GHS claims for private practices in Cyprus: a practical guide

For a private practice in Cyprus, a GHS visit is three records: the beneficiary and referral at check-in, the personal contribution or co-payment taken at the desk, and a claim for the rest that has to be submitted, tracked and reconciled. This guide walks through each step, the amounts that apply in 2026, the mistakes that cost clinics money, and a monthly reconciliation routine.

The General Healthcare System (GHS, ΓεΣΥ) has been running since 2019, and most private doctors and dentists in Cyprus now see beneficiaries alongside private and insured patients. The clinical side is familiar. The administrative side, which visits are claimable, what the patient pays, what the system pays and when, is where practices lose time and money. This guide is for the person at the desk and the owner who signs off the month.

Who pays what on a GHS visit

A beneficiary reaches a specialist in one of two ways, and the patient's share differs:

Some groups are exempt from co-payments, and some specialties, gynaecology for adult women for example, allow direct access without the €25. The desk needs the current exemption list within reach, not from memory.

Step 1: check-in

1. Confirm the beneficiary number. It goes on the patient record once and is checked, not retyped, at every visit.
2. Record the route. Referral with its date, or direct access. This decides the amount the patient pays and what the claim says.
3. Mark the payer on the visit. GHS, insurance or self-paid. A visit whose payer is wrong at check-in is a claim that is wrong at month end.

Step 2: take the patient's share

The co-payment or personal contribution is the patient's money and belongs in the cash book as a payment from the patient on that visit, not as part of the claim. Print or email a receipt as your receipt system requires. If the amount on a particular visit differs from the default, because of an exemption or direct access, change it on the visit and note why.

Step 3: create the claim

The claim is the remainder of the tariff: the visit, the doctor, the beneficiary, the referral where applicable and the amount. Create it the same day, while the visit is in front of you. Claims created in a batch at month end are where visits go missing.

Give every claim a status and keep it honest:

• Draft: created, not yet submitted.
• Submitted: entered on the GHS portal, with the reference and the date.
• Approved: accepted by the system, awaiting payment.
• Paid: money received, with the date and the remittance it appeared on.
• Rejected: refused, with the reason in the notes, so the correction can be resubmitted.

Step 4: submit on the portal, record the reference

Submission happens on the HIO portal, within the deadlines it sets. The single most useful habit is to copy the portal's reference back onto your own claim record the moment you submit. When a remittance arrives weeks later listing references and amounts, that is what you match against.

Step 5: reconcile monthly

Once a month, sit down with three lists: the visits marked GHS in your system, the claims by status, and the remittances received. Walk through in this order:

1. Every GHS visit has a claim. Visits without one are the first leak.
2. Every claim older than the submission deadline is at least "submitted". Drafts older than that are the second leak.
3. Every remittance line matches a claim, which moves to "paid". Lines you cannot match are either a claim you forgot to record or a payment for another month.
4. Every rejection has a reason and either a resubmission or a decision to write it off.

The output is one number: claimed but unpaid, by age. If it grows month over month, something upstream is broken, usually step 3.

Mistakes that cost money

• Recording the co-payment inside the claim amount, so the claim is overstated and rejected, or understated and underpaid.
• Treating direct-access visits as referral visits, or the reverse. The patient share is different and the claim must match.
• Claims created at month end from the calendar, missing the visits that were moved or re-entered.
• No reference on the claim, so the remittance cannot be matched and "approved" claims sit forever.
• Mixing GHS and private insurers in one pile. Insurers have their own references and timelines; track them the same way but separately.

Private insurers work the same way

A privately insured patient is a payer of type "insurance" with the insurer's name, a policy number and a claim with the insurer's reference. Keep your list of insurers in the system so the desk picks from it rather than typing. The five statuses and the monthly reconciliation are identical; only the deadlines and the forms differ.

A checklist for the desk

1. Beneficiary number on file and checked.
2. Route recorded: referral or direct access.
3. Payer set on the visit.
4. Patient share taken and receipted.
5. Claim created today with the amount.
6. Reference copied from the portal on submission.
7. Status updated when the decision or the payment arrives.