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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.

  • Understanding of how Major Medical Insurance works
  • Clarity on the different types of policies patients present with
  • Empowerment to answer difficult, policy related questions
  • Knowledge of the triangle that is the Practice/Insurance/Patient relationship
  • Key Understanding of the Federal BCBS Program benefit guidelines
  • Awareness of the value of reviewing Medical Review Policies

How Personal Health Insurance Works Implementation Guide

Fact Sheets:

  • Types of Insurance Policies
  • Glossary

Quick Questionnaire:

  • How Personal Health Insurance Works

Rapid Tutorial:

  • Major Medical Insurance Basics

Reference Tools:

  • BCBS FEP Benefit Plan
  • Aetna Medical Review Policy