Health Protection | Medical

Extended Panel

At Prudential, we continuously enhance our services. In addition to PRUPanel Connect (PPC), the Extended Panel (EP) now provides policyholders a wider choice of specialists and supports better continuity of care for policyholders

 

What is Extended Panel (EP)?


Extended Panel (EP) is an initiative by the Multilateral Healthcare Insurance Committee (MHIC), which is appointed by the Ministry of Health (MOH), to allow integrated Shield Plan (IP) insurers to recognise each other’s panel doctors mutually. Under the EP, you may enjoy selected panel benefits when seeking pre-authorised treatments from specialists that are not on our panel, as long as they are on other Integrated Shield Plan insurers panels, follow our fee schedule and meet our pre-authorisation terms and conditions. This provides policyholders a wider choice of specialists and supports better continuity of care for patients.



Refer to the Extended Panel FAQs

 

Who is Eligible for Extended Panel (EP)?



  • PRUExtra Premier
  • PRUExtra Premier CoPay
  • PRUExtra Preferred CoPay
  • PRUExtra Premier Lite CoPay
  • PRUExtra Plus Lite CoPay
  • PRUExtra Plus CoPay

Extended Panel Benefits


PRUExtra Premier, PRUExtra Premier CoPay, PRUExtra Preferred CoPay,

PRUExtra Premier Lite CoPay, PRUExtra Plus CoPay and PRUExtra Plus Lite CoPay

PRUPanel Connect (PPC) & EP Benefits Treatment at Non-PPC Partner HI* under Extended Panel specialist1 Treatment at Non-PPC Partner HI* under Non-Extended Panel specialist2
Pre-Authorisation
$3000 Stop loss for CoPay policies#


PRUExtra Premier, PRUExtra Premier CoPay, PRUExtra Preferred CoPay,

PRUExtra Premier Lite CoPay, PRUExtra Plus CoPay and PRUExtra Plus Lite CoPay

PRUPanel Connect (PPC)  & EP Benefits Treatment at PPC Partner HI* under PPC specialist3 Treatment at PPC Partner HI* under EP specialist Treatment at PPC Partner HI and/or Non-PPC Partner HI under Non-EP specialist
Pre-Authorisation
$3000 Stop loss for CoPay policies#
1 level limit increase on Claims-Based Pricing 4 4
Value added services (i.e. concierge, transport, appointment booking) 4 4
Cashless# 4 4

*For the extensive list of PPC Healthcare Institutions (HI), please refer to the PRUPanel Connect website at www.prudential.com.sg/ppc

#Co-Payment as applicable

For PRUExtra Preferred CoPay, the above benefits are not applicable for Private Hospitals and medical institutions under "No Access".

1Eligible EP policyholders who seek treatment from other insurer's panel specialist at non-PPC HI.

2Eligible EP policyholders who seek treatment from non-PPC and non-EP specialist at non-PPC HI.

3PPC Policyholders who seek treatment from PPC Specialist at PPC HI.

4For PRUExtra Plus CoPay, PRUExtra Plus Lite CoPay & PRUExtra Premier Lite CoPay this benefit is not applicable.

 

Submission Instructions



  • Download both forms and provide full information as requested in the forms
  • Email both completed forms and other relevant supporting documents to pre.auth@prudential.com.sg
  • Email has to be sent from business office of the healthcare institution/clinic of the EP specialist
  • Mandatory Forms to download



    Patient Consent

    Patient to fill in the Patient Consent Form and sign

    Patient Consent Form 
     

    Pre-Authorisation

    EP Specialist to fill in the Pre-Authorisation Form

    Pre-Authorisation

    How to Submit a
    Pre-Authorisation Request

     

    Frequently Asked Questions

    What is Extended Panel (EP)?
    Extended Panel (EP) is an initiative by the Multilateral Healthcare Insurance Committee (MHIC), which is appointed by the Ministry of Health (MOH), to allow integrated Shield Plan (IP) insurers to recognise each other’s panel doctors mutually. Under the EP, you may enjoy selected panel benefits when seeking pre-authorised treatments from specialists that are not on our panel, as long as they are on other Integrated Shield Plan insurers’ panels, follow our fee schedule, and meets our pre-authorisation terms and conditions. This provides policyholders a wider choice of doctors and supports better continuity of care for patients.

    Extended Panel (EP) will be launched to customers with a PRUExtra plan on 7 June 2022.
    How do I know if I'm eligible for the Extended Panel (EP)?
    Extended Panel (EP) is currently available for customers who have the following PRUExtra riders:

  • PRUExtra Premier
  • PRUExtra Premier CoPay
  • PRUExtra Preferred CoPay
  • PRUExtra Plus CoPay
  • PRUExtra Premier Lite CoPay
  • PRUExtra Plus Lite CoPay
  • How does a specialist qualify as an Extended Panel (EP) specialist?
    A specialist qualifies as an Extended Panel (EP) specialist if he or she meets all of the following conditions:

  • is on the main panel of another IP insurer
  • has obtained pre-authorisation approval from us,
  • follows our fee schedule, and
  • meets pre-authorisation terms and conditions
  • What are the benefits of being treated by an EP specialist?

    The Extended Panel (EP) initiative gives Prudential’s customers even more options to seek treatment from specialists they prefer, even if the chosen specialists are not on Prudential’s panel, as long as the chosen specialists are on the main panel of another Integrated Shield Plan (IP) insurer.

    When you choose to seek a pre-authorised treatment with an EP specialist, you can continue to enjoy selected panel benefits that comes with your plan. The benefits will differ based on the plan you have and whether the EP specialist provides the treatment at our Partner Healthcare Institution (Hospital or treatment centre) or not.

    Benefits for PRUExtra Premier, PRUExtra Premier CoPay and PRUExtra Preferred CoPay Customers when using an EP

    Here is a comparison of the benefits you enjoy when your EP specialist provides treatment at our PRUPanel Connect (PPC) Partner Healthcare Institution vs non-PRUPanel Connect (PPC) Partner Healthcare Institution.

    For a list of PRUPanel Connect (PPC) Partner Healthcare Institution, visit https://www.prudential.com.sg/ppc


    Benefits Treatment at PRUPanel Connect (PPC) Partner Healthcare Institution Treatment at non- PRUPanel Connect (PPC) Healthcare Institution
    Pre-Authorisation of Claim
    $3,000 co-payment cap per Policy Year for CoPay riders
    1 level limit increase under the Claims-based pricing approach
    Cashless medical treatment with a higher Letter of Guarantee amount
    Value added services (i.e. concierge, transport, appointment booking)

    Important Note: If you choose to seek treatment from a specialist who is not on Prudential’s Panel and also not an EP specialist, or if the specialist has not obtained the pre-authorisation before an admission/day surgery, you will not be able to enjoy the benefits listed above. For PRUExtra Preferred CoPay, the above benefits are not applicable for Private Hospitals and medical institutions under “No Access”.

    Benefits for PRUExtra Plus CoPay, PRUExtra Premier Lite CoPay and PRUExtra Plus Lite CoPay Customers when using an EP

    Here is a comparison of the benefits you enjoy when your EP specialist provides treatment at our PRUPanel Connect (PPC) Partner Healthcare Institution vs non-PRUPanel Connect (PPC) Partner Healthcare Institution.

    For a list of PRUPanel Connect (PPC) Partner Healthcare Institution, visit https://www.prudential.com.sg/ppc


    Benefits Treatment at PRUPanel Connect (PPC) Partner Healthcare Institution Treatment at non- PRUPanel Connect (PPC) Healthcare Institution
    Pre-Authorisation of Claim
    $3,000 co-payment cap per Policy Year for CoPay riders

    Important Note: If you choose to seek treatment from a specialist who is not on Prudential’s Panel and also not an EP specialist, or if the specialist has not obtained the pre-authorisation before an admission/day surgery, you will not be able to enjoy the benefits listed above.

    Is it compulsory for me to seek treatment at Prudential's Panel or an EP specialist?
    No, it is not compulsory. However, you will not be able to enjoy the benefits of being treated by an EP specialist if you choose to seek treatment from a specialist who is not on Prudential's Panel and also not an EP specialist.
    How does a specialist apply to be an Extended Panel specialist?
    Prudential does not require specialists to submit an application to be a part of our Extended Panel. As long as the specialist meets all the conditions of an EP specialist, he or she is deemed as an EP specialist.
    Do all treatments need to be at Prudential's PRUPanel Connect Partner Healthcare Institutions?
    EP Specialists may treat Prudential policyholders at any PPC or non-PPC Healthcare Institution. However, do note that benefits when using an Extended Panel may vary for PPC and non-PPC Healthcare Institutions. Please refer to the benefits of being treated by an EP specialist for a comparison.
    What should I do to enjoy Panel Benefits when using an Extended Panel?

    Once you have selected your specialist, inform the clinic staff that you need their assistance to submit a pre-authorisation request to Prudential. Selected panel benefits are only available if the EP specialist has obtained pre-authorisation approval from Prudential, meets the terms and conditions and follows our fee schedule as laid down in the pre-authorisation certificate.

    The specialist will need to submit 2 forms to Prudential for pre-authorisation purposes, namely the pre-authorisation form and the patient consent form, which are available at https://www.prudential.com.sg/ppc on 7 June 2022.

    What does the EP specialist have to do for me to enjoy selected panel benefits?

    To be eligible for panel benefits when using an EP, it is mandatory to seek treatment from a specialist that meets the conditions.

    Step 1: Specialist to book a date with the Healthcare Institution for the treatment

    Step 2: Submit a pre-authorisation request to pre.auth@prudential.com.sg.

    Step 3: Prudential processes the pre-authorisation request. In case approval is granted, EP Specialist must meet the terms and conditions, including specialists fees, as stated in the pre-authorisation certificate.

    Step 4: E-File claim directly through Healthcare Institution as per terms on the basis of which the pre-authorisation certificate was granted

    If all the above criteria are met and the claim is approved, the claim would be granted panel benefits when using an Extended Panel.

    How many days will it take for a pre-authorisation request to be processed?
    We will require between 1- 3 working days from the date we receive the completed pre-authorisation form and supporting documents. In the event further clarification is required, we may take longer to review the request.
    What can I expect after Prudential approves the EP pre-authorisation request? 
    We will issue the certificate of pre-authorisation stating the amount approved for the specific medical diagnosis, treatment date and procedures to the applicant.
    What are some common rejection reasons?
    Generally, we decline pre-authorisation requests due to policy exclusions, outstanding premiums or inadequate medical information necessary for assessing the pre-authorisation request.
    Do I still need to make a deposit payment even though the pre-authorisation request have been approved?
    The hospital has absolute discretion in determining whether a deposit is still required, even with the approved certificate of pre-authorisation.
    I am currently seeking treatment at a specialist not under EP (“non-EP specialist”). Will I enjoy selected panel benefits if I switch to an EP specialist?

    If you are switching from a non-EP specialist to an EP specialist (within the same Policy Year) and have claimed from PRUShield prior to the switch to an EP specialist, you will be eligible for the stop-loss benefit but not eligible for 1 level limit increase under the Claims-based pricing approach.

    Within the same Policy Year Treatment at PPC Healthcare Institution Treatment at a non-PPC Healthcare Institution
    First Claim:
    Non-EP specialist
    (Before, on or after 7 Jun 2022)
    No Stop-Loss

    Not eligible for 1 level limit increase under the Claims-based pricing approach
    Second Claim:
    EP specialist
    (On or after 7 Jun 2022)
    Stop-Loss

    Not eligible for 1 level limit increase under the Claims-based pricing approach
    If I am admitted to the hospital multiple times a year under an EP specialist, do all the admissions have to be at a PRUPanel Connect Partner Healthcare Institution in order for me to enjoy the 1 level limit increase on claims-based pricing?

    Yes, all admissions will have to be at a PRUPanel Connect Partner Healthcare Institution in order for you to enjoy the 1 level limit increase due to claims-based pricing.

    Are the panel benefits applicable if I consult an EP for inpatient hospitalisation, day surgery, outpatient treatment and Pre- and Post-hospitalisation?

    EP benefits are applicable only for inpatient hospitalisation, day surgery claims, and pre- and post-hospitalisation claims where the main inpatient or day surgery claim has been approved as an EP case. EP benefits do not apply to outpatient treatments.

    When is Prudential launching the EP? Do I get panel benefits for pre-authorised treatments with an EP before the launch of the EP?

    We are launching the EP programme on 7 June 2022. Admission before 7 June 2022 with an EP will not be eligible for any panel benefits.

    Why is Prudential launching EP on 7 June 2022 while some insurers have already launched their EP programme?

    Integrated Shield Plan (IP) insurers may adopt different approaches to rolling out EP. Some have chosen to provide EP to customers only after the next policy renewal while others have chosen to roll out the benefits to all customers on a fixed date.

    Will I always have access to EP benefits as long as I seek treatment from specialists who are on other insurer’s panels?

    No, panel benefits will only be granted when your treatment at an EP is pre-authorised, follow our fee schedules and meet pre-authorisation terms and conditions at the point of claim. Please note that a specialist may opt not to activate EP, depending on the case.