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Click here for more sample CPC practice exam questions and answers with full rationale

Understanding Insurance Types Part 1: Workers’ Comp & No-Fault

In this day and age, the vast majority of people have some form of medical insurance when they visit a provider. While this may sound relatively straightforward, there are several different insurance types, and each one has its own unique attributes. If you are a medical biller or a front desk employee, reviewing these different varieties of insurance is essential to providing a proper level of care to your patients.

Though private insurance is the most common of the insurance types, it has so many different flavors that it deserves its own article. On the other hand, workers’ compensation and no-fault insurance are both slightly rarer forms that don’t always get as much attention. Both of these insurance types require a monthly premium, although the exact amount (as well as whether these options are even available in the first place) vary from state to state.

Workers’ compensation and no-fault insurance each apply only to specific scenarios. As implied by the name, workers’ comp is provided by the employer in order to help employees in the event of accidents and injuries while on the job. In contrast, no-fault insurance stems from automobile insurance policies and helps cover medical bills in the event of a car accident. Because these insurance types are provided by third parties, all claims must be filed directly with the employer or auto insurance provider, respectively. In addition, these policies only cover the specific body areas that were harmed in the accident and not illnesses or injuries arising from other matters. Many states have laws requiring patients to accept no-fault and workers’ comp policies as payment in full for the sustained injuries, though this rules can vary based on region, deductibles, and case settlements.

Stay tuned for a follow-up article which will dive more deeply into explanations of private insurance and its many policies.