Contact: 083 285 6330
We empower people with quality training
Contact: 083 285 6330
We empower people with quality training
Imagine managing 150 billion Rands (per annum) worth of medical claims!!
Challenge: horrific amounts of figures, codes, business processes, procedures and policy all driven by legislation.
Governed by the Council for Medical Schemes and the Medical Schemes Act 130 of 1998!!
Who would be brave enough to take this on? There is a special kind of person……Medical Claims Assessors!
They do this by their understanding and focused knowledge of the medical claim. In itself, a complex and complicated document, governed by complex and complicated legislation thereby making them equal heroes to the team who are saving lives physically.
We are proud to be training, assessing and moderating the accredited qualification that has been developed by Inseta (insurance education training authority) to empower medical claims assessors to perform with quality and efficacy
Comments: The
Company is qualified and has experience of 10 years in the assessing, facilitating and moderating the subject of medical claims assessing. The Company registration encompasses the full
scope of registration with the INSETA (Insurance Education Training
Authority).
The
learners registering for this qualification gain knowledge and wisdom in the specialised
conciseness in which they need to perform when processing claims. The value that this qualification adds to
the workplace is the assessor’s power of accuracy, alertness and knowledge gained
as a learner when returning to work.
This is followed through with their knowledge applied to the
management of complicated and comprehensive systems of the corporate medical
schemes and hospital environments.
The systems
have a myriad of codes, descriptions, medication, care plans with algorithms
and volumes of legislation all batched into a budget of millions (for smaller
medical schemes) and billions of rand for larger schemes. The fiscal values are integrated into the
systems, business processes, procedures and policies through which the medical
claim is assessed. The medical claims assessor has expertise to enable them
to make appropriate and accurate decisions in accordance to expectations of
managing a claim.
The
Company welcomes other companies who perform the same work and are looking to
work with facilitators/assessors/moderators.
We choose
to work with service providers who have accredited material and are
registered with INSETA as accredited service providers. The company acts within the scope of assessors/facilitators
and moderators.
Presently contracted with an
accredited medical claim assessing service provider (a client).