Outstanding Statement Sample



  1. Statement Issuing Hospital


  2. Enquiry Numbers

    • Accounts Enquiry - For enquiries relate to information on statement
    • MSW Enquiry - Patients with financial difficulties in payment may contact Medical Social Worker (MSW)

  3. Balance Overdue for More Than One Month

    4. Outstanding payment for more than one month from the statement date

  4. Balance Overdue within One Month

    5. Outstanding payment within one month from the statement date

  5. Total Amount

    6. The total outstanding amount payable as at the statement date

  6. QR code for HA Go

    7. The QR code for hyperlink to download the Hospital Authority (HA) mobile application ‘HA Go’. Through HA Go, patients can check appointment records, make payment, book appointment for general outpatient services and new case of specialist outpatient services, view medication and perform rehabilitation exercise following prescriptions etc.

  7. Details of Outstanding Balance within One Month

    8. Details of relevant bills issued within one month are listed here.

  8. Administrative Charge

    9. Administrative charge will be levied if the relevant bill is not fully settled on or before the stated date.

  9. Electronic Payment Information

    10. The relevant Merchant Code and Account No. information for input when making bill settlement through PPS, internet banking or JETCO Automated Teller Machine (ATM). You can also make payment by scanning the FPS Quick Response (QR) code with supporting mobile applications of the banks or stored value facilities. Please note the bill settlement sequence printed on statement overleaf (if applicable).

  10. Shroff/Accounts Office

    11. Address and office hours of shroff/accounts office of statement issuing hospital

  11. Barcode for Payment at 7-11 Convenience Store

    12. Only for payment at 7-Eleven convenience store