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EasyUphill
CORPORATE DEVELOPMENT
+27 81 041 7673
training@eubiz.co.za
68 Sunstone Street, Germiston, 1401
eubiz.co.za
training@eubiz.co.za
68 Sunstone Street, Germiston, 1401
eubiz.co.za
Healthcare & Hospital Management
Health Insurance and Medical Scheme Administration
Duration
3 Days
Delivery
In-house, public or online
From
R13,000 per delegate
Certificate
On completion
Course overview
Claims are rejected and members are frustrated mainly through administrative failure rather than clinical dispute. This course covers benefit administration, claims processing and the controls that manage cost without denying valid care.
What you will be able to do
- Explain how medical scheme benefits are structured
- Administer membership, dependants and contributions
- Process claims accurately against benefit rules
- Apply pre authorisation and managed care protocols
- Detect and investigate fraudulent or abusive claims
- Handle member complaints and disputes fairly
Who should attend
- Medical scheme and insurance administrators
- Claims assessors and processors
- Hospital billing and case management staff
- Client service staff in health funding
Course outline
01
How medical schemes and benefit structures work
02
Membership, dependants, contributions and waiting periods
03
Claims processing against benefit rules
04
Pre authorisation, managed care and clinical protocols
05
Prescribed minimum benefits and mandatory cover
06
Fraud, waste and abuse detection in claims
07
Complaints, disputes and regulatory escalation
Upcoming public sessions
| Dates | Venue | Duration | Fee per delegate |
|---|---|---|---|
| 9 to 11 Nov 2026 | Durban | 3 Days | R13,000 |
| 24 to 26 Nov 2026 | Cape Town | 3 Days | R13,000 |
| 11 to 13 Jan 2027 | Johannesburg | 3 Days | R13,000 |
| 8 to 10 Feb 2027 | London | 3 Days | US$1,500 |
| 12 to 14 Apr 2027 | Dubai | 3 Days | US$1,500 |
| 28 to 30 Jun 2027 | Pretoria | 3 Days | R13,000 |
Fees exclude VAT. This course can also be delivered in-house at your premises on dates that suit your team, or live online.
To book or ask for an in-house quote
Reply to the email this brochure came with, call +27 81 041 7673, or visit eubiz.co.za and open this course.
EasyUphill Training & ConsultingTailored training that moves teams forward.
+27 81 041 7673 · training@eubiz.co.za
68 Sunstone Street, Germiston, 1401 · eubiz.co.za
68 Sunstone Street, Germiston, 1401 · eubiz.co.za