Panel claims and billing for clinics
How a panel claim goes through G-Flex, from the patient's visit to payment.
The steps
- Register the patient. Search for the patient by name or NRIC. G-Flex shows the plans the patient can use, with the annual limit, the remaining balance and the limit per visit. If the patient's employer has a treatment policy, it is shown before you continue. A patient can have one open visit record on a plan at a time; submitting the bill closes it.
- Check the guarantee letter, where one applies. You can look up a patient's guarantee letters to see whether one is valid, the approved amount and the expiry date. A guarantee letter is only viewed here, not issued by the clinic.
- Submit the bill. Enter the visit date, the claim number and the receipt type, then add the line items. The item types you can add depend on the type of clinic: for example a pharmacy sees consultation, medication and miscellaneous items, while a general practice also sees diagnosis, treatment, investigation and medical certificates. Diagnosis codes are searched from the ICD-10 list. If your clinic is registered for SST, you switch SST on and it is added to the bill. When you submit, the bill shows as pending.
- Follow the claim. The bills list shows the status of every bill: for example pending, approved, paid or rejected. If a bill is rejected, its page shows the reason recorded by the reviewer, and a rejected line item shows its own reason.
- See the payment. Claims are grouped into settlements, and a clinic is paid after each settlement. On each bill, the payment section shows the settlement number, the payment status, the payment date, method and reference, the bill amount, the system fee allocated to the bill, and the net amount paid for the settlement. A bill that is not yet in a settlement says so.
What a clinic pays
Each claim carries a system fee. Your administrator sets it for your clinic: it is either nothing, a fixed amount per claim, or a percentage of the claim. The fee is deducted when your settlement is calculated.
Questions about a claim or a payment
Contact your administrator, the organisation that manages your panel. This page does not quote a payment time.
Joining a panel
A clinic is added to a panel by the administrator that manages it, usually when an employer asks for the clinic to be included. To ask about joining, contact us.