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 Medical Insurance Management S1373 QR Code
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Medical Insurance Management



This course offers an overview of the medical terms, concepts, and language generally used in clinical practice settings. Classes in word construction and definition, pronunciation, Latin language roots, and spelling are designed to provide students with a fundamental knowledge of human anatomical names, diagnostic terms and medical procedures. The course is typically offered at the beginning of the program.

Course Objectives:

At the end of this course the participants will be able to:

  • Introduce participants to types of health insurance.
  • Introduce participants to medical and medical providers.
  • Define the participants in issuing and claims management.
  • Manage health insurance file.
  • Negotiate the renewal of contracts with health insurance.
  • Define health insurance contracts and various coverage.

Targeted Audience:

  • All managers are 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:

Unit 1: Introduction:

  • Insurance providers.
  • Origin of insurance and risk management.
  • Objectives and benefits.
  • Insurance terms and principles of insurance.

Unit 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.

Unit 2: 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.

Unit 3: Technical Study of Medical Insurance:

  • Introduction to the health care delivery system.
  • Coverage in health insurance.
  • Negotiate the renewal of contracts with health insurance.

Unit 4: Personal Accident Document and its Importance for Medical Insurance Contract:

  • Definition of personal accident document.
  • Coverage of personal accident document.
  • Linking personal accidents to medical records.

Unit 5: Disclosure of Fraud in Medical Insurance:

  • Disclosure of fraud in medical insurance.
  • Fraud Detection Methods.

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