Assessing medical claims related to the digestive system
Overview of the diagnoses and treatment of digestive system conditions for effective red flagging
Description
Are you a claims assessor that works with medical / health related products?
Do you want to broaden your knowledge base about or gain insight into medical / health related claims?
Specifically those that are related to conditions affecting the digestive system?
This is the course for you!
This course is designed to equip you with insight into how to red flag and therefore identify potentially fraudulent claims for conditions related to the digestive system by learning about:
The anatomy of the digestive system
The function of the organs of the digestive system
How conditions of the digestive system are diagnosed, treated and managed
Other factors that affect the decision to admit a patient
How to red flag claims for admissions related to conditions of the digestive system
I also provide case studies of actual, real life admissions I have reviewed and giving expert opinion on in the past to demonstrate how to use the above knowledge to red flag suspicious claims and potentially form a basis for repudiation or rejection of the claim
Claims assessors are 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 ability to this can be learned as your deepened your insight into the human body, its functions, pathology and treatment of pathology.
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.
What You Will Learn!
- Medical insurance claims assessment
- Anatomy of the digestive system
- Functions of the digestive system
- Conditions of the digestive system
- Diagnoses and treatment of conditions of the digestive system
- Determining when hospitalization is required
- Red flagging medical / health care claims related to the digestive system
Who Should Attend!
- Medical claim assessors
- Healthcare claim assessors