- Complaints & disciplinary sanctions
- Dispute settlement & arbitration
- Internal investigation
- Counselling for IHR practitioners
- WKKGZ (Netherlands)
- Refunds by health insurance companies
Refunds by health insurance companies
|REFUNDS BY HEALTH INSURANCE COMPANIES|
|Health insurance companies do not automatically refund the costs for a service or session done by an IHR practitioner.|
All health insurance companies have their own criteria on refunding costs for health related services and sessions.
The IHR practitioners have no obligation to comply with the criteria on refunding costs.
However, the IHR practitioners are obliged to inform the client upfront whether they comply with the critreria on refunding.
|!! Qualifying for refunds not automatically guarantees the actual refund !!|
|If the IHR practitioner qualifies for the refunding of costs by the health insurance company, this does not mean the client actually gets the refund. If the client gets a whole or partial refund, depends on several subjects, such as (1) does the polis covers this service or sessions? (2) are refunds limited? (3) did previous refunds effects the available budget within the polis and is there any budget left? (4) do own-risk-conditions apply? The client him/herself has the obligation to find with the haelth insurance company if a refund will be granted and paid out. The IHR practitioner is not liable for this.|
|The health insurance companies in The Netherlands have standarized the policy on refunds. If a medical professional can show proof of (1) a sufficient level of basis medical knowledge (MBK) of (2) a sufficient level of psychological-social knowledge (PSBK), the offered services and sessions qualify for refunds. If the level is not sufficient or can not be proven, the medical professional does not qualify and as result the client will not get any refund. |
The critria on MBK and PSBK are set and operated by PLATO (= Platform Onderwijs Opleiding Organisatie = Platform Education Training Organisation), subsidairy of the University of Leiden (Rijksuniversiteit Leiden).
If the IHR practitioner has a AGB-code, the health insurance company handles the invoice or declaration online and pays the IHR practitioner directly; as effect the cliënt does not pay directly to the IHR practitioner.
All IHR practitioners can display their current MBK and PSBK status and the AGB-code in the public profiles, so clients can see within one view if any refund is possible or not.