How to Answer the Question

If you have the right systems in place and ask the right questions, you'll be able to answer patients' questions about coverage.

Patient Experience

How to Answer the Question "Am I Covered?"

"Will my insurance cover this?" You either have heard this more times than you care to admit, or you will start hearing it as soon as you open your doors.


What will your answer be? Will you avoid the question?

Will you divert the question to your staff? What will be your system to handle this? I'm not going to answer those questions in this post, I am simply going to give some suggestions to consider as you answer them.

First and foremost, you need to have a set system in place. Nothing irritates a person more than a surprise bill coming from their doctor's office. I've had a number of clients come to me after seeing another chiropractor. The number one complaint has been a lack of clarity on the insurance question. Frustration abounds when there isn't a system in place.

Second, before you answer the questions, you need to know the answer to the question. No, this isn't a circular answer. It is a statement of a major problem that offices face. Even people with insurance cards that look similar may have different benefits. Assume nothing! Call on every single one to make sure you are imparting correct information to the client. More and more insurance companies are making this easier by publishing information online.

Third, addressing the question as soon as possible will help avoid future conflict. It can be uncomfortable talking with clients about money, but it is much easier talking about it beforehand when everyone is level headed, rather then later when they are angry about a bill. If for some reason you don't want to do it, make sure your staff is well trained to handle it. You should know what they are saying to your clients and make sure it is consistent with your goals for your practice.

Obviously there are a lot of nuances in dealing with this question, but to get your system started, please consider the previously mentioned three points.

Good luck!


The information in the NCMIC Learning Center is offered solely for general information and educational purposes. It is not offered as, nor does it represent, legal or professional advice. Neither does this information constitute a guideline, practice parameter or standard of care. You should not act or rely upon this information without seeking the advice of an attorney familiar with the specific legal requirements of the state(s) in which you practice. If there is a discrepancy between the site and an insurance policy you have with NCMIC, the policy will prevail.