Fundamentals of Health Insurance, Part B

Course Overview

Go from theory to real life. After you master the basics covered in Fundamentals of Health Insurance, Part A (Basics of Health Insurance), build from there by focusing on the operational side. The Fundamentals of Health Insurance, Part B (Company Operations) online self-study course provides a thorough introduction to the business principals, processes, and procedures that make health insurance work. You’ll come away with practical knowledge that helps you do your job even better.

What You’ll Learn
  • Explore how group health insurance plans are administered
  • Understand the landmark health care reform initiatives that underpin the health care industry
  • Gain a solid foundation in policy issuance, installation, and the renewal process
  • Get up to speed on premium billing and payment
  • Learn how to manage, submit, and process claims
  • Identify best practices for controlling operational costs
  • Assess how health insurance providers promote cost-effective health care
  • Put the brakes of fraud and abuse: learn how to define, detect, and prevent it
  • Nail the concepts behind product pricing strategies
  • Learn how to navigate the regulatory process at the state and federal levels
  • Understand how advances in health information technology lead to improvements in health care quality and efficiency
  • Dive into the concept of medical homes and see how their focus on preventive care lowers costs
  • Learn the elements, implementation, and expected return from wellness programs
  • Pinpoint who buys and sells health care and at what pricing levels
  • Assess the federal government’s role in advancing cost and quality transparency
Who Should Take This Course
  • Agents and brokers
  • Case managers
  • Health insurance provider staff
  • Medical directors
  • Technical business solutions advisors

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