Insurance in Singapore: Direct Billing

Posted on Apr 14, 2015 by Travis Jones

Singapore boasts one of the top health care systems in the world, offering a high standard of medical service in the private and public sectors. Although health care costs are fairly low for permanent residents of Singapore, many expatriates, as well as residents interested in accessing private facilities, choose to hold a private insurance policy. In recent years many employers have also begun to offer private insurance when recruiting high-caliber employees or finding new ways to offer workplace benefits.

When choosing a Singapore Health Insurance policy, or anywhere in the world for that matter, it’s important to evaluate options including co-pays, deductibles and lifetime limits. All of these will affect how much the policy holder pays for accessing health care services. Most insurance shoppers also know to check for exclusions (for example, a plan might not pay for alternative or Traditional Chinese Medical care), but it’s likewise important to ask: Does this policy offer direct billing?

What is direct billing?
Direct billing means that the clinic or hospital bills the insurance company directly. The patient doesn’t have to pay up front (unless there’s an in-person co-pay), and the patient also doesn’t have to submit any paperwork to her insurance company – all of that is arranged between the hospital administration and the insurer. Patients are normally given a health insurance card with a personal policy number, which they can hand over to the clinic or hospital administrator at the time of treatment. If the card is lost, patients can normally contact their insurer for a temporary virtual replacement copy, or they can simply use their personal policy number to continue receiving medical services with direct billing as usual.

Most patients find direct billing to be an extremely useful service. With direct billing there are no concerns about                 scheduling bills, keeping records of receipts and bank transfer slips, or having personal information get lost or stolen in the mail. Direct billing means that an experienced administrator will prepare a bill on behalf of the patient, including itemized pricing on consultations, treatments, tests, pharmaceuticals and so on. The patient can usually review these charges if he wishes, and then the bill is sent from the hospital or clinic to the insurance company.

Not every hospital in Singapore has a direct billing agreement with every insurance company. Choosing a policy from a well-known insurer with a global presence is a good way to guarantee that you’ll have a wide range of hospitals and clinics that can offer direct billing. All insurers will have a directory of hospitals; check this list to see which establishments offer direct settlement, or contact your insurance company if that information isn’t readily available online. It’s also important to find out if you need to contact your insurer prior to treatment to arrange for direct billing – at times, insurers ask that you confirm the direct billing particulars before going in for care.

Does your insurance plan feature direct billing?
Some insurance companies only offer direct billing for inpatient insurance, which means a patient not staying in hospital is still responsible for paying the health care provider up front and submitting those bills to the insurer to claim back that money. Most insurers that offer direct billing, however, will make it available for nearly all medical services, assuming you’re accessing those services through a designated facility under the direct billing scheme. An insurance network is often larger than a direct billing network, so don’t assume direct billing is available wherever your insurance policy is accepted.

Do be aware that if part or all of any directly-billed insurance claim is refused by your insurer, the hospital will ask you to pay that sum as soon as possible. Some insurance companies take this money directly from your bank account or credit card if that’s how the policy-holder normally pays monthly insurance fees. To avoid unexpected and potentially expensive bills, make sure you’ve read your policy thoroughly and understand exactly what’s covered and what’s not. As always, ask an insurance representative if you’re unsure about any procedure related to direct and indirect billing, and get in touch if you receive a bill or notice a bank withdrawal that you weren’t expecting

If you are on an insurance plan with a good hospital network and direct billing is an option, you will no doubt appreciate the convenience that comes with having outside administrators looking after your bills. However, it’s still important to understand your out-of-pocket co-pay responsibilities.

A co-payment is a set amount of money that must be paid by the patient when receiving certain services. The co-pay must usually be paid up-front or immediately after care is complete. Costs vary depending on the medical service and particulars of the coverage plan. For example, a co-pay could be SG$10 per visit to a general outpatient doctor, or 10 percent of any given medical bill. Insurance companies use co-payments to reduce their cost burden as well as to prevent patients from overusing non-essential medical services. (Inpatient or emergency co-pays are sometimes low or non-existent). As co-pays are meant to be paid in full by the patient, these will not be submitted to an insurance company for direct billing – therefore, patients should be prepared to pay these costs to the hospital or clinic as soon as possible.

If you have any questions about direct billing, co-pays, or any other aspects of your Singapore Health Insurance plan, contact Pacific Prime Singapore today. Our helpful and knowledgeable agents are available to provide you with information, as well as free quotations and plan comparisons from the world’s best insurers.