Introduction 

This training program, designed by Global Horizon Training Center, covers methods of obtaining, organizing, storing, and transferring patient health information, alongside emerging issues for information managers to consider. Participants will explore the latest health information technologies, current health information privacy laws, and how to integrate preventive health insurance models to improve patient outcomes and financial sustainability. This course may be taken in the second year of a master’s degree program.

Objectives

• Introduce participants to types of health insurance and medical providers.

• Define participants' roles in issuing policies and claims management.

• Manage health insurance files effectively.

• Negotiate the renewal of contracts with health insurance providers.

• Enhance understanding of health insurance correspondence.

• Clarify health insurance contracts and various coverage types.

• Manage medical expenses, premiums, and finance.

• Explore preventive health insurance models and their impact.

• Promote integration of preventive services and wellness initiatives within insurance frameworks.

Target Audience

• Managers responsible for the insurance sector.

• Managers responsible for social insurance programs.

• Employees of the health insurance department in insurance companies.

• Employees of the health insurance department in service provider organizations.

• Employees working in health insurance departments in all institutions.

Course Outlines

Day 1: Introduction to Health Insurance & Information Management

• Overview of insurance providers and the origin of insurance.

• Key insurance terms and principles of insurance.

• Risk management fundamentals in health insurance.

Day 2: Health Insurance Structures & Law

• Types of insurance and health insurance policies.

• Health insurance law and regulatory frameworks.

• Permanent health insurance cover and essential compliance factors.

Day 3: Medical Insurance Management

• Preparation of health insurance programs.

• Overpayments and endurance rates.

• Managing medical insurance files effectively.

Day 4: Claims Management & Financial Controls

• Health insurance correspondence best practices.

• Claims management and calculation methods.

• Managing medical expenses, premiums, and financing for insurance plans.

Day 5: Technical Study of Medical Insurance

• Introduction to health care delivery systems and their link to insurance.

• Coverage structures in health insurance and challenges faced.

• Negotiation techniques for renewing contracts with health insurance providers.

Day 6: Preventive Health Insurance Concepts

• Overview of preventive health insurance models and their global adoption.

• Importance of preventive care in reducing long-term costs and improving health outcomes.

• Integration of wellness initiatives in insurance policies.

Day 7: Building a Preventive Health Insurance Framework

• Designing health insurance packages that include preventive services (vaccinations, screenings, wellness exams).

• Incorporating health promotion and disease prevention into insurance coverage.

• Legal and regulatory considerations for preventive health insurance.

Day 8: Financial Aspects of Preventive Health Insurance

• Cost-benefit analysis of preventive models in insurance.

• Methods for calculating preventive care premiums.

• Strategies for encouraging uptake of preventive health insurance.

Day 9: Managing Fraud and Risk in Preventive Health Insurance

• Techniques for detecting and managing fraud within preventive health insurance.

• Linking personal accidents and preventive health initiatives.

• Fraud detection and prevention methods tailored to preventive health insurance.

Day 10: Best Practices and Future Trends in Health Insurance

• Case studies: Successful integration of preventive models in health insurance globally.

• Future trends and innovations in health insurance.