What is a self-pay patient in the context of medical billing?

A self-pay patient refers to an individual who pays for medical services directly, without utilizing health insurance. This means that the patient takes on the full responsibility for the costs associated with their healthcare at the time of service or shortly thereafter. In this context, being a self-pay patient indicates that there is no third-party payer, such as an insurance company, involved in the payment transaction.

This scenario often occurs when patients either choose not to carry insurance, have a high deductible that they opt to pay out of pocket, or seek specific services that are not covered by their health benefits. By understanding that self-pay patients are those who directly cover their medical expenses, one can appreciate the billing processes and policies that may differ from those used when dealing with insurance claims.