Audience: HR administrators
Plans: Panel claims — all plans. Non-panel submission — Plus and above.
Help employees get reimbursed for eligible medical expenses and monitor claim progress.
Types of claims in the HR Portal
| Type | Description | Who pays first |
|---|---|---|
| Panel (cashless) | Employee visits a network clinic; Soda settles with the provider | Soda / insurer (employee may pay co-pay only) |
| Non-panel (reimbursement) | Employee pays the provider, then submits receipts | Employee, then reimbursement |
| HR-submitted claim | HR submits on behalf of an employee who cannot self-serve | Depends on claim type |
Submit a new claim (HR)
- Go to Make Claim in the sidebar, or open a person’s record under People and start a claim on their behalf.
- Select the member (and dependant if applicable).
- Choose claim type — outpatient, dental, specialist, etc. (options depend on your plan).
- Enter visit details: - Date of treatment - Provider name - Diagnosis or reason for visit - Amount claimed
- Upload supporting documents — receipts, tax invoices, referral letters, MC where required.
- Review the summary and Submit.
Tip: Upload clear, legible PDFs or photos. Include GST invoice details where applicable for Singapore providers.
Edit or view a submitted claim
- Open a person’s record under People to see their claims, or go to Claims History company-wide.
- Find the claim by date, person, or claim reference.
- Open the claim to view status and details.
- If the claim is still draft or pending documents, you may be able to Edit and add information.
Track open claims
Panel claims (open)
- Go to Open Claims → Panel claims.
- Review in-progress panel visits and any items requiring attention.
- Filter by person, date range, or status.
Panel claims are usually processed automatically after the clinic visit. Items appearing here may need clarification or have been flagged.
Non-panel claims (open)
- Go to Open Claims → Non-panel claims.
- Monitor reimbursement claims awaiting assessment or payment.
- Click into a claim to see status updates and any requests for additional documents.
Claims History
Claims History shows completed and closed claims across your company.
- Go to Claims History in the sidebar.
- Search or filter by person, date, claim type, or outcome.
- Use Export To Excel for finance reconciliation.
Typical statuses you may see:
| Status | Meaning |
|---|---|
| Submitted | Received, awaiting assessment |
| Pending documents | Assessor needs more information |
| Approved | Approved for payment |
| Partially approved | Some items approved, others excluded |
| Rejected | Not payable under plan rules |
| Paid | Reimbursement completed |
What fields are visible for submitted and approved claims
This section lists exactly what an HR administrator can see for a claim, at each level of detail. Financial and visit information is visible; clinical diagnosis details are masked in the HR portal (see the privacy note at the end).
Claim History — list view (company-wide)
Each claim row in Claim History shows three groups of fields:
Member details
| Field | Description |
|---|---|
| NRIC | Identification number of the person who received care |
| Name | Claimant name |
| Member Type | "Insured Member" for the employee, or the dependant relationship |
| Policy No | Insurance/policy reference |
| Submission No | Submission reference number |
| Submission Date | Date the claim was submitted |
Claim line
| Field | Description |
|---|---|
| Claim# | Claim code (click to open the full detail view) |
| Incurred Date | Date of treatment/visit |
| Service Type | Claim type (e.g. GP, specialist, dental) |
| Receipt Amt | Total amount incurred / receipt amount |
| Co-Pay | Employee co-payment portion |
| Payable | Amount payable / approved |
| Status | Current claim status |
Amount summary (right side)
| Field | Description |
|---|---|
| Incurred Amount | Total amount incurred |
| Total Co Pay | Total co-payment |
| Approved Amount | Total payable (the approved value) |
You can filter this list by name / NRIC / claim code, submission date range, panel type (All, Panel, Non-Panel), and status, and Export to Excel.
Member profile → Submitted Claims — list view
When viewing a single member's submitted claims, the columns are:
| Column | Description |
|---|---|
| Claim Date | Date incurred |
| Claim Code | Unique claim reference |
| Amount Incurred | Amount claimed |
| Co-pay Amount | Employee co-payment |
| Patient Payable | Amount the patient pays |
| Amount Payable | Approved/payable amount |
| Status | Current claim status |
| Action | View (or Edit, where the claim is still editable) |
Claim detail view (clicking a claim)
Soda covers outpatient claims (GP, specialist, TCM, dental, etc.). The detail screen depends on whether the claim is panel (cashless) or non-panel (reimbursement):
- Panel (cashless) claims open the panel claim detail, with the visit, charges, and fee summary below.
- Non-panel (reimbursement) claims open the submitted claim form (read-only) with the uploaded receipts and the assessed Reimbursed amount.
For a panel outpatient claim, the detail view shows:
Visit & Consultation details
- Attending doctor name, Visit Date and Time, Panel Clinic Name
- Consultation Fee and Consultation Type
- Surcharge Fee and description
- MC No. of Days, MC Start Date, MC Reason
- Referral Clinic Name and referral notification code
Itemised charges (each shown only when the visit included it)
- Drugs — drug name, frequency/day, quantity, amount, total drug fee (when medication was dispensed)
- Procedures — name, code, price, total procedure fee (for specialist visits with procedures)
Claim Summary (fees)
| Field | Description |
|---|---|
| Drug Fee | Total drug cost |
| Procedure Fee | Total procedure cost |
| Visit Fee | Fee before GST |
| GST Amount | GST applied (with %) |
| Total Visit Fee | Total fee incurred |
| Co-Pay | Employee co-payment |
| Cash Collected | Amount the patient paid at the clinic |
| Total Claim Amount | Final approved/payable amount |
| Approval Code | Approval reference for the claim |
| Remarks | Assessor remarks on the claim |
Privacy: what HR cannot see in full
Diagnosis information is masked in the HR portal. While a claim may include diagnosis rows (description, type, code, primary/principal indicator), the HR portal masks the diagnosis description and diagnosis code. Full, unmasked clinical diagnosis detail is only visible in the insurer/assessor portal — not to HR administrators. This protects employee medical confidentiality while still letting HR verify and reconcile the financial and service details of a claim.
Member-initiated vs HR-initiated claims
Employees can submit many claim types through the Soda member app. HR typically submits when:
- The employee has not registered for the app
- Urgent submission is needed
- Bulk or sensitive submissions are handled centrally
- The employee needs assistance with document upload
Always confirm bank details are on file for reimbursement claims — members manage this in the app under payment settings.
Common issues
| Issue | What to do |
|---|---|
| Claim rejected — not covered | Check the Plan page for benefit limits and exclusions |
| Claim rejected — duplicate | Same receipt may have been submitted twice |
| Pending documents | Upload requested items via the claim edit/view screen |
| Amount partially approved | Review assessor remarks for excluded items |
| Cannot see Make Claim | Confirm Plus tier for non-panel; check permissions |