Payor (2024)

In healthcare, a payor is a person, organization, or entity that pays for the care services administered by a healthcare provider. This term most often refers to health insurance companies, which provide customers with health plans that offer cost coverage and reimbursem*nts for medical treatment and careservices.

The three main different types of healthcare payors are government/public payors, commercial payors, and privatepayors.

Government/publicpayors

Government payors include U.S. government-funded health insurance plans like Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). These programs help support certain populations and economicstatuses.

Commercialpayors

Commercial payors most often refer to publicly traded insurance companies like UnitedHealth, Aetna, or Humana that provide individual and group health insurance plans. People are often covered by these types of plans through their employers but can also purchase them directly, or through an insurancemarketplace.

Privatepayors

Private payors sometimes refers to private insurance companies like Blue Cross Blue Shield. These plans are similar to commercial plans that are available through an employer, from the insurance company, or through a marketplace. Private pay for insurance can also include non-insurance payment for healthcare services such as paying cash directly for a service rather than going throughinsurance.

What’s the difference between “payor,” “payer” and“payee”?

The terms “payor” and “payer” have the same meaning and are often used interchangeably. The American Medical Association (AMA) recognizes “payor” as preferable.Definitive Healthcare has adopted the same standardspelling.

A payee is the party who receives payment in the exchange ofservices.

Payor (2024)

FAQs

Payor? ›

Payor is used interchangeably with “payer”. The person making the payment, satisfying the claim, or settling a financial obligation. For example, the person writing a check is the payor, or an employer paying their worker is the payor.

Which is correct, payor or payer? ›

What's the difference between “payor,” “payer” and “payee”? The terms “payor” and “payer” have the same meaning and are often used interchangeably. The American Medical Association (AMA) recognizes “payor” as preferable.

Who is the payor and payee? ›

A payor (also referred to as a “payer”) is the party that is submitting payment in a financial transaction or obligation. Payor is not to be confused with payee, which is the person or party who receives payment. For instance, a payor would be the drawer of a check while the payee is the recipient.

What is a payor in healthcare? ›

At base, a “payor” is the entity that pays for services rendered by a healthcare provider. The payor may be a commercial insurance company, government program, employer, or patient.

What is a payor in British English? ›

/ˈpeɪə(r)/ /ˈpeɪər/ (specialist) ​a person who pays or who has to pay for something; a payer.

What does payor mean? ›

Payor is used interchangeably with “payer”. The person making the payment, satisfying the claim, or settling a financial obligation. For example, the person writing a check is the payor, or an employer paying their worker is the payor.

Is it third party payor or payer? ›

The term is defined as 'an entity (other than the patient or health care provider) that reimburses and manages health care expenses.” Third-party payers include insurance companies, governmental payers, like Medicare, and even employers (self-insured plans).

Is the payor the recipient? ›

The person making the payment is the payor or obligor. The person receiving the payment is the payee or obligee.

What is the opposite of a payor? ›

Payees are the opposite of payors and usually consist of the person or group that provides a certain product or service to a customer. They are the recipient of cash, checks, debts, or other financial payment options or obligations from the payor.

Am I the payee or payer? ›

The payer is the one making a payment, and the payee is the one receiving the payment. While the difference might seem simple, it is worth understanding the differences in detail. A simple slip-up when writing these similar-looking terms on an invoice or contract can lead to unfortunate mix-ups down the line.

Is Medicare considered a payor? ›

Primary payers are those that have the primary responsibility for paying a claim. Medicare remains the primary payer for beneficiaries who are not covered by other types of health insurance or coverage.

Who is the payor in life insurance? ›

Payor. This is the person or entity that handles paying the premiums for the life insurance policy. Although uncommon, the insured, owner and the payor can all be different people. Most of the time, the person who owns the policy is also the insured and payor of that policy.

What is a payor on insurance card? ›

Payor: An insurance company that finances/reimburses the cost of health services for its members (example: Cigna, Aetna, etc.). Policy number/Member ID: A unique identification number assigned to an individual that allows Children's Mercy and your insurance company to review your specific policy terms and information.

What is a US payor? ›

A financial account maintained by a U.S. payor. A U.S. payor includes a U.S. branch of a foreign financial institution, a foreign branch of a U.S. financial institution, and certain foreign subsidiaries of U.S. corporations. Therefore, financial accounts with such entities do not have to be reported.

What does payor mean in banking? ›

The person or organization who pays.

Is it tax payer or payor? ›

The two words have the same meaning. They, however, draw a slight difference in their spelling and, more often than not, in the context in which they are applied. Payor is often used in legal work documents, while payer is used in other official settings, such as healthcare services.

How do you use payor in a sentence? ›

Payment must be received from the payor bank before the item may be credited to the depositor's account.

What does payer mean? ›

payer. /ˈpeɪ·ər/ a person who pays or owes money that should be paid.

Is there a word payer? ›

You can refer to someone as a payer if they pay a particular kind of bill or fee. For example, a mortgage payer is someone who pays a mortgage.

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