Reimbursement for specialist mental healthcare
Focus GGZ offers specialist mental health care. This is in comparison with medical care: if you have a serious knee injury, you will be referred to a specialist in that field, an orthopedist by, for example, your general practitioner. The same applies to mental health care. If you have psychological complaints that have reached a certain level, you will be referred to a specialist in mental health care. This means that you will need a referral letter from your general practitioner in order to receive reimbursement by your health insurance for our treatments. We must receive this before the intake. If you do not have a referral letter, the intake cannot take place.
Do you have milder complaints and desire to talk to a professional, or not wish to see your general practitioner first? Then we also offer the option to pay for the treatment yourself. Read more about that at the bottom of this page.
The costs of your treatment are determined by the number of minutes spent on your file. This applies to direct minutes (minutes spent on face to face and telephone contact, but also contact via video calling) and indirect minutes (minutes spent on reporting, consultation and contact with, for example, your general practitioner). Rates are linked to the number of minutes. These rates are determined nationally by the Dutch Healthcare Authority. We have no influence on this. Click here
for the document in which all fixed rates for 2021 are stated.
Your financial contribution
Mental health care is always (partly) reimbursed by your health insurance and is included in the basic package, so you will be reimbursed for most of your treatment in any case. The amount of the reimbursement can differ per health insurance. Some health insurerances reimburse 100% of the rate set by the Dutch Healthcare Authority, and others, for example, only 60%. If we do not have a contract with your health insurer and you do not have a full refund policy (i.e. the insurer pays out up to 100% of the NZA rate), your treatment will only be partially reimbursed. In that case, Focus GGZ will bear part of these non-reimbursed costs. However we do request that you make a one time contribution towards the costs of € 250. This only applies if you actually start treatment after the intake. You will receive the invoice by e-mail after the intake, at the start of the treatment. The contribution to the costs is separate from the Health Insurance deductible. (Eigen risico)
Health insurers with whom we have a contract and for which the one time contribution does not apply are:
Claiming the costs incurred for your treatment
You will always receive an invoice for the healthcare you received when your file is closed. This can be after the intake, if it turns out that we do not have a suitable treatment for you, if you want care elsewhere, or if the treatment has been completed.
Contract with your health insurer:
When we have a contract with your health insurer, you do not have to do anything: we will send the invoice directly to your health insurer. You will receive a payment specification after completion. In some cases, even though we do not have a contract, we may still declare directly to the health insurer. Also in that case, you don’t have to do anything. This applies to:
- All labels of Zilveren Kruis
- All labels of VGZ
We do not have a contract with these health insurers and are not allowed to send the invoice directly:
No contract with your health insurer:
If we do not have a contract with your health insurer, we will receive a lower rate than stated on the invoice. Because we want to keep our care accessible to everyone, we will take care of the larger part of the difference. You will receive our invoice for your treatment by email. You then submit this to your health insurer yourself. They will let you know which amount they are going to transfer to you. This will be the amount that you transfer to us. As soon as you have transferred that amount to us, and sent us the payment specification by email, you will receive a credit note for the difference. To do this, follow the next steps.
Payment of invoice:
As soon as you have received reimbursement from your health insurer, you use this amount to pay our bill
To demonstrate that the amount you paid us corresponds to what you received from the health insurer, please send us the payment specification from your health insurer to: firstname.lastname@example.org
After we have received and verified it, you will receive a credit note (remission) from us for the remaining amount
Health insurance deductible
The amount of the statutory health insurance deductible, which the insured has agreed with the health insurer, is always at his own expense. Even if you refrain from further treatment after the intake. The health insurer can specify these costs as part of your statutory deductible. Your intake and treatment will be settled by your health insurer against your outstanding deductible.
The statutory deductible on the health insurance is determined by the government every year. This is the mandatory minimum amount charged by your health insurer for all care used in a calendar year. For 2021 that amount is € 385. You must therefore always pay your deductible if you receive care in the Netherlands and it is completely separate from the care we provide. So whether you go for treatment with us or somewhere else or receive another form of care, you will always be held responsible for this amount.
This means the following:
If your health insurer has transferred amount X, but you still have to pay € 385 euro excess yourself. Then you have to transfer the amount X + € 385, – to us.
Only transferring amount X to us is then not sufficient.
We can only send the credit note when the amount paid out by your health insurer + the deductible has been transferred to us.