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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.

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

DatesVenueDaysFeeCalendar
24 to 26 Aug 2026Mauritius3US$1,500
31 Aug to 2 Sep 2026Dubai3US$1,500
7 to 9 Sep 2026Lagos3US$1,500
14 to 16 Sep 2026Harare3US$1,500
21 to 23 Sep 2026Kampala3US$1,500
28 to 30 Sep 2026Dar es Salaam3US$1,500
5 to 7 Oct 2026Pretoria3R13,000
12 to 14 Oct 2026Cape Town3R13,000
26 to 28 Oct 2026Online3US$900
2 to 4 Nov 2026Mozambique3US$1,500
9 to 11 Nov 2026Cairo3US$1,500
16 to 18 Nov 2026Accra3US$1,500
23 to 25 Nov 2026Lusaka3US$1,500
30 Nov to 2 Dec 2026Kigali3US$1,500
7 to 9 Dec 2026Nairobi3US$1,500
14 to 16 Dec 2026Durban3R13,000
21 to 23 Dec 2026Johannesburg3R13,000

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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