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Related to payer: payer mix


, payer (pā'ŏr, -ĕr)
The person paying the bill, satisfying the claim, or settling a financial obligation.


n in health care, generally refers to entities other than the patient that finance or reimburse the cost of health services. In most cases, this term refers to insurance carriers, other third-party payers, or health plan sponsors (employers or unions).
References in periodicals archive ?
The healthcare payer services (outsourcing) market is segmented on the basis of service type, application, and end users.
However, in lieu of reporting exempt interest and exempt-interest dividends on 2006 Form 1099-INT and separately identifying AMT interest, payers be permitted to file with the IRS and furnish to payees a substitute statement in specified form setting forth exempt interest and exempt--interest dividends paid for 2006.
For example, NTSP regularly informed payers that its physicians had established minimum fees for payer contracts, identified the fee minimums, and stated that NTSP would not enter into or forward any of its physician's payer offers that were below the minimums.
Once the cheaper generic becomes available, the laws of most states and the pharmacy reimbursement policies of most third-party payers result in virtually automatic substitution of the generic drug when the brand drug is prescribed.
Will your system allow direct transmission to payers, or will the services of a clearinghouse be required?
Where a payer inadvertently fails to withhold the Regulation 105 tax and no additional payments are owed to a supplier from which under-withheld tax can be recouped, the Canadian payer will bear the burden of the tax.
Fourth, the case manager should communicate regularly with the payer, using a single point of entry if possible.
And we can make sure states have the means to set up their own single payer plans, a provision that's in the Clinton bill.
Incorporate payer feedback into product development and reimbursement strategy
The 95-page study, " Increasing Market Access through Innovative Payer Market Research: Assessing New Tools & Technologies to Gain Insight into Payer Decision Making," includes more than 200 metrics and 20+ narratives from payer research leaders.
As a result, the payer receives an amount that is not correct, according to the negotiated contract, and applies automated or manual rules logic to it to "adjudicate" the claim.