Compare the organisation's handling of health insurance compliance with recognised practice, and close the material gaps.
Managing Regulatory Compliance for Health Insurance Systems
Move health insurance compliance from general awareness to a repeatable, reviewable practice.
Course Overview
Accreditation bodies assess health insurance compliance on documented evidence of consistent practice. Variation in this aspect of health and pharmaceutical services between shifts and sites is where avoidable harm lives. The programme converts the practice within health and pharmaceutical services from an area of general awareness into a set of repeatable practices. The method assumes participants will be challenged on their handling of health insurance compliance and prepares them for it. The result is the confidence to make and defend decisions about this strand of health and pharmaceutical services under scrutiny. Mature organisations treat the health and pharmaceutical services capability as a standing capability rather than a project that finishes. It is pitched for practitioners with responsibility for health insurance compliance, not for observers of it. Buying a tool rarely fixes this area of health and pharmaceutical services; the underlying capability has to be built internally first. The programme closes with an action plan for this aspect of health and pharmaceutical services that each participant writes for their own organisation.
Expected Learning Outcomes
Review contracts and agreements for the obligations they create around health insurance compliance.
Design medication and treatment safety controls within health insurance compliance.
Prepare the documented evidence accreditation assessors expect on health insurance compliance.
Measure patient experience of health insurance compliance and act on what it shows.
Apply regulatory and licensing requirements governing health insurance compliance.
Draw practical lessons from failures in health insurance compliance without assigning blame that suppresses reporting.
Who Should Attend
Managers in small and medium organisations who own health insurance compliance alongside other duties.
Accreditation and compliance officers preparing evidence on health insurance compliance.
Supply chain and biomedical staff supporting health insurance compliance.
Health information and records staff supporting health insurance compliance.
Analysts producing the data on which decisions about health insurance compliance rest.
Pharmacists and pharmacy managers involved in health insurance compliance.
Course Modules
Health insurance compliance: regulation, licensing and accreditation evidence
2 sessions · 8 pointsSession 1The paperwork for health insurance compliance that is actually needed
- Map the clinical workflow for health insurance compliance as it is actually performed.
- Close the loop: confirm changes to health insurance compliance improved the indicator they targeted.
- Audit health insurance compliance by observing practice, not by reading policy.
- Assemble the accreditation evidence pack for health insurance compliance.
Session 2Comparing health insurance compliance with recognised practice
- Map the handovers in health insurance compliance between functions and secure them.
- Identify where judgement in health insurance compliance is legitimate and where it is not.
- Confirm patient data handled within health insurance compliance meets confidentiality obligations.
- Close out actions on health insurance compliance rather than leaving them open indefinitely.
Health insurance compliance: infection prevention and patient safety
2 sessions · 8 pointsSession 1Investigating an adverse event involving health insurance compliance
- Define the trigger that would require health insurance compliance to be redesigned.
- Prepare the summary of health insurance compliance that senior management will read.
- Remove steps in health insurance compliance that add effort without adding assurance.
- Identify infection transmission risks created by health insurance compliance and control them.
Session 2Medication safety checkpoints inside health insurance compliance
- Draft the minimum viable clinical protocol for health insurance compliance.
- Set escalation thresholds for health insurance compliance that work out of hours.
- Prepare the response for the most likely failure in health insurance compliance.
- Write down the assumptions underpinning the approach to health insurance compliance.
Health insurance compliance: cost, efficiency and sustainability of the service
2 sessions · 8 pointsSession 1Making incident reporting on health insurance compliance safe for staff
- Establish who is informed, consulted and accountable in health insurance compliance.
- Define acceptance criteria for health insurance compliance in advance.
- Apply structured root cause analysis to the last adverse event involving health insurance compliance.
- Confirm competence and continuing development for staff delivering health insurance compliance.
Session 2Consent, confidentiality and ethics in health insurance compliance
- Review whether health insurance compliance is aligned with the objectives of the clinical service.
- Define escalation criteria for deterioration detected through health insurance compliance.
- Cost health insurance compliance per episode and identify avoidable waste.
- Agree the smallest change to health insurance compliance that would be visibly useful.
Health insurance compliance: quality indicators and patient outcome
2 sessions · 8 pointsSession 1Designing health insurance compliance so it helps rather than obstructs care
- Agree what will be standardised in health insurance compliance and what will not.
- Build medication safety checks into health insurance compliance at the point of highest risk.
- Plan continuity of health insurance compliance during surge and outbreak conditions.
- Verify cold chain and storage conditions for materials used in health insurance compliance.
Session 2Building the method for health insurance compliance step by step
- Reduce unwarranted variation in health insurance compliance between shifts and sites.
- Match staffing levels on health insurance compliance to measured demand across the week.
- Build the competence framework that supports health insurance compliance.
- Confirm licensing and regulatory requirements applying to health insurance compliance are met.
Choose the package that suits you
Silver Package
At least 3 people
- Workshop or Program Participation
- Airport Transfers
- Customized Badge
- Expert Mentorship (Private Sessions)
- Supervision & Secretarial Services
- Accredited Certificate of Participation
- Complete Training Kit
- Coffee Break
- Closing Ceremony
Gold Package
At least 3 people
- 5-night stay in a 5-star hotel
- Workshop or Program Participation
- Airport Transfers
- Customized Badge
- Expert Mentorship (Private Sessions)
- Supervision & Secretarial Services
- Accredited Certificate of Participation
- Complete Training Kit
- Coffee Break
- Closing Ceremony
Complete your registration
We will contact you within one business day to confirm.