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Role Of Provider Reimbursement In Healthcare

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Healthcare is made up of many factors. Among those factors is the financial aspect such as provider reimbursement and the different types of financial methods used by the patients to acquire healthcare services. Provider reimbursement is important and necessary in order to maintain the continuation of healthcare. Like every organization, the healthcare industry also requires funds in order to pay for expenses accrued and to purchase the supplies needed to aid in rendering services. With that said, this is why there are many financial methods in existence today that are utilized by individuals to pay for their healthcare needs such as, Medicare, Medicaid, PPO plans, HMO and many others. In addition to being aware of the different types of financial …show more content…

Revenue is something that is required by any organization even if it is classified as a nonprofit organization. In order to render services to a patient, providers need to be equipped with the necessary tools to aid them in accomplishing such a thing. When discussing healthcare any healthcare entity that including, nurses, physicians, medical assistants, therapist, and so forth will need to receive currency in order to continue providing those services. It is very unlikely that anyone wants to work for free. Furthermore, the facility needs to make revenue to be able to purchase the necessary medical equipment or supplies to allow them to render quality services and to care for the patient. Every organization has expenses that accrual and without a steady income it would be practically impossible to sustain a facility. Provider reimbursement is necessary because that allows for the continuation of …show more content…

Some of those methods consist of third-party payers, government agencies, private health insurance, and patient payments. A third-party payer is that who pays for a service but does not consist of the provider or the patient. This can include another individual or organization. A government agency that finances healthcare can consist of Medicaid, Medicare, Veteran’s Affairs, or any agency that is administered by the government. Private health insurance comes from companies such as Aetna, Blue Cross Blue Shield, Cigna, and United Healthcare. This type of health insurance is typically provided by the patient’s employer. Patient payments are in connection with third-party payers. Usually, patients with third-party payers are responsible for a percentage of the services

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