Claims Management Essentials: Cost-Saving Strategies for Employees and Employers

Overview

Understand and master the various methods of medical claim reimbursements. This foundation is critical to understand health plan networks and how they function as the baseline for cost in fully insured and self-funded plans. This unit will expand on the previous unit's analysis of point solutions and how to build those into your plan design not only for the benefit if rate structures, but employees as well. The instructor will show you how to structure your medical plans to save the plan money by incentivizing the member through cost reduction programs.

Highlights

• Medical Claims

Prerequisites

None

Designed For

HR and Finance professionals

Objectives

• Medical Claim Reimbursement Continuum
• Reference Based Pricing
• Plan Design 101
• Learning to market your risk
• Point Solutions and how to use them
• Risk Management

Preparation

None