What does it mean to be conventionalized?

To protect the patient, health insurance funds make agreements with healthcare providers about rates. Whoever accepts the agreement is contracted.

Being conventional means choosing, together with the health insurance funds, to protect the patient against unpleasant financial surprises. As a healthcare provider, you then agree to the agreements made and respect the established rates.

Healthcare providers are not obliged to accede to this agreement.

Three situations

  • Conventional healthcare providers
    These healthcare providers accept the agreement with the health insurance funds. They charge the official rates and are not allowed to charge additional fees.
  • Partially conventional care providers
    These healthcare providers accept the agreement with the health insurance funds, but only charge the official rate at certain places or times.
  • Non-conventional healthcare providers
    These care providers do not accept the agreement with the health insurance funds and freely determine the fee.

Inform the patient

Healthcare providers must inform their patients in advance and explicitly about their convention status. The burden of proof of this information obligation lies with the healthcare provider.

You will also find the convention statute in the ' Find a healthcare provider near you ' application.

Special patient requirements

In exceptional cases, if you as a patient have special requirements, a conventional doctor may still charge supplements . The doctor must inform you about this in advance .

Examples of special requirements

  • Consultations at your request after 9 p.m. or on Saturdays, Sundays and public holidays, except when:
    • they fit within the organized guard service;
    • the GP holds an accessible consultation, receives appointments or makes visits during these hours and days;
    • your doctor asks you to register during the above times.
  • Home visits at your request:
    • non-urgent home visits outside the doctor's normal hours or rounds;
    • home visits that entail an unusually large trip for the doctor;
    • home visits at night, during the weekend or on a public holiday if the doctor is not on call and if it has been demonstrated that the local on-call service is sufficient.
  • Hospital admission in a single room at your request.