Introduction
Methods of obtaining, organizing, storing, and transferring patient health information are discussed in this course, along with potential concerns for information managers to remember. Students learn the latest health information technology to manage individual patient health history and test information while gaining an understanding of current health information privacy laws. This course may be taken in the second year of a master's degree program.
Course Objectives of Medical Insurance Management
- To introduce participants to types of health insurance
- Introducing participants to medical and medical providers
- Define the participants in issuing and claims management
- Manage health insurance file
- Negotiate renewal of contracts with health insurance
- Health Insurance Correspondence
- Definition of health insurance contracts and various coverage
- Management of medical expenses and management of premiums and finance
Course Target Audience of Medical Insurance Management
- All managers responsible for the insurance sector.
- All managers are responsible for social insurance.
- All employees of the health insurance department in insurance companies.
- All employees of the health insurance department of service providers.
- Employees working in the health insurance department in all institutions
Course Outlines of Medical Insurance Management
Day 1: An introduction
- Insurance providers
- Origin of insurance and risk management
- Objectives and benefits
- Insurance terms and principles of insurance
Day 2: Medical Insurance
- Types of insurance
- Health insurance law
- Types of health insurance policies
- Permanent health insurance cover
- Preparation of health insurance programs
- Overpayments and Endurance Rates
Day 3: Management of medical insurance contract
- Health Insurance Correspondence
- Versions and Claims
- Management of medical expenses and management of premiums and finance
- Self-financing funds for health insurance
- Claims and methods of calculation
- Method of calculating the health insurance premium and the most important factors affecting the insured's decision (insurance company)
- Medical Services
Day 4: Technical study of medical insurance
- Introduction to health care delivery system
- Coverage in health insurance
- Negotiate renewal of contracts with health insurance
Day 5: Personal accident document and its importance for a medical insurance contract
- Definition of personal accident document
- Coverage of personal accident document
- Linking personal accidents to medical records
Disclosure of fraud in medical insurance
- Disclosure of fraud in medical insurance
- Fraud Detection Methods
