Question

Obtain the payer mix from the healthcare institution you work for or one you are familiar...

Obtain the payer mix from the healthcare institution you work for or one you are familiar with. Review the breakdown of the payer mix currently. Then compare and discuss the changes in the payer mix for the past three years. What are the reasons for the changes and what external and internal actions caused the changes? What is the prevalent medical coding system associated with each of the categories in the payer mix? What are the major issues in the use of the respective coding systems? you can use any online data (payer mix for dental office ) thank you

Homework Answers

Answer #1

Payer mix for a healthcare institution bifurcates total revenue into different categories such as payments from private insurance, payments from government insurance and self-paying individuals. Such differentiation is important as in many cases government insurance may pay less than actual cost of the treatment. This may have profound impact on the bottom line of the company. The analysis of this mix is important to ensure that the healthcare institution is able to maintain proper margins.

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