For companies that allow employees to visit providers which are not part of Mednefits panel, your employees can submit a non-panel claim via the Mednefits mobile app or member portal if they visited a non-panel clinic or provider and paid for their visit out-of-pocket.

 

To know more about how your employee can submit a non-panel claim, kindly refer to this article: How do I submit a non-panel claim?

 

Once the administrator or HR approves a claim, the approved amount will be deducted from the employee's entitlement, and the balance will be updated. HR can process the reimbursement internally, or Mednefits will reimburse the employee if the company has appointed Mednefits to do so.

 

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🆕 New Feature Releases on Your HR Portal

We’ve just rolled out new updates to help you manage non-panel claims more efficiently:

 

1. Pending Claim Indicator

If you're managing multiple corporate accounts, you’ll now see a number next to each company showing how many non-panel claims need your review.

Click “Review claim(s) now” to go straight to the claim approval page based on your assigned role — whether it’s first or final in a two-level claim approval).

 

⚠️ The indicator adjusts based on the Admin's permissions, tier access, and, in two-level approvals, their specific approval level.

 

 

2. Amendment Status for Non-Panel Claim

Admins can now request changes to pending claims directly from the HR Portal.  Once a request is made, employees will receive a push notification and email, prompting them to edit and resubmit their claim via the Mednefits App.

 

Go to HR Portal > Non-Panel Claims > Overview or Action Page (for First-Level Approvers) > select a claim > Request Amendment.

⚠️ Please note:

 

• This feature is only available for claims that are still pending.

• Only the single approver or first-level approver (in a two-level setup) can request amendments.

• Employees must update their Mednefits App to use this feature.

 

 

3. Updated Claim Statuses

To improve clarity in claim handling, new claim statuses have been introduced. These updates help First-Level Approvers quickly understand the current stage of each claim and take the appropriate action. Below is the updated list of claim statuses:

 

First-Level Approval status:

 

• Pending : Awaiting review and action
• Awaiting Amendment : Awaiting changes or updates from the employee
• Approved - Awaiting Confirmation : Approved by the first approver, awaiting confirmation by the final approver
• Approved : Claim approved and employee has been informed
• Rejected - Awaiting Confirmation (If applicable) : Rejected by the first approver, awaiting confirmation by the final approver
• Rejected : Claim rejected and employee has been informed
• Escalated (applies only when Final Level Rejection is OFF) : Rejected by the first-level approver and escalated to the final-level approver to reject or approve the claim.

 

Final Level Approval status:

 

• Approved - Awaiting Confirmation : Approved by the first-level approver, awaiting confirmation by the final approver.
• Approved : Claim approved and employee has been informed.
• Rejected - Awaiting Confirmation (if applicable) : Rejected by the first-level approver, awaiting confirmation by the final approver.
• Rejected : Claim rejected and employee has been informed.
• Escalated (if applicable) : Rejected by the first-level approver and escalated to the final-level approver to reject or approve the claim.

 

 

To view more details about a employee's claim status, please refer to the article: How do I get notified about my claim status

 

Please refer to the respective article links below on how you can process your employees' non-panel claims, based on your corporate account's claims settings:

 

1. Claims Processing with One-Level Approver

2. Claims Processing with Two-Level Approval

 

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If Two-Level Approval is required, kindly refer to How to set up Two-Level Claim Approval? to set up and activate via your company HR Portal.