Medical schemes directly affect your revenue, compliance exposure, patient satisfaction and operational efficiency. If your practice does not fully understand how medical aids operate, you are operating at financial risk. This course is available in three specialised editions, tailored to your role.
Choose your edition
Practice Owner
R2 500ex VAT
Strategic oversight · Risk management · Revenue protection
For practice owners and directors who need a high-level understanding of medical schemes, regulatory compliance and financial exposure.
What you will learn
- The medical schemes industry landscape
- The Medical Schemes Act and regulatory framework
- Prescribed Minimum Benefits (PMBs) in depth
- Risk and financial management within schemes
- Contribution trends and industry sustainability
- Oversight of claims adjudication and dispute resolution
- A strategic approach to preventing revenue leakage
Outcomes for your practice
- Protect your practice against financial losses
- Make informed operational decisions
- Improve compliance awareness
- Lead your team with confidence
Practice Manager
R3 000ex VAT
Operational control · Claims oversight · Compliance management
For practice managers and senior administrators responsible for day-to-day medical aid interactions and workflow supervision.
What you will learn
- Structure and design of medical aid plans
- Detailed PMB interpretation and application
- Claim submission and administration processes
- Claims adjudication systems
- Complaint and dispute resolution processes
- The role of administrators and scheme processes
- Analysing complex claims
- Scenario planning and industry trend awareness
Outcomes for your practice
- Reduce rejected and partially paid claims
- Improve PMB approvals
- Strengthen internal systems
- Supervise billing and credit control effectively
- Manage disputes professionally
Credit Control
R2 700ex VAT
Billing intelligence · Dispute management · Revenue recovery
For credit controllers, billing clerks and accounts teams. A practical edition focused on improving collections and reducing write-offs.
What you will learn
- Medical aid product structures
- PMBs and their impact on payments
- Claim submission processes
- Claims adjudication outcomes
- Dispute escalation and complaint procedures
- Financial risk and shortfall management
Includes case studies on
- Claim follow-ups
- Motivation writing
- Shortfall recovery strategies
- Payment reconciliation
- Escalation processes
