Understanding the body and diseases processes for effective management

This short course will provide an understanding of the normal functioning of the body, disease processes and conditions that impact on health risk.

Topics include:

  • Normal functioning of the body systems and related common diseases and impairments.
  • Appropriate health care services including investigations and treatment.
  • The main tariff codes, important rules and modifiers.
  • Overview of the medical schemes act and how it relates to benefits.
  • The entitlement to prescribed minimum benefits for important conditions related to each body system.
  • The role of protocols and formularies in the management of risk.
  • The importance of coordinated care.

Who will benefit?

  • Case managers
  • Disease managers
  • Wellness coaches
  • Pre-authorisation
  • Claims assessors


  • Cardiovascular system
  • Respiratory system
  • Cancer
  • Reproductive system
  • Digestive system
  • Urinary system
  • Musculo-skeletal system
  • Psychological and psychiatric conditions
  • Endocrine system
  • Nervous system
  • RPL codes, rules and modifiers
  • Prescribed minimum benefits
  • The medical schemes act
  • Introduction to managed care

Programme delivery

This is offered as a flexible in-house programme with a choice of modules and face-to-face facilitation.

Can be delivered as an accredited skills programme towards either the medical claims assessing or long-term risk assessment qualification.

Contact us on info@ihrm.co.za for more information.

Training Date:

Date: 10/17/2019