Assessing Medical Claims Related To The Digestive System

Overview of the diagnoses and treatment of digestive system conditions for effective red flagging

What you'll 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
Requirements
Currently or in future will be working as a medical claims assessor
Want to upskill and broaden claims assessment knowledge
Interested in insurance claims assessment
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 managedOther 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 claimClaims 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.

Overview

Section 1: Introduction

Lecture 1 Introduction to the course

Lecture 2 Introduction to the conditions of the digestive system

Section 2: Overview of the organs of the digestive system

Lecture 3 Anatomy of the organs and their functions

Section 3: Diagnosis of conditions related to the digestive system

Lecture 4 Overview of investigations used in diagnosing conditions

Lecture 5 Diagnosing gastroenteritis

Lecture 6 Diagnosing peptic ulcer disease (PUD)

Lecture 7 Diagnosing gastro esophageal reflux disease (GERD)

Lecture 8 Diagnosing gastritis

Lecture 9 When abdominal pain is a symptom

Section 4: Treatment and management of the conditions of the digestive system

Lecture 10 Introduction to the treatment and management of digestive system conditions

Lecture 11 Treatment and management of gastroenteritis

Lecture 12 Treatment and management of PUD

Lecture 13 Treatment and management of GERD

Lecture 14 Treatment and management of gastritis

Lecture 15 Treatment and management of abdominal pain

Section 5: When is hospitalization required?

Lecture 16 Introduction

Lecture 17 Hospitalization for gastroenteritis

Lecture 18 Hospitalization for GERD / PUD or gastritis

Lecture 19 Hospitalization for abdominal pain

Section 6: Other factors affecting the decision to admit a patient

Lecture 20 Factors that could result in hospitalization

Section 7: Real life cases studies

Lecture 21 Child with Gastroenteritis

Lecture 22 Middle aged female with Gastritis

Lecture 23 Middle aged female with abdominal pain

Section 8: Red flagging medical claims

Lecture 24 Reflagging medical claims

Section 9: Conclusion

Lecture 25 Thank you!

Medical claim assessors,Healthcare claim assessors