Third-Party Payer Comparisons
A third-party payer manages healthcare expenses for the insured
(patient) and other covered parties and provides reimbursement for
treatment and services covered under a contractual agreement between
the insured and the payer. Several examples of third-party payers
include HMOs, PPOs, Medicare, and Workers’ Compensation. Select two of
the third-party payers to compare and contrast based on your readings.
Consider in your discussion the differences and similarities in access
to providers, choice of provider, out-of-pocket costs to the patient
such as required co-pays and coinsurance and deductibles, and appeals
for denied services. Identify based on your comparisons which type of
plan you would prefer as a patient and why.
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