Costs and reimbursements

Costs and reimbursements

The care providers in our practice have decided not to conclude contracts with healthcare insurers. Our therapists can therefore focus more on the individual needs of you as a client. Your healthcare insurer will partially or fully reimburse your treatment costs in mental healthcare (GGZ), provided that these are covered by your basic health insurance and you have a valid referral. A prior consent statement from the healthcare insurer may also be required.

Regardless of the amount of the reimbursement you receive for the treatment, this is always after settlement with your statutory excess. For 2020 government has set the minimum deductible excess at € 385 per year. This means that you have to pay the first €385 (or more, if you have opted for a higher deductible excess) of your health care costs yourself, at least if you have not already spent on other care in 2020.

You are responsible yourself for the financing of the treatment (including interviews before treatment, diagnosis, examinations and ROM). For treatment costs in both the generalist basic mental healthcare (GBGGZ) and specialist mental healthcare (SGGZ), you can normally receive a reimbursement up to 100% of the rate of the Dutch Healthcare Authority (NZa), the rate applied by our practice, through your healthcare insurer. You will have to deal directly with your healthcare insurer to ascertain what your reimbursement will be for the GGZ treatment that you want to receive in our practice. The billing company Famed will send our invoices directly to you. Depending on the cost indication for your treatment, your creditworthiness will be determined by Famed through a credit check.

Because the reimbursement percentage depends on the type of basic insurance you have at the time of the start of the treatment, we advise you to always ask your healthcare insurer in advance about 1. the precise reimbursement for treatment at a non-contracted GGZ institution with an approved quality charter and 2. what (policy) conditions will be applicable.

Changed conditions for care provided by a non-contracted mental health care institution

As the conditions of healthcare insurers in the field of mental health care have changed, we advise you to conduct a comparative study among health care insurers. Establish the following:

1. Do you have a genuine reimbursement policy that fully reimburses the costs of a GGZ treatment by a non-contracted care provider and
2. Does your healthcare insurer offer you the best conditions for following a long-term (multi-year) specialist mental health care treatment (SGGZ) by a non-contracted mental health institution?

Please note! The reimbursement percentage for treatment in the GGZ is therefore no longer the only thing that counts! More and more healthcare insurers have adjusted their conditions for an SGGZ treatment at a non-contracted mental health care institution and require that permission be requested from them in particular for long-term (multi-year) treatment! Some health insurance companies want to receive precise information about diagnosis, treatment duration and the deployment ratio between the practitioner in charge and other mental health practitioners before treatment starts. Considering we are dealing with complex care, we cannot grant such requests of health care insurers!

General basic healthcare (GBGGZ)

In the general basic healthcare, this determined on the basis of intake interviews and diagnosis, a short, medium or intensive treatment is chosen, in accordance with NZa guidelines. Based on each of these performances, a limited number of 45-minute treatment sessions are reimbursed by the healthcare insurer. It is therefore possible that your treatment will stop very soon. If you decide not to continue the procedure immediately after the first intake interview ends, €130.00 (2020) will be charged in the case of the basic mental health care for this consultation. A care note will only be sent to you after the (treatment) process has been completed in our practice.

Specialist healthcare (SGGZ)

The specialist help is recorded in a DBC (DBC stands for Diagnosis-Treatment Combination), a system to keep track of which actions and costs fit the assistance provided. A personal DBC is opened at the start of the intake procedure.

With the specialist mental healthcare a complete intake costs around €3,000.- in connection with the in-depth studies that are being carried out. If you decide not to continue the procedure immediately after the first intake interview, you will be charged €175.66 (2020) for this.

The management assistant, with whom you will have the first intake interview and the final interview, regularly monitors the progress of the treatment by means of pre-, interval- and post-measurements.

The direct and, above all, indirect time taken by the investigations and the ROM measurements are processed as minutes diagnostics in the DBC. The psychiatrist is also reimbursed via the DBC. You will receive a care bill only after a DBC has been concluded (a maximum of 365 days). You can find more information about your care bill in our client brochure.

NZa rates list GBGGZ en SGGZ

As standard price list, the rate lists of the Dutch Healthcare Authority (NZa) are used. Click on the NZa Tariff Decision 2019 for general basic care (GBGGZ) here. For 2020 click here. You will find the NZa Tariff Decree on Specialist Healthcare (SGGZ) in 2019 here. You will find that for 2020 here as an attachment.

Changing health insurance

You can change healthcare insurance once a year. We advise you to take a genuine reimbursement policy because you will then have the most freedom in choosing a doctor, hospital or GGZ institution. Although a reimbursement policy costs a little more in terms of premium than a natura-policy, you will often be reimbursed much more. Pay attention! Till 31 December you will be able to change healthcare insurer.

Reimbursements

If you wish to receive reimbursement for your treatment in mental health care, you need a referral from your general practitioner in addition to a good basic insurance policy.

When you seek care from a non-contracted GGZ institution, it is important to first determine what exactly the reimbursement will be for the treatment you want to follow and which conditions are linked to this by the healthcare insurer.

Healthcare insurers are unfortunately authorised by government in some cases to reduce your reimbursement and to require you to request a declaration of consent from them each time before you start a new treatment program (every 6-12 months). In order to prevent unexpected costs later on, we advise you to always ask your health insurer in advance about the exact reimbursements and (policy) conditions for a GGZ treatment by a non-contracted, BIG-registered care provider.

No-show fee

Each therapy requires an effort by both the therapist and the client. Regularity in attending therapy is very important for its effectiveness. The frequency of treatment sessions per week is predetermined to ensure that the desired progress will be made. Cancelling an appointment, even done timeously, is undesirable from a therapeutic point of view, because you miss an opportunity to make progress.

Our practice, however, also aims to counter waste in healthcare. We therefore feel compelled to charge a no-show fee of €110.00 to clients who do not appear at the sessions, without having cancelled timeously. You are required to cancel appointments at least two working days or 48 hours in advance (excluding weekends). You can only cancel your appointment by emailing us at or by using the email address of your therapist. Costs related to appointments for which you do not show up will not be reimbursed by healthcare insurance companies.

Requesting a copy of a medical file

A request for the retrieval of your medical file will be taken up immediately and, depending on the size or complexity, delivered to you within 1 month or 3 months. There are no costs associated with requesting a first copy of your medical file. For the provision of multiple copies of medical records data, you will be charged €0.23 per page as a reimbursement of costs. A maximum of € 22.50 per copy of your medical file applies here. If you do not submit it digitally, a copy of your medical record can only be retrieved by you personally at the practice (secretariat).