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Medical Scheme Claims and Healthcare Revenue Management

Rejected claims, short payments and slow reconciliation quietly drain a practice or hospital of income it has already earned. The administrative side of billing gets full attention, from patient registration and benefit checks through coding capture, claim submission and the disciplined follow up that recovers money owed by schemes.

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What you will be able to do

  • Map the revenue cycle from patient registration to final scheme payment.
  • Verify membership, benefits and authorisation before a service is billed.
  • Capture procedure and diagnosis codes accurately from the clinical record as recorded by the clinician.
  • Submit claims electronically and read scheme remittance advices and rejection reasons.
  • Work rejected and short paid claims through resubmission and dispute channels.
  • Apply the Prescribed Minimum Benefit rules of the Medical Schemes Act 131 of 1998 to billing queries.

Course outline

  1. 01The healthcare revenue cycle end to end
  2. 02Patient registration and data accuracy
  3. 03Membership, benefit and authorisation checks
  4. 04Billing code capture from the record
  5. 05Claim submission and switching houses
  6. 06Remittance advices and rejection reasons
  7. 07Rejected and short paid claim recovery
  8. 08Prescribed Minimum Benefits and scheme disputes

Who should attend

Medical billing and claims administrators, practice and hospital revenue managers, patient accounts and credit control clerks, case managers, and reception or admissions staff in private practices, clinics and hospital groups.

Dates, venues and fees

DatesVenueDaysFeeCalendarRegister
28 to 30 Sep 2026Online3US$900Closed
21 to 23 Oct 2026Johannesburg3R13,000Register
26 to 28 Oct 2026Cape Town3R13,000Register
27 to 29 Oct 2026Durban3R13,000Register
28 to 30 Oct 2026Pretoria3R13,000Register
2 to 4 Nov 2026Windhoek3US$1,500Register
3 to 5 Nov 2026Gaborone3US$1,500Register
4 to 6 Nov 2026Maseru3US$1,500Register
9 to 11 Nov 2026Mbabane3US$1,500Register
10 to 12 Nov 2026Lusaka3US$1,500Register
11 to 13 Nov 2026Harare3US$1,500Register
16 to 18 Nov 2026Lilongwe3US$1,500Register
17 to 19 Nov 2026Blantyre3US$1,500Register
18 to 20 Nov 2026Mozambique3US$1,500Register
23 to 25 Nov 2026Nairobi3US$1,500Register
24 to 26 Nov 2026Dar es Salaam3US$1,500Register
25 to 27 Nov 2026Kigali3US$1,500Register
30 Nov to 2 Dec 2026Kampala3US$1,500Register
1 to 3 Dec 2026Accra3US$1,500Register
2 to 4 Dec 2026Lagos3US$1,500Register
7 to 9 Dec 2026Cairo3US$1,500Register
8 to 10 Dec 2026Mauritius3US$1,500Register
9 to 11 Dec 2026Dubai3US$1,500Register

Fees are per delegate. South African venues are priced in rand; other locations and online in US dollars. Fees exclude 15% VAT where applicable. Group bookings of three or more delegates from the same organisation qualify for a reduced rate; contact us for a quotation.

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