What is a payer?
A payer (or payor) is the organization, entity, or person responsible for paying for medical services, acting as an intermediary between patients and their providers. Payers often negotiate or set rates for healthcare services supplied by providers. They also collect premiums and other payments from individuals and plan sponsors, process claims, and pay providers using premiums.
Examples of payers include individuals; employers, unions and other entities that sponsor health plans; and state and federal governments that operate healthcare entitlement programs.
What’s the difference between “payor” v. “payer”?
Payor is used interchangeably with “payer”. This is the entity that makes the payment, satisfying the claim, and/or settling any financial obligation.
What are payer solutions in healthcare?
MMIT’s payer solutions help health plans and pharmacy benefit managers establish reimbursement policies and formulary positioning that make therapies affordable for patients.
