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Note on Health Insurance Coverage, Coding, and Payment

By: Regina E. Herzlinger and Jo Ellen Slurzberg
  • Format:Print
  • | Language:English
  • | Pages:59
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Abstract

This note explains how health care innovators receive payment from government insurers, in the U.S. and abroad, and from private insurers. It explains each of the three steps needed to obtain reimbursement: coverage, coding, and payment. It also discusses how technology assessment techniques are used to reach coverage and payment decisions.

Keywords

Health Care Delivery; Health Care Costs; Health Insurance; Health Insurance Marketplaces; Health Care and Treatment; Cost; Insurance; Innovation and Invention; Private Sector; Public Sector; Decision Making; Information Technology; Health Industry; Insurance Industry

Citation

Herzlinger, Regina E., and Jo Ellen Slurzberg. "Note on Health Insurance Coverage, Coding, and Payment." Harvard Business School Background Note 313-042, August 2012. (Revised March 2021.)

About The Author

Regina E. Herzlinger

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