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HealthCare Insurance Training
Live Online & Classroom Enterprise Training
Understand the foundations, policies, and processes of healthcare insurance systems, including coverage types, claims management, and regulatory compliance.
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What is HealthCare Insurance Training about?
What are the objectives of HealthCare Insurance Training ?
Who is HealthCare Insurance Training for?
What are the prerequisites for HealthCare Insurance Training?
Available Training Modes
Live Online Training
2 DaysCourse Outline Expand All
Expand All
- History & Evolution of Health Insurance
- Key Stakeholders: Insurers, Policyholders, Regulators
- Types of Health Insurance (Individual, Group, Government Schemes)
- Role of Third-Party Administrators (TPAs)
- Basic Economic Concepts in Healthcare
- Supply & Demand in Health Insurance
- Cost-Benefit Analysis in Health Policies
- Economic Impact of Universal Health Coverage
- Health Insurance Policy Structure
- Policy Design, Pricing & Premium Calculations
- Reinsurance in Health Insurance
- Claims Processing & Settlement Procedures
- Underwriting & Actuarial Role in Policy Development
- Individual vs. Group Health Insurance
- Critical Illness & Disease-Specific Plans
- Senior Citizen & Maternity Health Insurance
- Top-Up & Super Top-Up Plans
- Wellness & Preventive Health Insurance
- IRDAI Guidelines & Compliance
- Consumer Protection Laws & Policyholder Rights
- Fraud Prevention & Anti-Money Laundering in Insurance
- HIPAA, GDPR & Data Protection Regulations
- Ethical & Legal Challenges in Health Insurance
- Risk Assessment & Underwriting Guidelines
- Pre-existing Conditions & Exclusions
- Actuarial Principles in Underwriting
- AI & Data Analytics in Underwriting
- Underwriting Challenges in High-Risk Cases
- Risk Identification & Mitigation Strategies
- Cashless vs. Reimbursement Claims Processing
- Claims Adjudication & Settlement Procedures
- Medical Fraud Detection & Prevention
- Customer Experience in Claims Management
- Basics of Medical Coding
- Coding Systems (ICD, CPT, HCPCS)
- Role of Medical Coding in Health Insurance
- Medical Billing & Claims Processing
- Overview of ICD-10 Coding System
- ICD-10 Implementation & Compliance
- Medical Record Documentation & Accuracy
- ICD-10 in Claims & Fraud Detection
- Role of Technology in Health Insurance
- Key Health Insurance Software (PegaSystems, Oracle Insurance, Applied Rater, Audit Stream)
- AI & Machine Learning in Claims Management
- Blockchain & Smart Contracts in Health Insurance
- InsurTech Innovations & Automation
- Comparative Analysis of Health Insurance Models (US, UK, India, Europe)
- International Health Insurance Regulations
- Cross-Border Health Insurance Policies
- Role of Medical Tourism in Health Insurance
- Hospital Empanelment & Network Agreements
- Negotiation of Insurance Contracts with Healthcare Providers
- Cashless Treatment Procedures
- Coordination Between Insurers & Hospitals
- Fundamentals of Actuarial Science in Insurance
- Predictive Modelling & Risk Scoring
- Data Analytics in Claims Processing
- AI & Big Data in Health Insurance Decision-Making
- Customer Expectations & Service Quality in Health Insurance
- Digital Marketing in Health Insurance
- Distribution Channels: Agents, Brokers, Online Platforms
- CRM & Customer Retention Strategies
Who is the instructor for this training?
The trainer for this HealthCare Insurance Training has extensive experience in this domain, including years of experience training & mentoring professionals.
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