Mini course · Intermediate level
Insurance Claims & Denial Management
Find out why claims get rejected, fix the causes and recover the revenue you have already earned.
What is Insurance Claims & Denial Management?
Claim denials and rejections cost healthcare providers revenue and staff time, yet many are preventable. This course explains how insurance claims are processed, the most common denial reasons (eligibility, authorisation, documentation, coding and medical necessity), how to analyse denial patterns, write effective appeals, and build prevention processes with front-desk, clinical and billing teams. Examples draw on several insurance markets.
- Duration
- 1.5 hours
- Lessons
- 5
- Level
- Intermediate
- Format
- Online, self-paced
What you'll be able to do
- Describe how a healthcare insurance claim is processed
- Classify described denials by root cause category
- Analyse denial data to identify the highest-impact problems
- Write a clear, evidence-based appeal for a described denial
- Design a prior authorisation checklist for a high-risk service
- Develop a denial prevention plan across front-end, clinical and billing teams
Who this course is for
Course content
5 lessons · 1.5 hours total · free preview available
1How Claims Are Processed
16 minFree preview· Course content
How Claims Are Processed
From submission to adjudication and payment.
2Why Claims Are Denied
18 min· Course content
Why Claims Are Denied
Available after you enroll.
3Analysing Denial Patterns
18 min· Course content
Analysing Denial Patterns
Available after you enroll.
4Appeals That Succeed
18 min· Course content
Appeals That Succeed
Available after you enroll.
5Preventing Denials
20 min· Course content
Preventing Denials
Available after you enroll.
Earn a credential employers can check
Every AIHCM credential has a unique ID that anyone can verify online in seconds.
Issued: on completion
How it works
- Finish all 5 lessons at your own pace.
- Get your digital credential with a unique ID.
- Share it — employers can verify it at aihcm.us.
Questions people ask
Does the course cover specific insurers?
No. It teaches universal principles that apply across insurance markets.
Is it relevant for dental clinics and pharmacies?
Yes. Denial causes and prevention apply to all provider types.
Are electronic claims covered?
Yes, at a principles level.
Can I edit the templates?
Yes. All templates are editable.