Payor/Payer
A Payor (or Payer) in the healthcare industry refers to an entity responsible for financing or reimbursing the cost of health services. Payors include insurance companies, government programs like Medicare and Medicaid, employer-sponsored health plans, and other organizations that cover healthcare expenses.
Payors play a crucial role in the healthcare system by managing the financial aspects of patient care. They determine coverage policies, negotiate payment rates with healthcare providers, process claims, and ensure that providers receive payment for services rendered to insured individuals. Payors also implement strategies to control healthcare costs and promote efficient, high-quality care through various payment models and incentives.