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How Personal Health Insurance Works

Understand how Major Medical Insurance affects the balance between the patient's responsibility and the carrier's responsibility, your responsibilities as a provider, and benefits and coverage.

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Personal health benefits, also known as Major Medical Insurance Benefits, play a key and active role in many chiropractic offices. Amazingly, many offices function by accepting Major Medical Insurance with no true understanding of how it works, what the differences are in the policies and the relationships that come into play between the insurance company, the patient and the provider's office.

A keen understanding of how Major Medical Insurance works is essential to ensure the most confident and prepared team members. Your knowledge concerning the ins and outs of personal health benefits is the key to being prepared to answer questions posed by patients. This understanding also equips you to handle those insurance issues that arise in every chiropractic practice such as refusal to pay, incorrect benefits given by the insurance companies and patients lack of understanding of their personal responsibility as compared to their insurance companies' responsibility, benefits and coverage.

  • Differentiate between and explain the various types of plans and polices patients present
  • Discuss exactly how commercial health insurance works in the chiropractic office
  • Confidently answer difficult policy-related questions
  • Identify and collect the correct patient deductibles, co-insurances, and co-payments for services rendered
  • Demonstrate a strong familiarity with managed care
  • Apply Medical Review Policies and Medical Necessity where appropriate

Commercial Health Insurance Basics Implementation Guide

Fact Sheets:

  • Types of Insurance Policies
  • Managing Managed Care
  • What is MRP-Why Does it Matter?

Rapid Tutorial Videos:

  • Commercial Health Insurance Basics (11 minutes)
  • Understand Various Insurance Plans (11 minutes)
  • Managed Care Madness (7 minutes)

Self Assessment:

  • Commercial Health Insurance Basics

Support Tool:

  • Carrier and Verification Reference Tool
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