HEALTHCARE PAYMENT EXPECTATIONS
Unit 1 Individual Project
HLTH420 – Healthcare Finance
November 7, 2012
This research paper will explain the payment expectations of government, commercial, and liability insurances, as well as self-pay/cash pay patients. An in depth explanation of how they differ, such as rules, will be made. This report will help readers understand the different types of programs in bill collecting, and account and project financial expectations.
Healthcare Payment Expectations Payment expectations are the reimbursement of the services given to patients. There are many alternatives to how healthcare organizations collect their payments or revenues. They can be handled through cash
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Depending on the responsible party of paying that claim, it can either be the insured or the insurance company; it varies with each plan per individual. Self-pay or cash pay patients are usually those patients that does not have medical insurance or those who just prefer not dealing with the hassles of Medicare or insurance reimbursement or claims, will pay an out of pocket expense for the medical services they seek and get. Medical doctors and clinicians view these patients as more compliant and motivated to doctor’s orders (Carter, 2011). Without any insurance help, self-pay patients would usually get a discount percentage due to the high cost of medical services. Self-pay or cash patients will have to pay the full amount or partial before or after the service, and if a balance remains would need to pay in the next couple of months depending on the payment plan. All of these components of payment expectations of different insurances would need to familiarize with by medical business professionals in order for efficient billing, collecting, accounting, and the projection of financial expectations to occur. All health insurances, it doesn’t matter what type of insurance, has to follow basic standards of regulations of the service and product, but each state and health facility has its own discretion in how to price their services and also deciding how much a patient is responsible for their balance.
There is much that needs to be