ABSTRACT
Healthcare Payment Systems: A Historical Perspective The fundamental model for healthcare payment involves only two parties: the patient receiving services and the healthcare provider dispensing services. The payment process is quite simple: The provider charges for the services, and the patient pays for the services. This fundamental model is still used for what are termed self-pay patients. Over time, a third party was interjected into this fundamental model, and the process became more complex. The third party was generally an insurance company or government program that paid for some or all medical services on behalf of the patient. For the third party to make payment, a claim had to be filed and adjudicated. While the responsibility for filing claims actually lies with the patient, today, for a variety of reasons, healthcare providers file claims on behalf of their patients.
