Oral care process
The amount of the personal share for an oral care program depends on the reimbursement of dental care provided the previous year.
Due to the oral care process, the amount of the personal share depends on the reimbursement of dental care (only services referred to in Article 5 are eligible) carried out in the previous year .
As a result of the corona crisis, this amount in 2024 exceptionally depends on the reimbursement of dental care performed in 2023 or 2022. This exceptional measure will stop from 2025 and will therefore only take into account the reimbursed dental care that was provided in 2024.
Which dental care does this affect?
The oral care process has an impact on the following provisions of Article 5:
- conservative care;
- extractions;
- radiographs (except for patients with increased reimbursement);
- dental prostheses;
- oral implants;
- emergency supplements.
The oral care process does not affect the following provisions of Article 5:
- consultations;
- preventive treatments;
- periodontics;
- specific dental care services for cancer patients or anodontics;
- orthodontics;
- for patients with increased reimbursement: radiographs and some additional fees (adhesive techniques, rubber dam, wound suture).
Which patients does this apply to?
The oral care process only applies to patients aged 18 and over.
How much is the personal share?
What about the third-party payment scheme?
- Have you provided reimbursed dental care to your patient in the past year and are you sure that the oral care process has been followed? Then you may invoice according to the amounts of the oral care process .
- Do you not know whether reimbursable dental care was provided in the past year? Then charge the rates as if the oral care process had not been followed . If our data shows that the oral care process was nevertheless followed, we will pay the additional amount to the person concerned.
You can consult the rates via MyCareNet. The display automatically takes into account whether or not an oral care program has been followed (based on the data in our possession).