We live in an unstable world and the catastrophic events like the Tsunami Disaster, earthquake, flood, volcanic eruptions etc. And the compensation against such loses is a remarkable one. Thus Insurance is the sole factor that supports human beings under such losses. This tutorial will explain you all the basic facts that you need to know about the Insurance domain. The insurance industry is a vast one and there are several types of insurance and various terminologies that are used in this industry.
+ Health Insurance Interview Questions and Answers, Question1: What is Coinsurance for health insurance policy? Question2: My father's age is 55, central. Interview questions about Businesss Analyst and Healthcaret hat are Real time interview Health Insurance Domain Healthcare Domain Course Material. Industry Domain Knowledge for Software Testers, Healthcare Domain The health care industry, or medical industry, is a sector that provides.
Romans speak different English. So at initial level to understand the accent can be a challenge but after some time you will become perfect What is your understanding on Risk and Issue?
Health insurance domain interview questions
Risk is something which can be forecasted and can be handled by formulating mitigation plans. Risk which happened is called Issue. There will be contingency management or issue management to solve issue. Basically we will be not solving the issue but will try making Damage control and take it as learning for other projects. What would you do if you haven't received all the required signoffs on phase documentation submitted for approval?
Highlight risk management process - how to flag these? Resolution - of such scenarios, by working alongside PM. Explain how you organize or prioritize your workload Make a list. Work out what order to do things in by thinking about which tasks are urgent and how important each task is. Patient goes to the hospital 2. Services are provided, Sign and Symptoms will be checked by dictor and according to that the procedure and services are done, and the procedure and service will be converted to a code HCPC 3.
After discharge the Charge Entry will happened 4. This is when the actual Billing process Starts 5. Charge Entry, The cash poster will post the charges in the system c. Read Free For 30 Days. Interview questions about Businesss Analyst and Healthcaret hat are Real time interview questions. Flag for inappropriate content. Related titles.
Jump to Page. Search inside document. For example: who should be given what kind of access to the system, what path will the document How do you deal with difficult stakeholders?
Resolution - of such scenarios, by working alongside PM Explain how you organize or prioritize your workload Make a list. Ramakrishna Ch. Venkat Reddy Arrabiri.
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Glenn Barker.Insurance Interview Questions And Answers
Irvin Shrewsbury Betson Cajayon. Helien Parra Riveros. Kian Fajardo. Prajit Dhar. Ananya Kay. Depending on your health insurance company either you can get an increase in the sum insured or get a discount on the annual premium or at times a combination of both. In case a claim is made, specified percentage of Sum Assured is deducted from the cumulative bonus in the subsequent year.
An important point to keep in mind is the fact that your policy should be renewed without a break to be liable for a cumulative bonus. Question 7. Answer : NCB retention is a relatively new add-on cover offered by general insurance companies. No claim bonus, commonly known as NCB is a reward offered by insurance service providers to their clients in case they do not file for any insurance claims. As a reward, insurance companies offer discount on the annual premium for policy renewal.
Car owners can get as much as 50 percent discount on the own damage part of the insurance premium using no claim bonus.
No claim bonus retention is an add-on cover attracting a number of car insurance seekers. Under this, add-on claims made by the individual under a specific pre defined limit do not alter the NCB bonus thus allowing the car owner to avail full discount on annual premium.
Hence NCB retention is a good way to exercise claims while keeping your no claim bonus intact. Question 8. Answer : Sub limit means that the insurance policy will put a maximum cap limit for various disease types and surgeries. For example if the policy offers a sub limit for say cataract surgery you can claim only up to a certain amount for cataract surgery claims even though the total sum assured may be higher.
It is always good to know the insurance sub limit in detail for various diseases before taking any health insurance policy. Question 9. Answer : If the insurance company is linked to your bank, chances are that it will offer your health insurance at a lower premium compared to other companies. Most of these health policies have a very small premium to attract the vast customer base of the bank. One of the biggest downside of bank associated low premium health care policies is the fact that banks have no active role in any decision making.
Healthcare Domain Knowledge
Neither can the banks help the consumer in case of claim settlement. Once you have opted for a health insurance policy, the bank is simply an intermediary and you will have to deal insurance service provider directly. Hence choose your health insurance plan wisely. Question Answer : General treatment for ear, eye, nose and throat are not covered under a general health insurance policy.
Dental and ENT treatments are considered to be part of a cosmetic procedure and do not impact the health of an individual directly and hence excluded from general health insurance cover. You will need to check with your health insurance company if they offer any policy covering ENT treatment. Answer : Currently premium is based on the age of the policyholder and does not matter if it is the first health policy of the applicant. As per the new guideline proposals, if two people of the same age buy a health policy at the same time, an individual who has already had a health policy should be charged a lower premium compared to the other person applying for the health plan for the first time.
Answer : Premium is the amount, the policy-holder or their sponsor e. Answer : Health insurance policies have various exclusions that are not covered under the ambit of the policy. Most policies also exclude any charges for second opinion from the health insurance cover. Answer : Prior Authorization is a certification or authorization that an insurer provides prior to medical service occurring.
Obtaining an authorization means that the insurer is obligated to pay for the service, assuming it matches what was authorized.
Many smaller, routine services do not require authorization. Answer : Capitation is an amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.
Answer : Pregnancy and childbirth related medical coverage is not extended to all health care policies. However some policies have this as an add-on cover. If you wish to take this add-on cover, I suggest you to check with leading insurance providers about the coverage offered for pregnancy related expenses. Make a good comparison; you can do it online. Some policies may also have a waiting clause for pregnancy for a period of one to two years while others exclude all pregnancy and child birth related medical expenses from general medical insurance.
If you are looking for any specific protection against pregnancy and childbirth related expenses, like for example, cesarean fee, post-delivery care etc, you can also check out pregnancy specific healthcare policies instead of a general health insurance policy. Answer : These days health insurance policies cover a large number of day care and OPD procedures. For your exact case you will have to seek advice of your insurance company but usually eye and dental surgeries that are done on OPD basis are by and large covered under most health insurance schemes.
Answer : Yes all health insurance companies need to settle all duly filled claims within a stipulated period of 30 days. If the insurance company is unable to process your claims within 30 days of receipt of all required documents and claim form, the policy holder has the legal right to seek interest in the claim amount for the delayed period.
Technical interviews test your knowledge of the health care industry. Below is a list of questions candidates have been asked in recent years. Many of these. Basics of Insurance are explained clearly in this Insurance Domain Health insurance provides coverage against the medical expenses or. Gathered from real world experts in Health care insurance companies. some good experience in healthcare domain as a Business Analyst.
Answer : Coverage Limits: Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maxima. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.
Answer : Exclusions are the services which are not covered. The insured are generally expected to pay the full cost of non-covered services out of their own pockets. Answer : In-Network Provider is a health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider.
Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers. Answer : Deductible is the amount that the insured must pay out-of-pocket before the health insurer pays its share. It may take several doctor's visits or prescription refills before the insured person reaches the deductible and the insurance company starts to pay for care.
Furthermore, most policies do not apply co-pays for doctor's visits or prescriptions against your deductible. Answer : To get cover for a surgery you can opt for a surgical protection plan instead of a general basic cover.
A general policy may deny your claim for the same surgery on various counts but with a surgery centric policy you get paid a fixed amount for each surgery depending on the surgery grade. Health insurance companies list surgeries on a rating scale depending on the complexities involved.
Deductible is one of the several types of clause that are used by the insurance company as a threshold for policy payment for health insurance. Prepare for your insurance interview with these tips, answers and questions. Make sure to read our helpful suggestions on getting your next insurance job by. 95 healthcare interview questions with answers pdf free ebook download. The delivery of modern health care depends on groups of trained.
So depending on the grade or rank of the surgery involved the policy will pay you a fixed stipulated amount irrespective of your hospital bill. Customer Relationship Management Tutorial.
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