Question

In your own words describe in detail, the relationship between costs and payor reimbursement.

Answer 1

In general, Hospital treatment require a huge amount of money from patients, even for primary healthcare. If the patient does not have health insurance, it might be very difficult for him to survive and to bay these huge bills. Payer reimbursement is based on various factors-

• The payer reimbursement depends on all payment receipts and also on the eligibility criteria of the insured person.
• The payer reimbursement depends on the health premium of the health insurance. The person will not be paid above and beyond that limit.
• According to data analysed by records, the average cost a person pays for healthcare (either on insurance or on hospital s) is higher than the reimbursement he receives.

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