Health Insurance Claims Management
Insurance Institute of India: Diploma Examination
Practice MCQs for the III Specialised Diploma paper IC-36 Health Insurance Claims Management: medical terminology for health insurance, the health claims process and adjudication, the role of Third Party Administrators (TPAs), provider network management, cost containment and clinical audit, medical coding (ICD-10, ICD-10-PCS, CPT), and fraud and abuse control.
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IC-36 exam at a glance
| Course | III Specialised Diploma in Health Insurance |
|---|---|
| Exam | 2 hours, online, multiple choice |
| Pass mark | 60% (75% for distinction) |
Across 7 chapters, every question reviewed and exam-aligned.
Tap a chapter to see what it covers.
1Basics of Medical Terminology for Health Insurance45 questions45
Medical terminology: human body systems, medical terms, common diseases and hospital functional units.
2Claims Management45 questions45
Health claims management: the claim process, documents, reserving, PM-JAY, personal accident and travel claims.
3Role of Third Party Administrators45 questions45
Third party administrators: TPA regulations, insurer and TPA relationship, claims control, service and monitoring.
4Provider Network Management45 questions45
Provider networks: types of providers, accreditation, empanelment, hospital tariffs and network management.
5Cost Containment45 questions45
Cost containment in health insurance: clinical audit, medical management, case management, wellness and preventive care.
6Medical Coding45 questions45
Medical coding: meaning and types, international classification of diseases, Indian diagnostic and procedure codes.
7Fraud and Abuse Control45 questions45
Health insurance fraud and abuse: types, parties involved, detection, prevention, verification and investigation.
Draws from all 315 questions across every chapter, so no two attempts are the same.
IC-36: frequently asked questions
What does IC-36 cover?
IC-36 covers health insurance claims management: medical terminology, the health claims process, third party administrators, hospital networks, cost containment, medical coding and fraud control.
Which course is IC-36 part of?
The III Specialised Diploma in Health Insurance. Since January 2016, diploma papers do not count as credit points towards Licentiate, Associateship or Fellowship.
What is the pass mark for IC-36?
60%. A score of 75% or more is a pass with distinction.
How long is the IC-36 exam?
2 hours. It is an online exam with multiple choice questions.
When will I know my result?
You see your score right after the online exam. The formal result usually follows within about a month.
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