ngaphandle kokuthi icele isinqumo esiphelelwe yisikhathi. Incwadi kumele isayinwe nguwe noma i-DCR yakho. Singakusiza ngencwadi, uma udinga usizo.
Le ncwadi kumele ithunyelwe ku-:
Ukufinyelela kwe-Colorado
UMnyango Wokudlulisa Izikhalazo
I-PO Box 17950
I-Denver, i-CO 80217-0950
• Wena noma i-DCR yakho ingacela isinqumo sokuthi "ukugijimela" noma ukuhanjelwa ngokushesha uma usesibhedlela, noma uzizwa ukuthi ukulinda isikhalazo njalo kungongela impilo yakho noma impilo yakho. Isigaba esibizwa ngokuthi "Izikhalazo ze-Expedited (" Rush ")" sikutshela kabanzi ngalolu hlobo lokukhalaza.
• Uma uthola izinsizakalo esizivumile kakade, ungakwazi ukuqhubeka uthola lezo zinsizakalo ngenkathi ukhala. Kungadingeka ukhokhele lezo zinsizakalo ozitholayo ngesikhathi sikhalazo uma ulahlekelwa. Ngeke udingeke ukhokhe uma uphola isikhalazo. Uma ufuna ukuqhubeka nokuthola izinsizakalo zakho, sicela usazise uma ucela isikhalazo.
Izikhalazo eziveziwe ("Rush")
Uma unomuzwa wokuthi ukulinda isikhalazo kungathinta kakhulu impilo yakho noma impilo yakho, ungadinga isinqumo esisheshayo kithi. Wena noma i-DCR yakho ingacela isikhalazo "esisheshayo" esihambelanayo.
Ngesikhalazo sokusheshisa, isinqumo singenziwa phakathi kwamahora we-72, esikhundleni sezinsuku zebhizinisi ze-10 ukuze sikhalaze njalo. Sizokwenza isinqumo sethu ngesicelo esihambelanayo phakathi namahora we-72. Lokhu kusho ukuthi wena noma i-DCR yakho inesikhathi esincane sokubheka amarekhodi ethu, kanye nesikhathi esifushane sokusinika ulwazi. Ungasinika ulwazi ngomuntu noma ngokubhala. Ngalesi sikhathi, amasevisi wakho azohlala afanayo.
Uma siphika isicelo sakho sokudlulisa isikhalazo, sizokubiza ngokushesha ngangokunokwenzeka ukukukwazisa. Sizokuthumela futhi incwadi ezinsukwini ezimbili zebhizinisi. Khona-ke sizobuyekeza isikhalazo sakho ngendlela evamile. Uzothola incwadi ekutshela isinqumo sesikhalazo. Kuzokwazisa futhi isizathu.
Indlela Yokucela Ukulalela Uhulumeni Kazwelonke
- Ukuzwa kwe-State Fair kusho ukuthi ijaji lomthetho wezokuphatha (ALJ) lizobuyekeza isinqumo noma isenzo sethu. Ungacela ukuzwa kwe-State Fair:
- Emva kokuthola isinqumo esivela kithi ukuthi awuvumelani nayo,
- Uma ungajabuli nesinqumo sethu mayelana nokukhala kwakho. Isicelo se-State Fair Hearing kumele sibhalwe phansi:
- Uma isicelo sakho sithinta ukwelashwa esingakaze samukelwe ngaphambilini, wena noma i-DCR yakho kufanele wenze isicelo ngaphakathi kwezinsuku zekhalenda ze-120 kusukela ngosuku olukulolu hlobo olutshela isinyathelo esithathile, noma uhlele ukuthatha.
- Uma isicelo sakho sithinta ukwelashwa esikuvumile ngaphambili, wena noma i-DCR yakho kufanele wenze isicelo phakathi nezinsuku zekhalenda ze-10 kusukela ngosuku owalutshwa ngalo okutshela isenzo esithathile, noma uhlele ukuthatha, noma ngaphambi kosuku olusebenzayo kokuguqulwa noma ukushintshwa kwenkonzo kwenzeka, noma yikuphi okulandelayo.
Uma wena noma i-DCR yakho ifuna ukucela ukuzwa kwe-State Fair, wena noma i-DCR yakho ungashayela noma ubhalele ku:
Ihhovisi Lezinkantolo Zokuphatha
I-633 yesishiyagalolunye yesitayela - i-Suite 1300
I-Denver, i-CO 80202
Ifoni: I-303-866-2000 Ifeksi: 303-866-5909
Indlela Yokucela Ukulalela Uhulumeni Kazwelonke
Ihhovisi Lezinkantolo Zokuphatha likuthumelele incwadi ekutshela inqubo futhi izobeka usuku lokuzwa kwakho.
Ungakwazi ukukhuluma ngokwakho ku-State Fair Hearing noma ungaba nenkulumo ye-DCR kuwe. I-DCR ingaba ummeli noma isihlobo. Kungaba futhi ummeli noma omunye umuntu. Ijaji lomthetho wezokuphatha lizobuyekeza isinqumo noma isenzo sethu. Bese bayokwenza isinqumo. Isinqumo sejaji siphelile.
Uma ungathanda ukufaka isikhalazo, kufanele uqale uyifake nge-Colorado Access. Uma ungajabuli ngesinqumo sethu, ungacela ukuzwa okusemthethweni. Lokhu kuzwa kuzokwenzeka ngejaji lomthetho wezokuphatha (ALJ). Ulwazi loxhumana nabo lwe-ALJ lubhalwe ngenhla. Kumelwe wenze isicelo sakho se-ALJ esizwa ngokubhala. Kumelwe futhi usayine isicelo sakho.
Uma uthola amasevisi esiwavumele kakade, ungakwazi ukuqhubeka nalawo masevisi ngenkathi ulinda isinqumo sejaji. Kodwa uma ulahlekelwa ku-State Fair Hearing, kungase kudingeke ukhokhele izinsizakalo ozithola ngesikhathi sakho isikhalazo. Ngeke udingeke ukhokhe uma uphola.
Uma ufuna usizo nganoma yiluphi uhlangothi lwenqubo yokudluliswa kwezicelo, sicela uxhumane nathi. Singakusiza nganoma yimiphi imibuzo onayo. Singakusiza futhi ukufaka isikhalazo.