How is a healthcare bill formed?
Whoever goes to the hospital can get care, and this can range a doctor’s examination to an X-ray. But the hospital does not charge this separately. The care provided is itemized in one bill and therefore provided as one package, a so-called DBC-care product. DBC stands for Treatment Diagnosis Combination and consists of all the hospital’s activities and medical specialist used to provide a particular. Diagnosis and treatment are grouped together and charged as a single cost. This is recorded in one administrative code. The Dutch Healthcare Authority has outlined the process from hospital visit to finally invoicing the costs, in order to provide an understanding of how reimbursement works in hospitals: What do doctors register? And how that is billed finally? For more information, watch the video of the Dutch healthcare authority.
Reimbursement of basic care
Reimbursement of basic care means all care paid from the basic package budget by your Dutch insurer. The care covered from this budget is determined by the Government, but it is mainly about the medical necessity of the care provided. Whether (a part of) the treatment is covered or not by the basic package, will be promptly indicated by your practitioner, so no unexpected costs will arise.
Referral letter
You will need a referral letter from your general practitioner or dentist in order to be financially compensated for the basic care provided. You must provide the referral letter when you visit us during your first appointment. Without the referral letter, the treatment cannot be considered as basic care and will not be covered by the package, even if it is a disorder that is included in the basic package. The care will then be considered as non-covered care.
Refund or Natura policy
Do you have insurance with full coverage (refund policy)? In that case the medically necessary care even with a non-contracted healthcare provider will be fully covered. Do you have a limited coverage (natura policy)? Please contact us for more information about procedures, applications and fees regarding your healthcare provider and policy. The terms and conditions set by your health insurance provider also state the level of compensation you are entitled to. The own risk applies to a treatment for both the refund policy and the natura policy. Administration and settlement of insurance covered basic healthcare, and the treatment thereof are in accordance with the DBC system. More information can be found on the website of the Dutch Healthcare Authority
Additional insurance covered healthcare and other care
Treatment that is not medically necessary is not covered by basic insurance, but may be covered by additional insurance. In that case, after the completion of the treatment you will settle the bill directly with us and then apply for a refund from your health insurer afterwards. If there is any clarification needed, we will be more than happy to assist you in the correct declaration of your medical expenses. Please consult the terms of your healthcare policy to determine the level of supplementary insurance offered. These conditions may differ depending on the health insurer. For questions concerning this issue, we advise you first to contact your health insurer.
Foreign health insurance
Generally, foreign health insurance companies always cover hospitalization and nursing costs regarding outpatient specialist. In addition, the costs of general practitioners, paramedical assistance, childbirth and maternity care, dental costs for youth and orthodontics are (almost) always guaranteed to be covered. However, these components may differ with respect to the maximum level of reimbursed. In addition to possible restrictions on the amount of fees, it should be noted that not every fee is given without further notice. In order to be eligible for a reimbursement, you must in most cases have prior referral for the treatment issued from the insurer or have a prescription from the general practitioner/specialist. We will gladly assist you in claiming the compensation you are entitled to by contacting your insurance company.
