DISCUSSION A patient payor pays completely out of pocket for all health costs. A private payor is a payor or insurance company that is not provided through the government as a public payer is only provided by the government. When it comes to processing claims with the two different payors, there are similarities as well as differences in the process. Some of the similarities and differences that the two have when processing claims are that each payor type has different eligibility plans, and the cost of a public payer plan is either Medicaid or Medicare. Medicaid is 100% paid by the government and Medicare has different plans which are determined by eligibility. Private payers have different plans to choose from regardless of age or health conditions. The cost a lot of the time depends on the size of the organization that is offering it. Ethical issues that could arise with personnel during the claims filing processes may be discrimination public payers are based on factors such as income or age but a private payer base is off of what works best for the organization as far as what the cost may be from one person to another.

Healthcare Reimbursement - Discussion

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