Fundamentals Of Health Insurance, Part B (Basics Of Company Operations)



This online course is a survival guide when it comes to understanding health insurance operations. You’ll gain a thorough introduction to business basics, including issuance and installation of policies; policy renewal and changes; premium billing and payment; claims administration; pricing; and state and federal regulation of insurance. Recently expanded and now offered in a convenient online format, this course brings you up to date on new developments, such as wellness programs, the medical home concept, health information technology, price and quality transparency, and landmark health care reform initiatives. To facilitate study and review, short quizzes are included in each section of the course.

What You’ll Learn

  • The administration of group health insurance plans
  • Procedures for issuance and installation of policies
  • Policy renewal processes
  • Premium billing and payment
  • How to manage, submit, and process claims
  • How to control operational costs
  • How to promote cost-effective health care
  • The definition, detection, and prevention of health insurance fraud and abuse
  • Product pricing strategies
  • Insurance regulation, including roles of federal and state government
  • Improvements in health care quality and efficiency associated with health information technology
  • How the medical home concept helps lower costs by focusing on preventive care
  • Elements, implementation, and expected return from wellness programs
  • Who buys and sells health care and at what prices
  • Federal role in advancing health cost and quality transparency
  • Relevant terms and key concepts

Who Should Take This Course

  • Employees of health insurance companies, especially those who need a basic orientation to health insurance principles and operations
  • Agents and brokers who specialize in group and individual health plans
  • Case managers and medical directors who seek a broader administrative background
  • Technical business solutions advisors who seek more knowledge in client operations
  • Consumers and others in related fields who seek expertise in this area


  • $165 AHIP Members
  • $215 Non-members

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Health Insurance Nuts and Bolts: An Introduction to Health Insurance Operations

  • $40 AHIP Members
  • $50 Non-members

Earn a Designation

This course is good towards earning the following professional designations:

Health Insurance Associate (HIA®)
Disability Healthcare Professional (DHP)
Healthcare Customer Service Associate (HCSA)
Managed Healthcare Professional (MHP)