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Medical Insurance Management

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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)

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