Final answer:
Patients receiving services from a NON PAR provider are generally expected to pay a reduced amount after insurance considerations, such as deductibles and co-insurance. Non-participating providers have not agreed to an insurer's terms, which can mean less coverage and higher out-of-pocket expenses for patients.
Step-by-step explanation:
Patients that receive services from a NON PAR provider expect to pay a reduced amount after insurance coverage, which involves the deductible, co-payments, and any co-insurance rates that may apply. Non PAR providers (Non-Participating Providers) are those who have not agreed to the insurance company's terms, therefore, often patients will pay more out-of-pocket because the insurance will cover less of the total fees. In a traditional fee-for-service health financing system, these providers are paid according to the services they provide, which could result in higher charges for patients if insurance reimbursement rates are lower for non-participating providers.
The costs to the patient can also be influenced by the type of insurance plan. For instance, with a Health Maintenance Organization (HMO) plan, providers are paid a fixed amount regardless of the number of services provided, encouraging patients to use in-network providers for their services, thus minimizing costs. If patients opt to use non-participating providers, they must be prepared to cover more of the costs themselves. This contrasts with the deductible, a predefined amount that must be paid by the insured before the insurance plan starts to pay, and which might be higher when using a non-participating provider.