Covid 19 Claim Assessment For Assessors

A framework for assessing the validity of admission for the treatment of COVID 19 to prevent insurance fraud

What you'll learn
Framework for the assessment of COVID 19 Insurance Claims
Identification of irregularities in fraudulent COVID 19 claims
Understanding COVID 19 and how it is treated
Requirements
Interest in medical claims assessment
Description
We had no way to know or prepare for the devastating impact of COVID 19! The insurance industry is vulnerable to fraud in general and COVID 19 related health claims pose a special risk! Training mitigates fraud! This course was created for medical assessors, insurance claims assessors or insurance adjustors who work with health-related insurance products. COVID 19 is a growing reality and has already impacted the insurance industry globally. The material in the following lectures will assist you in assessing claims for COVID 19 admissions to determine the validity of the claim and to identify red flags that could indicate irregularities, abuse and potential fraud. Fraud occurs in various forms within the insurance industry and the global pandemic may be exploited for the purpose of committing fraud in one specific area that we identified.By focusing on how COVID 19 is diagnosed, treated and managed the claims assessor is equipped to identify red flags that will make assessment effective and potentially prevent fraud from being committed. Red flagging at the claims stage is critical for the identification and remains the most effective method of prevention of health-related insurance fraud. The information contained in this course can be applied to hospital cash back insurance products, medical aide or medical scheme claims or illness and disability claims and in claims where the length of admission or severity of the disease impacts the quantum or value of the claim.No prior medical training is required and the information in the course can be applied to claims the world over. This is an all level course, beginner to advanced will find value in this course.

Overview

Section 1: Introduction

Lecture 1 Introduction

Section 2: The assessment of COVID 19 claims

Lecture 2 Overview of the claims assessment process

Lecture 3 History of COVID 19

Lecture 4 Risk factors for severe disease progression

Lecture 5 Signs & Symptoms of COVID 19

Lecture 6 Clinical investigations

Lecture 7 Determining the severity of the disease

Lecture 8 Case studies

Lecture 9 Treatment of COVID 19

Lecture 10 The discharge of COVID 19 admissions

Section 3: Summary

Lecture 11 Summary

Medical assessors,Claims assessors,Insurance assessors,Insurance adjustors,Insurance investigators