Ukuvala Ukufakwa Okuqhubekayo
Background
NgoJanuwari 2020, uMnyango Wezempilo Nezinsizakalo Zabantu wase-US (HHS) uphendule ubhubhane lwe-COVID-19 ngokumemezela isimo esiphuthumayo sezempilo yomphakathi (PHE). I-Congress yaphasisa umthetho wokuqinisekisa ukuthi noma ubani obhalisele i-Medicaid (i-Health First Colorado (uhlelo lwe-Colorado Medicaid) e-Colorado), kanye nezingane kanye nabantu abakhulelwe ababhalise kuHlelo Lomshuwalense Wezempilo Wezingane (Uhlelo Lwezempilo Lwezingane). plus (CHP+) eColorado), baqinisekiswa ukuthi bazogcina ukuvikeleka kwabo kwezempilo ngesikhathi se-PHE. Lena yi- imfuneko yokufakwa okuqhubekayo. ICongress yaphasisa umthethosivivinywa oqede imfuneko eqhubekayo yokufakwa entwasahlobo ka-2023.
Ukuhlelela Ukuphela Kwendaba Eqhubekayo
Yamalungu
Amalungu e-Health First Colorado kanye ne-CHP+ abuyele ezinqubweni ezivamile zokuvuselela ukufaneleka. Amalungu afanele ngo-May 2023 aziswe ngo-March 2023. UMnyango Wezokunakekelwa Kwezempilo Nokuxhaswa Ngezimali wase-Colorado (HCPF) uzothatha izinyanga ezingu-14, kuhlanganise nokuqaphela, ukuze udlule futhi uqedele ukuvuselelwa komuntu ngamunye cishe kwezigidi ezingu-1.7 ezibhalisiwe.
Yini okudingeka uyazi mayelana nenqubo yokuvuselela?
Ukuqonda inqubo yokuvuselela kuzokusiza ukuthi usekele kangcono iziguli zakho ezifanelekile ze-Health First Colorado ngalolu shintsho. Chofoza lapha ukuze bafunde kabanzi ngalokho okufanele bakwenze ukuze bavuselelwe, okuhlanganisa nokunquma ukufaneleka kanye nendlela yokubhalisa kabusha.
Senzani ukuze sisekele abahlinzeki bethu?
- Sazisa amalungu ethu mayelana nokuphela kokusakazwa okuqhubekayo. Ithimba lethu labaphathi bokunakekela libathinta egameni labahlinzeki bezokwelapha abayinhloko (PCMPs), futhi babeka kuqala amalungu asengozini enkulu.
- Sidale khulula amaflaya olwazi, izincwajana nezinye izinto ongazinika iziguli zakho. Ungazicela lezi khulula izinto zokwakha zilethwe ehhovisi lakho ngokusebenzisa yethu new uhlelo loku-oda lwe-inthanethi. Okwamanje izinto zokwakha ziyatholakala ku isiZulu futhi ISpanishi.
- Sidale amavidiyo okufundisa ukuze wabelane nabasebenzi bakho namalungu. Lezi zitholakala ngesiNgisi nangeSpanishi.
- Sengeze izinsuku zokuvuselela zamalungu embikweni we-attribution wanyanga zonke (PEPR) ukuze ukwazi ukuhlunga umbiko wakho kumalungu athembisene umshado nabangathembisene umshado, amalungu asengozini enkulu, kanye namalungu ngezinsuku ezizayo zokuvuselela. Cela iziqondiso kumsizi wakho wokuzilolonga.
- Sidale imiyalelo yesinyathelo ngesinyathelo yokuthi ungahlola kanjani ukufaneleka kwamalungu ku- State Web Portal.
- Uma unemibuzo mayelana nokuhlola ukufaneleka sicela uxhumane nomphathi wenethiwekhi yakho ukuze uthole ukwesekwa okwengeziwe.
- Ukuze uthole ukuthi ubani umphathi wenethiwekhi yomhlinzeki wakho sicela uthumele i-imeyili providernetworkservices@coaccess.com
- Sidale i-FAQ ukuze ubuyekeze imibuzo ephakanyiswe kontanga yakho. Sicela uskrolele ezansi kwaleli khasi ukuze ubuke i-FAQ.
Ukuqwashisa Ngogaxekile
- Basabisa amalungu kanye nabafake izicelo ngokulahlekelwa usizo lwezempilo
- Bafuna imali
- Bacela ulwazi lomuntu siqu olubucayi futhi bangasongela ngisho nokuthatha izinyathelo zomthetho
I-HCPF ayiceli amalungu noma abafake izicelo imali noma ulwazi lomuntu siqu olubucayi njengezinombolo eziphelele zokuphepha komphakathi ngocingo noma ngombhalo; I-HCPF ayisongeli isenzo somthetho ngocingo noma ngombhalo.
I-HCPF kanye neminyango yesifunda yemisebenzi yabantu ingase ithinte amalungu ngocingo ukuze icele ulwazi lokuxhumana lwamanje oluhlanganisa inombolo yocingo, ikheli le-imeyili, nekheli leposi. Ungabuyekeza lolu lwazi ku-PEAK noma kunini.
Amalungu, abafake izicelo kanye nozakwethu kufanele bavakashele iwebhusayithi yoMbuso ukuze bathole ulwazi olwengeziwe futhi babike imilayezo yokukhwabanisa engaba khona ku-Attorney General Consumer Protection Unit.
Abahlinzeki bangasiza kanjani?
- Ungasisiza ukuthi siqwashise amalungu ngemikhonyovu engaba khona ngokwabelana ngemiyalezo (umbhalo, umphakathi, incwadi yezindaba) etholakala kuwebhusayithi ye-HCPF: hcpf.colorado.gov/alert
- Ungabika umkhonyovu futhi ufunde kabanzi ku hfcgo.com/alert
Ungathatha kanjani isinyathelo?
- Qinisekisa ukuthi abasebenzi bakho bajwayele ukufaneleka kwe-Health First Colorado nezinqubo zokubhalisa kabusha ukuze bakwazi ukuphendula noma yimiphi imibuzo iziguli zakho ezingaba nayo.
- Ukuze uqinisekise ukuthi uthola imbuyiselo efanele, kufanele uhlole ukufaneleka kwe-Health First Colorado kwesiguli sakho ngasinye:
- Ngaleso sikhathi ukuqokwa kwabo kuhleliwe
- Lapho isiguli sifika lapho sibonana khona
- Buza umsizi wakho wokuzijwayeza noma yimiphi imibuzo ongase ube nayo.
- Buka izinhlu zethu zenyanga zesichasiso. Lolu hlu luzokusiza ukuthi uqonde ukuthi yiziphi iziguli okufanele zivuselelwe futhi nini. Lolu hlu luzobonisa:
- Izinsuku zokuvuselela iziguli zakho
- Iziguli zakho ezithembisene umshado futhi ezingashadile
- Noma yiziphi iziguli zakho ezifaneleke njengengozi enkulu
- Ozakwethu bomtholampilo abathuthukisiwe (ECPs) bangamalunga axhumene nabo.
Ungazisiza kanjani iziguli zakho ezifanelekile ze-Health First Colorado?
- Ungasiza ekuqwashiseni amalungu mayelana nokuvuselelwa kwe-Medicaid ngokwabelana ngemiyalezo kumathuluzi e-HCPF futhi ukuthumela iflaya nezincwajana ezindaweni zomphakathi nasemadeskini okwamukela izivakashi.
- Yazisa iziguli zakho ukuthi kumele zithathe izinyathelo zokuvikela impilo yazo, nokuthi zingakwenza kanjani lokho. I-HCPF ithuthukise amathuluzi ozakwethu ukusiza ekubuyiseleni ezinqubweni zokuvuselela ezivamile. Buyekeza Ikheli Lakho futhi Thatha Isinyathelo Ngokuvuselelwa Kwakho amathuluzi wonke afaka izinsiza zokusiza amalungu ukuthi athathe isinyathelo ukuze agcine ukufakwa kwawo. Lezi zinto zikhomba izinyathelo ezibalulekile amalungu okufanele azithathe okuhlanganisa; bebuyekeza imininingwane yabo yokuxhumana, bathathe isinyathelo lapho kufanele kwenziwe kabusha, futhi bafune usizo lokuvuselela izinsiza zomphakathi noma zesifunda lapho beludinga.
- Zifundise wena kanye nabasebenzi bakho inqubo yokuvuselela ukuze ukwazi ukusiza iziguli zakho ngempumelelo. Buka i-HCPF Ikhithi yamathuluzi Yezemfundo Yokuvuselela. Imibuzo evame ukubuzwa (FAQs) mayelana nokuphela kwesidingo sokuhlanganisa okuqhubekayo kanye nokubuyela ezinqubweni zokuvuselela ezivamile kuyatholakala ku PHE Planning Resource Centre.
- Thumela amalungu anemibuzo mayelana nenqubo yokuvuselela ekhasini lewebhu lokuvuselela i-Health First Colorado elitholakala ku- isiZulu futhi Spanish.
- Qondisa noma yiziphi iziguli zakho ezingasafaneleki ukuthola i-Health First Colorado ukuze izinsiza zokunakekelwa kwezempilo ezithengekayo.
Siyabazisa ubambiswano lwakho futhi sikukhuthaza ukuthi wabelane ngempendulo mayelana nemikhuba emihle, amathuluzi amasha, namamethrikhi anenjongo nathi practice_support@coaccess.com.
Gcina ama-Coloradans Emboziwe
I-HCPF ilinganisela ukuthi amalungu amanje angaphezu kwe-325,000 ngeke esafaneleka i-Health First Colorado ngemva kokubuyekezwa kwawo kokufaneleka konyaka. Lokhu kubuyekezwa kuzokwenziwa ngenyanga yokugubha usuku ilungu labhalisa ngalo, okusho ukuthi uma ilungu libhalisa ngoJulayi 2022, ukubuyekezwa kwalo kokufaneleka kuzokwenziwa ngoJulayi 2023.
Uma izimo zelungu lamanje zishintshile kusukela abhalisa ku-Health First Colorado, njengokuqala umsebenzi omusha ongase ubeke phezu komkhawulo weholo, kufanele bathole ezinye izinketho zokuthola umshwalense wezempilo ukuze bagweme imiphumela engase ibe yingozi yokungabi namshuwalense.
Kusukela ngo-Ephreli 2023, imikhawulo yokufaneleka kwemali engenayo inyuke ukuze ibhekane nokwehla kwamandla emali. Nakuba umndeni ungase udlule umkhawulo weholo le-Health First Colorado, kungenzeka ukuthi izingane kulowo mndeni zifanelekele i-CHP+. I-CHP+ iphinde ivikele abantu abakhulelwe ngokukhulelwa kwabo nokubeletha, kanye nezinyanga eziyi-12 ngemuva kokubeletha. Chofoza lapha ukuze ubone imikhawulo yokufaneleka ebuyekeziwe.
Xhuma ku-Health Colorado
Labo abangasafaneleki ukuthola usizo lwe-Health First Colorado bangathola ezinye izinketho zokunakekelwa kwezempilo Xhuma ku-Health Colorado, isimo semakethe yomshuwalense wezempilo esemthethweni waseColorado.
Ngizokwazi Kanjani Uma Ukuvuselelwa Kwami Kudingeka?
Spring 2023
Ngiyiqedela Kanjani Inqubo Yokuvuselela?
Spring 2023
Amathiphu Asheshayo Okugcwalisa Ukuvuselela Kwakho
Spring 2023
Ngingaluthola Kanjani Usizo Ngokuvuselelwa Kwami?
Spring 2023
imibuzo ejwayelekile ukubuzwa
Kuzokwenzekani ekufakweni kwe-telehealth?
- Ukuvakasha kwefoni nevidiyo kuzoqhubeka kukhaviwe kuwo wonke amalungu e-Health First Colorado kanye ne-CHP+. Lokhu akufaki ukuvakasha kwezingane kahle.
- I-Telemedicine isazoba inzuzo, sisusa amakhodi Okuhlola Ingane Kahle ku-telemedicine kusukela ngoMeyi 12, 2023. Amakhodi enqubo athintekayo ahlanganisa 99382, 99383, 99384, 99392, 99393 kanye no-99394. Funda kabanzi lapha. Uma unemibuzo, sicela uthumele i-imeyili ku-Morgan Anderson morgan.anderson@state.co.us noNaomi Mendoza at naomi.mendoza@state.co.us.
- Amalungu e-Health First Colorado kanye ne-CHP+ angasebenzisa ukuvakasha kwefoni nevidiyo ukuze bathole ukunakekelwa kwezokwelapha okujwayelekile, ukwelashwa nokunye ukuvakasha. Akubona bonke abahlinzeki abanikeza izinsiza ze-telehealth, ngakho-ke amalungu kufanele ahlole ukuthi umhlinzeki wabo unikeza i-telehealth. Lolu bekuwushintsho lwenqubomgomo eyenziwe ukuphendula i-COVID-19 i-Health First Colorado eyenze yahlala njalo.
Kuzokwenzekani ngabahlinzeki abavale iminyango yabo futhi basebenza ngokugcwele benza i-telehealth?
Abahlinzeki basengasebenza futhi bakhokhise ngendlela efanayo ngemva kwe-PHE. Okukhethekile kwabahlinzeki, ibhizinisi le-e-health, lemitholampilo kanye namaqembu abahlinzeki abangebona odokotela abaletha izinsizakalo ngokukhethekile nge-telemedicine izotholakala maduze. Uma isitholakala, laba bahlinzeki bazobuyekeza ukubhaliswa kwabo kwamanje ukuze babonise ukuthi bahlinzeka ngamasevisi nge-telemedicine kuphela.
Ingabe kuzoba noshintsho lwezinga lokuziphatha ngocingo lwezempilo?
Ngokuvakashelwa kwe-telemedicine yezempilo yenkokhelo yesevisi, alukho ushintsho lwezinga elilindelwe ngenxa ye-PHE. Ukulingana kwenkokhelo phakathi kokuvakasha komuntu siqu kanye ne-telemedicine kusekhona. Ngeke kube khona ushintsho endleleni ama-RAE akhokha ngayo izinzuzo ze-telemedicine yezempilo yokuziphatha.
Ingabe abahlinzeki bazokwazi ukubona izinsuku ezimisiwe zokuvuselela kuphothali Yomhlinzeki?
Iphothali yabahlinzeki ayinikezi izinsuku zokuvuselela ukufaneleka. Iphothali izobonisa izinsuku zokuqala nezokuphela kwekhava. Sikhuthaza amalungu ukuthi angene kuma-akhawunti awo e-PEAK ukuze abone izinsuku zawo zokugcina zokuvuselela.
Ingabe ikhona inkambu yedatha ethile ebonisa isimo sokuvuselela?
Amafayela edatha angeviki avela ku-HCPF awanayo inkambu ethile ebonisa isimo sokuvuselelwa kwelungu. Akwenzeki ukunquma ukuthi ukuvuselela kuthunyelwe yilungu noma kusenqubweni yokubuyekezwa yisisebenzi esifanelekile. Nokho, ngokusebenzisa inkambu yedethi yokuvuselela abasebenzisi banganquma ukuthi ukuvuselela akukakagunyazwa yini.
Ingabe ikhona inkambu yedatha ebonisa amalungu azovuselelwa ngokuzenzakalela?
Okwamanje, amafayela e-HCPF awafaki inkambu ebonisa ukuvuselelwa okuzenzakalelayo. Kodwa-ke, uma izinqubo ezaziyingxenye yeqembu sezenzeka nyanga zonke, izinsuku zokuvuselela amalungu zizobuyekezwa zibe onyakeni olandelayo.
imibuzo ejwayelekile ukubuzwa
Kungani sibona izinsuku zokunquma kabusha ezifana no-2018, 2011 kwamanye amalungu?
Asikwazanga ukuthola ukucaciseleka ku-HCPF mayelana nokuthi kungani sibona lezi zinsuku. Kodwa-ke, noma yiluphi usuku lokuvuselela kusukela eminyakeni emithathu yokugcina ye-PHE engaphambi kuka-5/31/23 luzoba ngaphansi kokufakwa njalo. Amalungu athola iphakethe lokuvuselela elinedethi yokuvuselela kaMeyi 2023 noma kamuva kudingeka agcwalise lelo phakethe ukuze agcine izinzuzo.
Uma ilungu lingenalo ikheli le-imeyili noma inombolo yocingo, lingayidala kanjani i-akhawunti kuwebhusayithi ye-PEAK?
Ukusethwa kwe-akhawunti ye-PEAK akunikezeli enye inketho ngaphandle kwenombolo yocingo noma ikheli le-imeyili. Okuwukuphela kwendlela yokwenza lokhu okwamanje ukusiza ilungu ukuthi limise ikheli le-imeyili ukuze lidale i-akhawunti.
Ingabe izingane ezinakekelwa yibo noma lezo ezazikade zikhuliswa ziyovuselelwa ngokuzenzakalelayo?
Izingane ezikhuliswa yingane ekungeyona eyakho zizothola iphakethe lokuvuselela ukuze zibuyekeze imininingwane yezibalo zabantu. Nokho, uma ilungu lingathathi sinyathelo khona-ke lisazovuselelwa ngokuzenzekelayo. Izingane okwamanje ezinakekelwa izingane ezingaphansi kweminyaka engu-18 zizovuselelwa ngokuzenzekelayo futhi ngeke zilithole iphakethe. Labo abebekade bekhuliswe yingane ekungeyona eyakhe bazoqhubeka nokuvuselelwa ngokuzenzekelayo baze babe neminyaka engu-26 ubudala.
Ingabe izifunda zizoba nokusekelwa okwanele kwabasebenzi ukuze zihambisane nevolumu yokuvuselelwa kwamalungu e-Medicaid?
I-HCPF njengamanje iphenya ukuthi ingabasekela kanjani abasebenzi abafanelekile ukubhekana nokusilela emuva komsebenzi. I-HCPF izophinde itshale izigidi ezingu-15 zamaRandi kwezinye izinsiza zezikhalazo.
Izoba yini inqubo uma ukuvuselelwa kuhanjiswa ngesikhathi esifanele, kodwa isifunda singakucubunguli ngaphambi kokuphela kosuku lokubhalisa kwelungu?
Uma ukuvuselelwa kwelungu kuhanjiswa nge-PEAK, ukuvuselelwa kuthathwa njengokuthunyelwe ngalolo suku. Kuzoba nesikhathi somusa phakathi komhlaka-5 no-15 wenyanga ngayinye ukuze kuvuselelwe amalungu aleyo nyanga. Uma nje i-PEAK “ivuma” ukuvuselelwa kwelungu ngomhla ka-15 wenyanga okukhulunywa ngayo, izobhekwa njengephelele ngezinjongo zokuvuselela.
Abahlinzeki bangasiza kanjani ngenqubo yokuvuselela?
Abahlinzeki bangaletha ukuqwashisa mayelana nenqubo yokuvuselela ngokuthumela amaflaya ethu ezindaweni zabo zomphakathi. Amaflaya, inkundla yezokuxhumana, okuqukethwe kwewebhusayithi, namanye amathuluzi okufinyelela angatholakala kwethi Ikhasi lewebhu le-PHE Planning. Izinto eziqukethwe ku-toolkits ziqwashisa ngezinyathelo ezibalulekile amalungu okufanele azithathe: ukubuyekeza imininingwane yokuxhumana, ukuthatha isinyathelo lapho kufanele kwenziwe kabusha, kanye nokufuna usizo lokuvuselela ezinsizeni zomphakathi noma zesifunda lapho zikudinga.
Abahlinzeki bangakwazi futhi ukuzifundisa bona kanye nabasebenzi babo ngezisekelo zenqubo yokuvuselela ukusiza iziguli okungenzeka zibe nemibuzo. Bona wethu Ikhithi yamathuluzi Yezemfundo Yokuvuselela.
Imibuzo eyengeziwe evame ukubuzwa mayelana nokuphela kwemfuneko yokufakwa okuqhubekayo ingatholakala lapha.