Arrangements and fees
Psychodiagnostics and psychotherapy are in principle fully reimbursed under the health insurance (basic package), provided you have been referred by your general practitioner. Treatment in specialist mental healthcare is claimed on a monthly basis according to the so-called Zorgprestatie model. You can find what the government rates are here, as determined by the Dutch healthcare authority.
No contracts with health insurance companies
I have no contracts with health insurance companies, because the conditions of these contracts are too binding and regularly conflict with the professional standards in our profession. More information about our objections and concerns about mental health care can be found on op Contractvrije Psycholoog, an information site of psychologists working in mental health care in the Netherlands, who do not want to be bound by the health insurer’s impositions. If you have a so-called reimbursement policy (restitutiepolis), the care is generally fully reimbursed. With a “natura” policy, as a rule, at least 70%.
It is important to first inquire whether your health insurance will cover my care as I have no contracts. From 2022 onwards, some health insurance companies require prior application for reimbursement for a non-contracted clinical psychologist and psychotherapist . Without permission, the treatment may not be reimbursed.
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Treatment rates and "No show"
The rates for the treatments are based on the standard amounts set by the Dutch healthcare authority. You can find what the government rates are here. The invoice is sent directly to you as a client each month; you can submit the bill to your insurer.
You will be given the opportunity to pay when you have received the reimbursement from the insurer. If your insurance does not reimburse the full NZa rate, a payment arrangement will be made prior to the treatment. The expected personal contribution to the treatment will be charged to you per session, in the form of a monthly advance invoice (maximum €55 per session, depending on your insurance conditions). This is to prevent you from being faced with high costs afterwards.
More about rates for Other Healthcare Product (OZP) and rates for self-payers can be found here.
If you do not show up for an appointment or if you cancel less than 24 hours in advance, the reserved time will no longer be reimbursed by the health insurer. From January 1, 2014, this is an amount of € 50. A cancellation recorded on the answering machine during the weekend counts, as well as an e-mail, as a timely cancellation, provided that it is recorded / sent more than 24 hours in advance.
Choice health insurance
A new insurance policy can always be selected at the end of each year. If you want to switch, it is good to keep an eye on two dates: you must cancel your current insurance before 1 January and a new insurer must be chosen before 1 February of the same year. To possibly choose a new insurance policy, use can be made of the overview of van Contractvrije Psycholoog; there you will find the full refund policies and the corresponding monthly premium. No rights can be derived from the overviews.
*** Care in specialist mental healthcare is administratively included in so-called DBC processes. Such a DBC has a maximum term of 365 days. For example, if your DBC was opened on 11/30/2020, that process will run until 11/30/2021 at the latest and a new DBC will be opened if the treatment is continued. The costs of the process running from 11/30/2020 to 11/30/2021 will be reimbursed by the health insurer you had in 2020 and settled with the deductible for that same year. The process that starts on 30/11/2020 will be reimbursed by your health insurer for 2020. The start date therefore counts!
The registration waiting time (waiting time from the moment of first contact for an appointment and the date on which the intake takes place) is at least 3 months. You will be placed on the waiting list as soon as the referral from the doctor and the registration form have been received. There is no treatment waiting time (waiting time from the moment of intake to the start of treatment). Waiting time is independent of where you are insured.
If you think the waiting time is too long, you can always contact the healthcare provider or ask your health insurer for waiting list mediation. Your health insurer can support you so that you have an intake interview within 4 weeks of your first contact with a healthcare provider, and that the treatment has started within 10 weeks of the intake. These are the maximum acceptable waiting times that have been jointly agreed by healthcare providers and health insurers (the target standards).
When you have a complaint
The professional codes of NIP, LVVP and NVP are leading. If you are not satisfied with the treatment and/or care, you can first make this known in a conversation. A solution is oftentimes found. If you are still dissatisfied, then you can consider submitting a complaint. You can find out how this works here on the P3NL website.
-Cliëntenfolder LVVP 2020
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