How industry works

Let’s see the basic flow of health care industry. Insurance company sells its products to individual or groups. It also set-up contracts with various health care providers so that it can get health care available for it’s members on cheaper rates.
Member goes to provider (physician or hospital) and then provider send claim to health plan.

This is very basic flow. Thus we see the healthcare pillers a)Member b) provider c) sales d) Benefits e) Claims