The Best Healthcare and Hospital Management Training Courses


Medical Insurance Management Training Course

Introduction:

Medical insurance is one of the most important financial sources that covers the cost of medical treatment in the private health sector. It’s a contract between the health insurance holder and the insurance company. Medical insurance has conditions, and the purchaser of the insurance contract must read it carefully to be fully aware of all terms.

Also, individual and group insurance contracts include disclosure in the insurance application, referring to the statements in the application; either the company accepts the insurance, rejects it, or covers it on limits. After the contract is issued, the insured benefits from the network of service providers contracting with his insurance company.

The insured goes to the service provider (Hospitals, Clinics, Doctors, Pharmacies, etc.) and requests approval for the treatment. In this service, the beneficiary obtains approval or rejection of the service based on the terms of the contract.

Throughout this course, we will delve into the intricacies of medical insurance management, focusing on the role of the medical insurance manager and the critical importance of global medical management insurance.

By participating in our comprehensive medical insurance training and following the robust medical insurance course syllabus, individuals will gain the expertise needed for executing effective medical management programs in insurance.

Target groups:

  • All managers are responsible for the insurance sector.
  • All managers in charge of social insurance.
  • Employees of the health insurance department in insurance companies.
  • Staff working in the health insurance department of service providers.
  • Health insurance department employees across various institutions.
  • Individuals seeking to enhance their skills and experience in medical insurance management.

Course Objectives:

At the end of this medical insurance management course, participants will be able to:

  • Differentiate between individual and group contracts.
  • Recognize various group insurance types.
  • Acquire knowledge of different health insurance.
  • Understand medical providers and their networks.
  • Grasp the concepts of underwriting and claims management.
  • Become proficient in managing health insurance files.
  • Develop skills for negotiating health insurance contract renewals.
  • Learn efficient health insurance correspondence.
  • Comprehend health insurance contracts and diverse coverages.
  • Master medical expense management and premium management.

Targeted Competencies:

Upon the end of this medical insurance management Training, participants competencies will:

  • Understand Medical Insurance Policies and Regulations.
  • Claims Processing and Adjudication.
  • Risk Management in Health Insurance.
  • Customer Service and Communication Skills.
  • Data Analysis and Reporting.
  • Fraud Detection and Prevention.
  • Medical Billing and Coding.
  • Compliance and Ethical Standards.
  • Financial Management and Budgeting.
  • Health Informatics and Technology Use.
  • Strategic Planning and Policy Development.
  • Provider Relations and Contracting.
  • Quality Assurance and Improvement.

Course Contents:

  • The inception of insurance and risk management.
  • Detailed exploration of medical insurance.
  • Medical insurance contract management.
  • Technical study of medical insurance.
  • Financial details of medical insurance.
  • Significance of personal accident documents in medical insurance contracts.
  • Strategies to detect medical insurance fraud.

Unit 1: Health Insurance The Origin, Objectives, Principles:

  • Insurance providers and their roles.
  • The origins of insurance and the practice of risk management.
  • Objectives and primary benefits of health insurance.
  • Key terms and foundational principles in insurance.

Unit 2: Medical Insurance:

  • Various types of insurance.
  • Legislation governing health insurance.
  • Health insurance policy categories.
  • Coverage under permanent health insurance.
  • Framework for structuring health insurance programs.
  • Overview of deductibles and cost-sharing measures.

Unit 3: Medical Insurance Contract Management:

  • Efficient health insurance correspondence.
  • Roles of the underwriter and claims adjuster.
  • Medical expense and premium management, including financing.
  • Self-financed health insurance funds and their operation.
  • Claim calculation methods.
  • Factors influencing health insurance premiums and insurer decisions.
  • Relationships with medical service providers.

Unit 4: Technical Study of Medical Insurance:

  • Introduction to healthcare delivery systems.
  • The extent of coverage considerations in health insurance.
  • Strategies for negotiating health insurance contract renewals.

Unit 5: Financial Study of Medical Insurance:

  • The concept of the actuarial study in health insurance.
  • Applications of actuarial studies in the field.
  • Essential skills for health service providers.
  • The role of reinsurance in pricing health insurance.

Unit 6: Personal Accident Document and its Importance for the Medical Insurance Contract:

  • The definition of personal accident documents.
  • Policy coverage under personal accident insurance.
  • The interconnectedness of personal accident documents and medical insurance.

Unit 7: Detecting Medical Insurance Fraud:

  • The significant impact of fraud on insurance contracts.
  • Tactics for identifying medical insurance fraud.
  • A variety of fraud detection methodologies.

Istanbul (Turkey)
14 - 18 Jul 2024
4200 Euro
Manama (Bahrain)
28 Jul - 01 Aug 2024
3900 Euro
Cairo (Egypt)
04 - 08 Aug 2024
3000 Euro
Istanbul (Turkey)
11 - 15 Aug 2024
4200 Euro
Madrid (Spain)
12 - 16 Aug 2024
4900 Euro
Vienna (Austria)
26 - 30 Aug 2024
4900 Euro
Cairo (Egypt)
01 - 05 Sep 2024
3000 Euro
Istanbul (Turkey)
01 - 05 Sep 2024
4200 Euro
Istanbul (Turkey)
08 - 12 Sep 2024
4200 Euro
Kuala Lumpur (Malaysia)
15 - 19 Sep 2024
3900 Euro
Barcelona (Spain)
16 - 20 Sep 2024
4900 Euro
Istanbul (Turkey)
29 Sep - 03 Oct 2024
4200 Euro
Rome (Italy)
07 - 11 Oct 2024
4900 Euro
Milan (Italy)
07 - 11 Oct 2024
4900 Euro
Istanbul (Turkey)
13 - 17 Oct 2024
4200 Euro
Munich (Germany)
28 Oct - 01 Nov 2024
4900 Euro
London (UK)
28 Oct - 01 Nov 2024
5200 Euro
Dubai (UAE)
03 - 07 Nov 2024
3900 Euro
Geneva (Switzerland)
11 - 15 Nov 2024
5500 Euro
Online
24 - 28 Nov 2024
1500 Euro
Sharm El-Sheikh (Egypt)
24 - 28 Nov 2024
3500 Euro
Paris (France)
09 - 13 Dec 2024
4900 Euro
Casablanca (Morocco)
16 - 20 Dec 2024
3000 Euro
Kuala Lumpur (Malaysia)
22 - 26 Dec 2024
3900 Euro
Istanbul (Turkey)
22 - 26 Dec 2024
4200 Euro
Istanbul (Turkey)
05 - 09 Jan 2025
4200 Euro
London (UK)
06 - 10 Jan 2025
5200 Euro
Amman (Jordan)
12 - 16 Jan 2025
2900 Euro
Kuala Lumpur (Malaysia)
12 - 16 Jan 2025
3900 Euro
Istanbul (Turkey)
19 - 23 Jan 2025
4200 Euro
Barcelona (Spain)
20 - 24 Jan 2025
4900 Euro
Dubai (UAE)
26 - 30 Jan 2025
3900 Euro
Boston (USA)
10 - 14 Feb 2025
5500 Euro
Madrid (Spain)
10 - 14 Feb 2025
4900 Euro
Istanbul (Turkey)
16 - 20 Feb 2025
4200 Euro
Amman (Jordan)
16 - 20 Feb 2025
2900 Euro
Dubai (UAE)
02 - 06 Mar 2025
3900 Euro
Istanbul (Turkey)
02 - 06 Mar 2025
4200 Euro
Online
09 - 13 Mar 2025
1500 Euro
Lisbon (Portugal)
10 - 14 Mar 2025
4900 Euro

The Best Healthcare and Hospital Management Training Courses
Medical Insurance Management Training Course (HL)

 

Mercury dynamic schedule is constantly reviewed and updated to ensure that every category is being addressed at least once a month, if not once every week. Please check the training courses listed below and if you do not find the subject you are interested in, email us or give us a call and we will do our best to assist.