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43 - HCM - Healthcare Management & Administration

HCM 106 - Healthcare Insurance and Payment Systems

Code	Start Date	Duration	Venue
HCM 106	20 January 2025	5 Days	Istanbul	Registration Form Link
HCM 106	09 February 2025	5 Days	Istanbul	Registration Form Link
HCM 106	06 April 2025	5 Days	Istanbul	Registration Form Link
HCM 106	16 June 2025	5 Days	Istanbul	Registration Form Link
HCM 106	27 July 2025	5 Days	Istanbul	Registration Form Link
HCM 106	21 September 2025	5 Days	Istanbul	Registration Form Link
HCM 106	16 November 2025	5 Days	Istanbul	Registration Form Link

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Course Description

This course covers basic concepts and issues related to health insurance and payment systems for health care providers. Topics covered in the course include theories behind demand for health insurance, mechanisms through which people obtain health insurance, the impact of health insurance on health as well as payment arrangements for health care providers.

Course Objectives

Describe basic concepts related to health insurance coverage
Explain how both private health insurance and public health insurance are financed
Explain the ways in which private and public health insurers reimburse medical providers
Compare and contrast private and public financing and delivery models of healthcare services
Identify the various determinants of access to care for low income and vulnerable populations
Evaluate how specific policy proposals will likely affect access to care and healthcare spending
Analyze how the political process affects the financing and delivery of healthcare System

Who Should Attend?

Health care managers or supervisors,
Healthcare systems employees looking to provide cost-effective training opportunities,
Physicians, nurses, social workers, and healthcare professionals who have recently joined a managerial position,
Healthcare professionals at rehabilitation centers,
Those who intend to build their understanding of healthcare insurance and payment systems

Course Details/Schedule

Day 1

Introduction to Health Insurance
Life Cycle of an Insurance Claim
Introduction to Healthcare Reimbursement
Bundles
Health Care Reform/economics

Day 2

The Clinical Coding Reimbursement Connection
Healthcare Insurance Plans
Government Sponsored Healthcare Programs
Automate communications, billing and insurance payment

Day 3

Managed Care Plans
Prospective Payment Systems
Reimbursement issues
Coding for medical necessity

Day 4

Tricare
Workers’ compensation
Salaries and fringe benefits
Ambulatory payment systems
Revenue cycle management

Day 5

Quality Issues
Risk aversion
Accountable Care Organizations (ACOs)
Patient-centered medical homes
Pathways

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SAHARA Group Training and Consultancy INC (in Turkish: SAHARA Group Eğitim ve Danışmanlık AŞ)

Tax Office: Beyoğlu (Istanbul/Turkiye,Tax No: 7390525151 (Vergi Dairesi: Beyoğlu (İstanbul), Vergi No: 7390525151)

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(Click Category to List Courses)

43 - HCM - Healthcare Management & Administration

HCM 106 - Healthcare Insurance and Payment Systems

Course Description

Course Objectives

Who Should Attend?

Course Details/Schedule

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Day 5

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