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43 - HCM - Healthcare Management & Administration

HCM 106 - Healthcare Insurance and Payment Systems

Code Start Date Duration Venue
HCM 106 15 July 2024 5 Days Istanbul Registration Form Link
HCM 106 12 August 2024 5 Days Istanbul Registration Form Link
HCM 106 09 September 2024 5 Days Istanbul Registration Form Link
HCM 106 07 October 2024 5 Days Istanbul Registration Form Link
HCM 106 04 November 2024 5 Days Istanbul Registration Form Link
Please contact us for fees


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