Third party payment scheme: electronic invoicing (eFact)

As a general practitioner or specialist, you can enter your invoices electronically in the third-party payment scheme for consultations, home visits and technical services.

CM applies the legally provided principles of payments/compensation for eFact payments as determined by art. 206bis of the coordinated law of 14 July 1994*.

What does this mean?

CM will take into account all payable and recoverable invoices when paying the eFact invoice. This applies to invoices that are drawn up with the same Riziv number and the same bank account number. This means that one or more invoices can be included in one payment, depending on whether there are yet un(re)paid invoices that have been registered for the same Riziv number and bank account number.
In case of daily invoicing, multiple invoices can be included in one payment (e.g. the invoice we receive on Thursday evening will be paid together with the Friday evening invoice).
If you invoice periodically (once a week or once a month), multiple invoices will only be included in one payment in the event of corrections.
For such a 'composite' payment, the paid invoices are listed in a payment slip.
If you use different account numbers for your eFact invoicing (e.g. you work in multiple practices with different account numbers), your payments for those different account numbers will not be mixed.
For substantive questions about the performance for which we are correcting, please contact your UCP .

_{* Art. 206bis § 1. In the context of the insurance for medical care, any sum that must be paid by the insurance institutions to a healthcare provider can be used by operation of law by the insurance institutions to pay the amounts owed by the healthcare provider that he has wrongly received , or to settle any other debt claim arising under this law, its implementing decrees and regulations and the agreements and arrangements concluded under the same law.}

Invoicing is done via MyCareNet and is drawn up in accordance with the instructions for invoicing on magnetic or electronic media , as laid down by the Riziv. A general practitioner cannot open a global medical file via this circuit (102771). This can be invoiced digitally via the eGMD .

The use of eTar (only for general practitioners) and eFact does not require informed consent from the patient or therapeutic relationship .

For invoicing you need software that has been approved by the NIC or for which the approval procedure is underway .

Advantages

Electronic invoicing is simpler and faster than the paper procedure.
The payment term is a maximum of fifteen days instead of thirty days for general practitioners and two months for specialists.
If your electronic invoicing is accepted, you will first receive a payment file and then your payment. This payment will be made a maximum of fifteen days after receipt of your shipment. The following factors also play a role in this: priority rules (receipt date of shipments, statutory payment terms) and the provision of funds by the Riziv.
Your invoicing will be processed without sending any papers (summary invoice, certificates, supporting documents, etc.).
For patients without increased compensation, the application of the third-party payment scheme is justified via your software .

Request information

With a view to correct billing, you can request the following information when contacting your patient via MyCareNet:

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). CM will check these rules when it checks your invoicing.