Overview
A health insurance course offers an in-depth and structured understanding of the health insurance industry, covering its fundamental principles, operational frameworks, regulatory guidelines, and the various socio-economic and policy-driven factors that shape its evolution. These courses are tailored for individuals aspiring to enter the healthcare or insurance sectors, professionals aiming to specialize in health insurance, or those engaged in related areas such as healthcare management, policy, or administration who require a more nuanced grasp of insurance mechanisms. Participants may include MBBS doctors, AYUSH practitioners, pharmacists, nurses, hospital administrators, insurance agents, or any other professionals involved in these dynamic and interrelated fields. The course equips learners with both theoretical knowledge and practical skills needed to navigate and contribute effectively to the health insurance ecosystem.
What You'll Gain
- Key concepts of health insurance, role of health insurance in Universal Health Coverage
- Models of healthcare financing
- Role of Insurance Regulator - IRDAI
- Concepts of health insurance underwriting and actuarial pricing,
- Understanding of the Health insurance claims management and reimbursement
- Standard medical terminology, formats and documentation for claims processing
- Pre-auth, claim approvals and payments
- Data standards and digital exchange platforms
- Different Coding methodologies- ICD, PCS, Snowmed City, ICHI etc.
- Challenges related to pre-existing disease (PED), non-disclosure, exclusions, Fraud etc
- Grievance Redressal
- Medico-Legal aspects.
Description
This comprehensive Professional Certificate in Health Insurance & Management offers participants a deep dive into the foundational principles, operational mechanisms, and strategic nuances of the health insurance industry. From the basic types of coverage to complex claims processing, regulatory compliance, and emerging industry trends, this course is designed to equip you with the knowledge and practical skills needed to thrive in this vital sector.
Curriculum
Learn the Healthcare financing and the role of health insurance in Universal Health Coverage, the various models of healthcare financing and the key concepts of health insurance
Understand the Indian health insurance market– the key stakeholders, customer segments and products including both self and government-funded health insurance schemes such as Ayushman Bharat Pradhan Mantri -Jan Arogya Yojana as well as the role played by Insurance Regulator - IRDAI, various Health Insurance Regulations in India, and the key provisions and guidelines pertaining to COVID-19
Learn key concepts of health insurance underwriting and actuarial pricing, the key products and clauses in health insurance- inclusions and exclusions, standard definitions etc.
Enhance in health tech with key concepts like - Data standards and digital exchange platforms, Different Coding methodologies- ICD, PCS, Snowmed City, ICHI etc. and the impact of the Ayushman Bharat Digital Mission (ABDM) on healthcare.
Enhance in health tech with key concepts like - Data standards and digital exchange platforms, Different Coding methodologies- ICD, PCS, Snowmed City, ICHI etc. and the impact of the Ayushman Bharat Digital Mission (ABDM) on healthcare.
Understand how to deal with key issues and challenges faced by key stakeholders in health insurance relating to pre-existing disease (PED), non-disclosure, exclusions, Fraud and abuse, Customer Experience and Grievance Redressal as well as Medico-Legal aspects.
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Frequently
Asked Questions
This course is open to All professionals in the healthcare service and insurance industries. Whether you're an MBBS doctor, AYUSH doctor, pharmacist, nurse, hospital administrator, or any other professional working in these dynamic sectors, you'll gain a wealth of valuable knowledge and practical skills.
9 hours to be complete (self-paced program to be completed within 6 months after enrolment.
Rs 6999/+GST
To receive the program completion Certificate, participants must thoroughly view all of the videos, activities, and exercises, as well as attempt both formative and summative assessments.