If you are in treatment in the mental health care system (GGZ) in 2022, you will notice a change in the way you will be invoiced.

The mental health care system will start invoicing in a new way, called the Zorgprestatiemodel, which translates into Healthcare Services Model. It means that instead of being invoiced once a year for the whole treatment (as done up until 31-12-2021) you will be invoiced monthly or bimonthly, with separate charges for each service. The new model is meant to bring more clarity to patients and clients about the invoice.

In the below text you can read more about the changes and the effect thereof on invoices for individual clients.

PAY ATTENTION:

Many health insurers have changed their policy conditions for the year 2022.

Check carefully with your health insurer with regard to the full (100%) reimbursement for psychotherapy (GGZ) at a non-contracted practice. Only policies that are a so-called “zuivere restitutie polis” will give a 100% reimbursement of the treatment at Ithaca Psychotherapy, since we are a non-contracted / independent practice.

Moving forward from 2021 to 2022

The new invoicing system for mental health care will come into effect on January 1, 2022.

If you have received treatment in 2021 and your treatment continues into 2022, you will be invoiced under the old system up until 31 December 2021. You will receive a separate invoice for the treatment until 31 December 2021. Starting from 1 January 2022 your healthcare provider will register and invoice your healthcare according to the new Healthcare Services model.

What does this mean for you? We explain the consequences of the new model below.

  • How does the Healthcare Services model work?
  • What will my treatment cost?
  • What will change on the invoice?
  • What services might be mentioned on the invoice?
  • What is ‘healthcare demand typing’?
  • What happens to my “eigen risico” (“own risk”)?

 

How does the Healthcare Services model work?

It has become clear that the old way of invoicing mental health care is no longer suitable. The invoice for treatment was sent only at the end of the treatment process ( sometimes) or after a year. The invoices were often not clear to clients. That is why a new way of invoicing will come into effect starting 1 January 2022: the Healthcare Services model. In the new system, mental health care treatments are no longer seen as a whole, but as separate services (Healthcare Services). Invoices will show the separate services instead of a treatment as a whole.

The healthcare you receive will not change. It will become easier for you to check your invoice. You will be able to see exactly who you spoke with during a consultation and how much time you are charged for this. Moreover, the invoices will be sent monthly or bimonthly instead of once a year.

 

 

 

 

How much will my treatment cost?

At the start of your health care treatment it is not always clear how long your treatment will take or what exactly is needed (individual sessions, group therapy etc.). That is why it is usually not possible to estimate the total cost of your treatment in advance.

However, it is clear right from the start how much each part of the treatment costs. Your healthcare provider charges a fixed rate for each individual part of the treatment (the healthcare service).

Ithaca is an independent psychotherapy practice. There are separate rates for independent mental healthcare providers. The rates are therefore different (and often lower) than the rates for mental health care in an institution. All rates are nationally determined by the Dutch Healthcare Authority (Nza). You will find all rates in the rate finder of the NZa online at tarievenzoeker.  Ithaca charges the Nza rate for independent healthcare providers.

Sometimes health insurers don’t reimburse the entire invoice for care provided in an independent practice. Please carefully review the policy conditions of your health insurance or call the customer service.

What (Healthcare) services can be on the invoice?

In the independent psychotherapy practice, four different healthcare services are distinguished:

  • diagnosis consultation: during diagnosis, your practitioner/intaker ,usually together with the team, examines what your treatment needs are,

what are the issues you seek mental help for;

  • Individual treatment consultation: during treatment you will have treatment sessions with your practitioner;
  • peer consultation: if your practitioner considers it is necessary for your treatment to consult with a colleague outside or inside the practice;
  • travel time: if the practitioner has to come to you;
  • group Therapy consultation: if you participate in group therapy

The rate for each of these healthcare services can vary according to the profession of your practitioner. The final amount on the invoice can vary, based on the variable duration of the consultation.

Group size is a factor in the invoicing of  group therapy.

Up until 31-12-2021 the diagnosis determined the overall price of the treatment. This is no longer the case with the new system. The specific services your care demands, the duration thereof and the profession of your practitioner determine the final amount on your invoice.

What is ‘care need typing’?

Health care insurers are asking for a new type of classification of our clients, which is to replace the old system based on diagnosis of the clients. This new classification is done by stating the type of care need for each client.

Determining the type of care need will be done by the coordinating practitioner. For this a questionnaire will be administered to each client, called HoNOS+.

Based on the answers to the HONOS+ questionnaire, the coordinating practitioner determines which type of care need best suits the issues you present. The type of care need will ultimately give information about the expected treatment effort and will be stated on your invoice.

What happens to your “eigen risico” (“own risk”)?

Mental health care is always charged to your “eigen risico” (“own risk”), even when the treatment is 100% reimbursed by the health insurance. The “eigen risico” (“own risk”) is calculated per calendar year. Since our old invoicing system will be closed on 31-12-2021, it is highly likely you will receive an invoice for your own risk at the beginning of 2022, when the new invoicing system will come into effect. Would you like to know more about your own risk? Please contact your health insurer.

 

Good to know:

  • Remain alert if you decide to switch to another health insurer or policy. If your treatment continues into the new calendar year, this part will be covered by the new health insurer or policy. Check whether the new health insurer or policy will (fully) reimburse your treatment at Ithaca Psychotherapy practice in 2022.
  • Are you already in treatment at Ithaca Psychotherapy practice and will your treatment continue in 2022? Then you don’t need a new referral from your GP.