Third-party payment scheme
Dentists can apply the third-party payment scheme for all services.
Since January 2022, all healthcare providers can apply the third-party payment scheme for all services, regardless of the patient's status or age.
The third-party payment arrangement means that the healthcare provider or care institution receives reimbursement for the health and disability insurance directly from CM. The patient only pays any co-payments .
This arrangement makes care more accessible to everyone. People who are temporarily in a vulnerable situation or have a low income can use it.
When are you required to apply the scheme?
You are obliged to apply the third-party payment scheme for dental care:
- if your patient is hospitalized;
- for services from the section 'Dental care for cancer patients or anodontia'.
When is the scheme not recommended?
If your patient is not in compliance , it is better not to apply the third-party payment scheme, regardless of the patient's situation.
Request cash payment and advise your patient to make arrangements with CM. If you invoice via third party payment, you will not receive a refund .
You can consult your patient's insurability via your software package or the MyCareNet portal.
How can you check whether your patient is entitled to the third-party payment scheme?
There are two ways to know whether your patient is entitled to a third-party payment arrangement:
How can you consult rates?
The rates (eTar) can be consulted in two ways:
- via a recognized software package;
- via the MyCareNet portal.
Based on the CM data and that you provide (e.g. nomenclature codes), you will receive the following information:
- patient insurability (automatically checked in many software packages);
- is your patient entitled to the third-party payment scheme?;
- the rate that you can invoice per service (eTar);
- a payment obligation provided that the nomenclature rules are respected (e.g. renewal period, prohibited cumuls) and you invoice electronically. CM will check these rules when it checks your invoicing.
How can you invoice CM?
There are two options for invoicing CM:
Where can you go with questions and problems?
Contact the CM team in your region for questions and support.
If you have questions about your software package , please contact your software supplier directly.