Health insurance protects you and your family from financial hardship caused by unexpected accidents, illnesses, or disabilities. There are various health insurance policies that can help cover expenses during these times. It is important to note that some health insurance policies are short-term, meaning they cover a specific period. Therefore, you should verify the duration of the coverage and whether there is a guaranteed renewal option. Health insurance can be an independent policy or added to life insurance with additional benefits. Depending on the type of health insurance, the benefits may vary according to the duration and age.

Through this course, we aim to provide trainees with a comprehensive understanding of health insurance, the procedures for implementing it, and a focus on how to prepare health insurance programs, manage contract planning, and calculate premiums. Additionally, we will address common issues and mistakes faced by health insurance management, how to avoid them, and how to handle them if they occur, including identifying fraud in insurance and how to detect it.

Target Audience:

• All managers responsible for the insurance sector.

• All managers responsible for social insurance.

• All employees in the medical insurance department of insurance companies.

• All employees in the medical insurance department of service providers.

• Employees working in the medical insurance department in all institutions.

Program Objectives:

Equip participants with new skills and effectively enhance existing abilities through:

• Introducing participants to types of medical insurance.

• Introducing participants to the standards for managing medical insurance.

• Introducing participants to healthcare providers and the medical network.

• Introducing participants to managing policy issuance and claims.

• Managing medical insurance files.

• Negotiating medical insurance contract renewals.

• Correspondence related to medical insurance.

• Introducing participants to medical insurance contracts and various coverage options.

• Managing medical expenses and handling premiums and financing.

Overview
History of the Development of Health Insurance
Providers of Medical Services
Expected Benefits and Objectives of this Course
Principles and Conditions of Insurance
Health Insurance
Insurance Classifications
Health Insurance Procedures
Health Insurance Law
Continuous Health Insurance
Types of Health Insurance Policies
Types of Insurance
Health Insurance Law
Types of Health Insurance Policies
Permanent Health Insurance Coverage
Designing Health Insurance Programs
Deductibles and Co-payments
Designing Health Insurance Programs
Cost of Deductibles and Co-payments
Methods for Managing and Planning Insurance Contracts
Health Insurance Correspondence
Issuances and Claims
Medical Expense Management and Premiums and Financing Management
Self-Funded Health Insurance Funds
Claims and Calculation Methods
Method of Calculating Health Insurance Premiums and Key Factors Affecting the Insurer's (Insurance Company) Decision
Introduction to Medical Services
How to Calculate Premiums for Health Insurance
Insurance Companies and Insured Persons
Medical Service Providers
Healthcare Systems
Personal Accident Policy – Definition, Importance, and Its Relationship with Medical Accidents
Recent Amendments to Insurance Contracts
Identifying Insurance Fraud and How to Detect It
Applications of Health Insurance