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Medical Insurance Management

couse code : mim 001

course hours : 16 hours

PREQ: N/A

Course Description

The course is designed to develop an understanding of the basic concepts and procedures needed for performing the tasks involved in medical insurance forms as well as insurance claim forms. Knowledge of basic definitions and how to apply those definitions to medical documentation is also gained. Moreover, the course covers the medical benefits, their design and the factors that are observed. Additionally, different types of medical insurance coverage companies are included.

Learning Outcomes

By the end of the course, the participant will be able to:

  • Understand medical benefits, insurance plans and types of contracts
  • Identify types of companies participating in the medical cover
  • Design a medical network
  • Identify discrepancies within the medical providers’ pricing
  • Deal with local/imported drugs
  • Handle commonly covered acts under insurance plans
  • Deal with expenses/medical acts not reimbursed under insurance plans
  • Employ group/Individual approaches and techniques
  • Interact with legal and contractual frameworks
  • Carry out types of pricing
  • Handle extensions and waiting periods
  • Apply reimbursement processes
  • Deal with insurance companies
  • Handle third party administrators (TPA)

Date

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