'To health insurer', 'To patient' and 'Rejected'
These are the three columns that we split the declaration's total amount over.
You will have to judge whether this rejection is valid and how to continue: should it be invoiced to the customer or should it be submitted to the health insurer again, possibly with a correction. Of course you could also choose to not charge the rejected amount at all.
- To health insurer -> The share that the health insurer will cover
- To patient -> The share that the health insurer will not cover
- Rejected -> The share that the health insurer rejected with a return code given (only visible for declarations that require action)
You will have to judge whether an insurer's rejection is valid and how to continue. You might invoice the declaration to the patient or want to resubmit it to the health insurer, possibly with a correction. Of course you could also choose to not charge the rejected amount at all.
Why is the declaration rejected?
Health insurers use return codes to elaborate on their acceptance or rejection. If a declaration is (partially) rejected you can hover over the return code of each treatment to see their reasoning.
If the return code's reason is unclear or if you think this might be wrong, you can contact the relevant health insurer to ask for more elaboration.
How do I invoice the declaration to the patient?
If the health insurer has rejected the declaration and you agree with this rejection, you can also invoice the declaration to the patient. To do so, check the rejected treatments and select 'Create invoice'. You will then see an overview of what will be invoiced. Choose 'Create invoice' again to create the invoice.
How do I resubmit a declaration?
Sometimes a declaration needs to be resubmitted, with or without a minor adjustment. You can read how this works in this support article.
The health insurer has informed me that the reimbursed amount will change
Occasionally, a health insurer may go back on an earlier decision. They may still reimburse (part of) a treatment - for example, after phone contact - or they may withdraw reimbursement. We explain how to deal with that in this support article.
