Medical organizations rely on the insurance payor to follow a claim process, beginning from the initial moment of service, all the way through to the final disbursement of coverage and/or medical expenses. For this to work effectively, health insurance payors must be trained within the necessary systems and processes to maintain regulatory compliance with regards to patient privacy and the medical organization’s expectation that coverage will be provided in a timely and prompt fashion.
Health Insurance Payor
Health insurance payors and providers are essential for providing service and protection to hospitals and patients alike. Whether insurance payors are subsidized through the government or are privately held, as is the case in several Western countries, systems are vital to ensuring that claims are processed correctly and in a timely manner. Check out the Health Insurance Payor APQC Frameworks below.