Glossary Entry

Health Insurance > Insurance plan operations

Needs a little more detail
Subtopics: Enrollment, premium accounting, claims, provider contracting, member services, sales/marketing, information technology, finance, accreditation, subcontracting (pharmacy, behavioral health, specialty care) and underwriting.

Learning Objectives:

Undergraduate students should be able to 
  1. List the key operational functions of a health plan
Graduate students should also be able to
  1. Analyze key operational functions of a health plan for their impact on plan profitability
  2. Analyze key operational functions of a health plan for their impact on member and provider satisfaction
Created By: Gerod Blue 12-18-2012
Last Updated By: Gerod Blue 12-18-2012
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