Insurance Management ( TPA Operations) — DU B. Voc – Healthcare Management Previous Year Question Papers

MANAGEMENT (TPA OPERATIONS) (DSC-11) Attempt Five out of the seven questions. 1. Describe the claim processing of health insurance? 2. A 100 bedded hospital wants to get empanelled with insurance companies. Explain the empanelment procedure, eligibility criteria, document required and inspection process? (18) 3. What is underwriting in health insurance? Explain the process of underwriting. (18) 4. Discuss the health insurance schemes in developing and developed countries. (18) 5. Write a note on the following :– (3×6=18) (a) Domiciliary Hospitalization (b) Network & Non-work Hospital (c) Combined Life Insurance & Health Insurance 6. Compare CGHS, ECHS & ESI scheme in terms of eligibility, contribution, and coverage? (6,6,6=18) 7. A hospital insurance coordinator is guiding a patient who wants to port his health insurance policy to another insurer. Explain the process benefits and rules of health insurance portability? (18) MANAGEMENT (TPA OPERATIONS) (DSC-11) Attempt Five out of the seven questions. 1. Describe the claim processing of health insurance? 2. A 100 bedded hospital wants to get empanelled with insurance companies. Explain the empanelment procedure, eligibility criteria, document required and inspection process? (18) 3. What is underwriting in health insurance? Explain the process of underwriting. (18) 4. Discuss the health insurance schemes in developing and developed countries. (18) 5. Write a note on the following :– (3×6=18) (a) Domiciliary Hospitalization (b) Network & Non-work Hospital (c) Combined Life Insurance & Health Insurance 6. Compare CGHS, ECHS & ESI scheme in terms of eligibility, contribution, and coverage? (6,6,6=18) 7. A hospital insurance coordinator is guiding a patient who wants to port his health insurance policy to another insurer. Explain the process benefits and rules of health insurance portability? (18)