Learning Outcomes

Describe the basic features of medical insurance policies.

Compare indemnity and managed care plans.

Discuss the fee-for-service and the capitation methods of payment for medical services.

Compare health maintenance organizations, point-of-service plans, and preferred provider organizations.

Describe the key features of a consumer-driven health plan.

Describe the major types of payers for medical insurance.

List the ten steps in the medical billing process.

Identify the most important skills of medical insurance specialists.

Discuss the types of health care organizations that employ medical insurance specialists.

Compare medical ethics and etiquette.