HEALTHCARE Domain TRAINING. RequirementsInc.com
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1 HEALTHCARE Domain TRAINING RequirementsInc.com
2 BA Average Salaries National Average is less than 42K 2
3 Benefits of Becoming a Domain Expert Helps you get into the niche markets and stay in demand Helps you get into senior positions and reach 100K sooner Provides better job security as a specialized resource
4 Job Market Share Vanilla BA Finance BA Healthcare BA Finance + Healthcare BA 25% 25% 25% 25% 20% 20% 20% 20% 25% 45% 45% 65% Regular BA job requirements without requiring domain knowledge is about 25% 5 in 20 jobs With finance domain training, you would additionally qualify for 20% jobs, exclusive to domain experts 9 in 20 jobs With healthcare domain training, you would additionally qualify for at least 25% jobs, exclusive to domain experts 11 in 20 jobs With finance + healthcare domain training, you would additionally qualify for 40% exclusive jobs 13 in 20 jobs 4
5 Healthcare IT HEALTHCARE DOMAIN TRAINING 5
6 Duration: 16 Hours. Delivery: On-Demand 24/7. TRAINING INFO
7 Health Care Terminology Check out the Free Demo to learn this topic Subscriber Member Provider Claims Coinsurance Copayment Deductible FSA (Flexible spending accounts or arrangements) MSA (Medical Savings Account) / HSA (Health Spending Account) 7
8 Health Care Terminology Cont. In-depth Terminology Coverage Type Enrollment, Effective and Termination Dates Capitation etc PHI HIPAA Health Care Plans COB TPL ICD Codes ICD9 vs. ICD10 HL7 8
9 Commercial Health Care Plans Preferred provider organization (PPO) Exclusive provider organization (EPO) Health maintenance organization (HMO) Supplemental Insurance MediGap 9
10 Medicaid Eligibility Coverage Government Health Care Plans Medicare Eligibility Coverage 10
11 Health Insurance Portability and Accountability Act (HIPAA) What is HIPAA? HIPAA Basics HIPAA Transactions Claims submission (Professional / Institutional and Dental) Enrollment (Benefit Enrollment and Maintenance) 820 Premium Payments (Payroll Deducted and Other Group Payments) 270/271 Eligibility and Benefits (Health Care Eligibility Inquiry and Response) 278 Authorization (Health Care Services Request for Review and Response) 4010 to 5010 conversion 11
12 Health Care Systems Member Management Provider Management Reimbursement Management (Claims Processing) Benefits Administration Prior Authorization Rate Setting 12
13 What are ICD Codes? Benefits of Conversion? Concerns Things to account for Analysis Guidelines Testing Considerations ICD 9 to ICD 10 Conversion 13
14 Coordination of Benefits (COB) What is COB? Why COB? COB Rules COB and TPL Third Party Liability (TPL) What is TPL? Why TPL? TPL Rules 14
15 Bonus Topics Section 111 Reporting Health level 7 (HL7) 15
16 Health Care Basics Subscriber - Person who pays the premium and under whom the family is covered Member - Who receives medical coverage under a subscriber. Dependents of the family. Provider - In simple words. Any place where we can go and get treatment. Formal definition Any individual, institution, or agency that provides health services to health care consumer. Claims - An invoice from the provider to the doctor for the services rendered. Coinsurance - A form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible amount, if any, was paid. Copayment - A form of medical cost sharing in a health insurance plan that requires an insured person to pay a fixed dollar amount when a medical service is received. The insurer is responsible for the rest of the reimbursement 16
17 Health Care Basics 2 Deductible - A fixed dollar amount during the benefit period - usually a year - that an insured person pays before the insurer starts to make payments for covered medical services. FSA (Flexible spending accounts or arrangements) - Accounts offered and administered by employers that provide a way for employees to set aside, out of their paycheck, pretax dollars. Can pay only medical expenses. Money lost if unused.fsa can cover childcare expenses, if setup separately MSA (Medical Savings Account) / HSA (Health Spending Account) - Savings accounts designated for out-of-pocket medical expenses. Employers and Employees can contribute to this and are pre-taxed. Can carry unused funds into future year. Are normally combined with high-deductible or catastrophic health insurance plans. Fully Insured Plan - A plan where the employer contracts with another organization to assume financial responsibility for the enrollees medical claims and for all incurred administrative costs. 17
18 Business Analysis Training Options BA Workshop $1000 BA Workshop Plus $1500 $1300 BA Workshop Pro $2000 $1500 BA Workshop Addl. Domain Training Pick 1 Domain Get 2 Domains BA Course Website 2 Months 6 Months 12 Months 1 BA On-Demand Retake 15 Days Pass 30 Days Pass 60 Days Pass 2 BA Referral Bonus $50 for You, $50 Your Friend $75 for You, $50 for Your Friend $100 for You, $50 for Your Friend Best Value 1 BA On-Demand Retake: Receive one free On-Demand retake within one year of enrollment of the BA Workshop Course. 2 BA Referral Bonus: Refer your friends and earn when they enroll in our BA Workshop Program. 18
19 THANK YOU! It was a Pleasure!! Your referral is out greatest compliment. Please tell your friends about us! Will you give us a Thumbs Up and let your friends know? Like our Page and Post on facebook.com/requirementsinc Tweet and please May we ask you for 2 minutes of your time? requirementsinc.com/ba/demo/feedback RequirementsInc.com BusinessAnalystWorkshop.com Training@RequirementsInc.com
FINANCE and HEALTH CARE Domain Training. RequirementsInc.com 703-468-1921 Info@RequirementsInc.com
FINANCE and HEALTH CARE Domain Training RequirementsInc.com 703-468-1921 Info@RequirementsInc.com BA Average Salaries US National Average Wage is less than 42K! 2 Benefits of Becoming a Domain Expert Helps
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