KING ABDULAZIZ UNIVERSITY
Faculty of Economics and Management
Health Services and Hospitals Administration Dept.
Bachelor program (Regular)
COURSE TITLE : Health Insurance Administration
CODE/NO : HSA 372
Prerequisites : ECON 107
Year : 1433\1434
Second Term
Prof.Dr. Talaat Al-demerdash Ibrahim
Office (Room) No. 451
Tel. (office) :62624
Mobile : 0567159004
E mail: talaat_1956@yahoo.com
Times of Lectures : 8 – 8,50 AM
(Saturday , Monday , Wednesday )
Male Room : 108A
Building :T 75
Female Room : 916A
Building : T09
Office Hours: Every Day 11AM – 3 PM
Exception wed.
Course Description:
It was designed to focus on general insurance concepts and particularly health
insurance in addition to health cooperative guaranty programs which are applied
in the kingdom.
Course Objectives:
1. Knowing about the health insurance industry and its different national and
international characteristics.
2. knowing about the health and administrative aspects concerned with health
insurance:
 Physicians, pharmacists, nurses, employees …. Etc.
 Health care organizations (hospitals, centers, polyclinics, clinics,
pharmaceutical companies, insurance …..etc.)
3. Providing students and employees with the necessary information about the
insurance program characteristic and how to run them efficiently.
4. Developing the students the skills and research knowledge about health insurance.
Scientific Contents:
Part I : HEALTH INSURANCE THEORY :
1. introduction to health insurance.
2. Health insurance characteristics.
3. Health insurance's legal and legislative topics.
4. Disease classification and current coding for procedural terminology.
1
5. Current coding for procedural terminology.
6. The common coding system for health care.
7. Kinds, methods and programs for health insurance compensation.
8. Basics and instructions of compensation request
Part II : INTERNATIONAL HEALTH INSURANCE EXPERIENCE :
Part III : SAUDI COOPERATIVE HEALTH INSURANCE ACT :
Course Outcomes:
By the end of this course, students should be able to:
1. Defining different health insurance industry characteristics.
2. Knowing how to organize health care organizations.
3. Knowing different procedures for coding terminology.
4. Knowing the kinds of health insurance.
5. Knowing how to deal with different health insurance classifications.
6. Knowing how to do insurance compensation.
7. Knowing about the health insurance marketing.
8. Decision making skill.
9. Computer skills.
10. Collecting information skills and their statistical analysis.
11. Communicating with customers skills
Teaching Methods:
Using audio-visual media and modern teaching of this article will depend on the
use of a variety of methods such as:
1 - Lectures .
2 - Group discussions.
3 - Research projects, individually and collectively in English.
4 - Field visits to health insurance companies.
5 - Meetings and Interviews with the leaders in health insurance companies
2
Assessment Methods:
1 Attendance , participation and discussions.
2 Applied cases
3
* Case study of the health insurance branch in one of the
insurance companies operating in the Kingdom (through
the company's annual report)
Or &
* A comparative study of the situation the total market for
health insurance in the kingdom between the two years.
(Through the report of the Saudi insurance market, the
Saudi Arabian Monetary Agency, Department of Insurance
Supervision).
Or &
* A case study of health insurance experience in any
country comparative with the experience of KSA.
periodic examinations (15% first exam, second exam
15%)
15
15
30
40
100
4 Final exam
Total
Text Book:
1- Health Insurance
by Michale A Morrisey, Health Administration Press , Chicago , 2008.
2-The Act of cooperative health insurance in KSA
Supplementary References:
1- Understanding Health Insurance: A Guide to Billing and
Reimbursement
by Michelle A. Green and JoAnn C. Rowell (9th Edn.), Thomson Delmar Learning,
USA 2007
2- WHO Reports.
3
Time table for distributing course contents:
Week
Subject
Remarks
1
Introduction to health insurance
2
Health insurance characteristics
3
Health insurance characteristics
4
Health insurance's legal and legislative topics
5
Health insurance's legal and legislative topics
6
Disease classification and current coding for procedural
terminology
7
Disease classification and current coding for procedural
terminology
16-3-2013
First Exam
8
Current coding for procedural terminology
9
Current coding for procedural terminology
10
The common coding system for health care
11
The common coding system for health care
12
Kinds, methods and programs for health insurance
compensation
13
Kinds, methods and programs for health insurance
compensation
14
15
Sat. 4 - 5 – 1434
Basics and instructions of compensation request
Sat. 0 - 0 – 1434
Second Exam
0 – 0 -2013
Basics and instructions of compensation request
After 0 – 0 - 1434
Final Exam
4
Important instructions:
In order to achieve maximum benefit from this course please pay attention to the
following:
1 - Commitment to the presence of the lecture
2 - Prepare the scientific material in advance.
3 - active participation in discussions and activities quarterly.
4 - quarterly business performance and delivery on time .... Any delay would be
unacceptable, but an official excuse.
5 - Close the phone before the start of the meeting.
6 - deleted from the curriculum: All lectures, unless mentioned in the academic
or scientific literature of the material.
7 - types of questions in the tests include (model true or false, choosing the
correct answer (multiple choice) objective questions, such as Define, Enumerate,
explain, compare, and applied questions such as giving specified health
insurance problem shall be required study the problem, analyze and provide
appropriate solutions or recommendations).
8 - Use the search over the Internet is very important in order to see the
developments and changes in the health insurance markets, particularly with
regard to the contents of the article and see reports of the World Health
Organization, the World Bank, the Saudi Ministry of Health and the Saudi
Arabian Monetary Agency
5