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Our mission is to educate long-term care providers and other professional advisors about how to work more effectively on behalf of clients with LTC insurance at the time of claim.
The goal of LTCCP® is to improve the quality and availability of long-term care services for clients who own LTC insurance by equipping the professionals who serve them with greater competency when managing and participating in the claim process. |
The LTCCP® curriculum is presented in 3 formats:
Successful completion of a web-based exam is required to use the LTCCP® designation.* |
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COURSE OUTLINE
Introduction:
- Mission
- The LTCI "claims wave."
- Course overview - general concepts.
Insurance basics:
- Introduction to insurance.
- Basic principles of insurance law with a focus on practical applicability at time of a LTC claim.
- Who has certain rights under the policy.
- Who can call/talk to the insurance company and when.
- HIPAA’s impact on LTC claims & communication.
History and development of LTC insurance:
- Examination of old, “problematic” policy provisions that may still be in-force.
- How to manage claims with problematic provisions.
- Regulatory changes and their impact on policy language and claims, now and in the future.
- How insurance carriers manage different, diverse policy definitions within the same company.
The Claims Process:
- Working with families who are not ready to start a claim.
- Setting claim responsibility and timing expectations with clients/family.
- How to help policyholders prepare to file a claim.
- Claims due diligence for professional caregivers, advisors, and their clients.
- Claims timing expectation.
Benefit Eligibility:
- ADLs.
- Hands-on vs. stand-by definition of loss.
- Cognitive impairment.
- Medical necessity.
- Impact on provider charting and caregiver training.
- Examples of good and bad practices.
- Definitions pre & post-HIPAA.
- Working with physicians or other providers who don’t understand what information is required.
Provider Eligibility:
- How is “home care” defined.
- Home Health Care vs. Home Care in LTC insurance.
- What is an “agency.”
- State licensure/non-licensure, policy definitions, and impact on provider approval.
- Is assisted living/memory care covered and how.
- Working with carriers when there is a denial of provider.
- Managing client expectations.
- Preserving client relationships.
Policy Benefits & Definitions:
- Benefit amount:
- How to ID different benefits for different services
- Daily vs. weekly or monthly payments
- Reimbursement vs. indemnity
- Ethical concerns
- Benefit period:
- Time limited vs. pool of money
- Elimination period:
- Different ways to count EP days for home care
- Strategies to help clients through the EP
- Using the EP and claims process to engage clients early
- Inflation increases:
- Types & how they work
- Automatic vs. purchase options
- How to get updates on current benefits
- Other benefits:
- Home modification
- Homemaker services
- Respite care
- Care coordination
Policy Types:
- Comprehensive, Facility Only, Home Care Only
- Traditional/Stand-Alone LTCI
- Partnership LTCI
- Hybrid LTCI
- Claim issues depending on policy type
Tax Considerations:
- HIPAA.
- When benefits are tax-free at time of claim.
- Tax considerations of Indemnity/Per Diem policies.
The LTCCP® coursework & passing the final exam is pre-approved
for 5-hours of Certified Senior Advisor (CSA)® renewal CE credits.
The course is NOT currently eligible for insurance license CE or CFP® CE.
for 5-hours of Certified Senior Advisor (CSA)® renewal CE credits.
The course is NOT currently eligible for insurance license CE or CFP® CE.
* The right to publicly use the LTCCP® designation in any form is subject to usage standards, guidelines, ethical behavior and an annual renewal fee as established by the certifying organization. Usage may be further limited by an employer, regulatory agency, or other supervisory relationship.