Basic Claim Assessment for Day-In-Hospital Benefits

Are you a claims assessorthat works with or wishes to work with medical / health related products?

Do you want tobroaden your knowledge baseabout or gain insightinto medical / health related claims?

Specifically how to assess claims that for a benefit that will pay out for every day that the insured client is admitted?

This is the course for you!

This course is designed to equip you with insight into how to assess and therefore red flag and verify these types of claims and ultimately to prevent the payment of potentially fraudulent claims by learning about:

• Why effective claims assessment is necessary

• The reasons that fraud is committed

• Current trends in fraud related to the above mentioned insurance products

• How to verify diagnosis, treatment and hospitalizations

• Using medical documents as an integral part of the claims process

I also provide case studies of actual, real life admissions I have reviewed and giving expert opinion on as well as investigations I have performed in the past to demonstrate how to use the above knowledge to assess your claims effectively and red flag suspicious claims and potentially form a basis for repudiation or rejection of the claim

Claims assessorsare the first line of defense against insurance fraud, they are the gate keepers that prevent abuse of insurance products and detect fraud by spotting discrepancies and asking questions. The skill and abilityto do this can be learned as your deepen your insight into the assessment of insurance claims

This will help you in your career and build your confidence as a medical claims assessor and allow you to stand out among your peers.

PLUS!

I have added some EXTRA videos for enhanced and deepened learning to this course to take your knowledge to the next level. These include: 

1. Extra: Criteria for red flagging claims for admissions related to COVID 19

2. Extra: A discussion on a previous parastatal investigation related to massive medical fraud including document tampering and falsification of admissions

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Frequently Asked Questions

How long do I have access to the course materials?

You can view and review the lecture materials indefinitely, like an on-demand channel.

Can I take my courses with me wherever I go?

Definitely! If you have an internet connection, courses on Udemy are available on any device at any time. If you don’t have an internet connection, some instructors also let their students download course lectures. That’s up to the instructor though, so make sure you get on their good side!