Introducing the zorgprestatiemodel
Published: 1 oktober 2021
Updated: 15 december 2022
From the 1st of January 2022, mental health care will be charged in a new way. This new method is called the zorgprestatiemodel. Your health insurer will continue to reimurse the care, that will not change. The construction of the bill is simplified.
Own Risk per calender year
The most important change that comes with the implementation of the zorgprestatiemodel is the moment you pay your own risk (in dutch: eigen risico). The zorgprestatiemodel applies to the reimbursement of care at Psychiatrie Noord. Previously, you could stay in care for 365 days, whereby the care was only charged to the own risk for the year in which the care started at Psychiatrie Noord. This will be different. You will now pay the own risk for each new calender year. This is a government decision. Patients who are also in care after 2021 will again pay the own risk for the care in 2022.
Example: duration of care 365 days - care ends in 2024
-payment Own Risk zorgprestatiemodel, end date of treatment after January 1st, 2024-
Start treatment: January 1st, 2023
End of treatment: February 1st, 2024
To be paid: You pay the Own Risk for both 2023 and 2024 for this treatment process. The legally required own risk in 2023 and 2024 has been set at €385,- per person per year.
About the zorgprestatiemodel
The implementation of the zorgprestatiemodel makes administration easier and faster. It also becomes easy to find out which care has been paid for you. The bill of your health insurer will be transparent; you can see when a care service was provided, who did it and what it costs.
What are zorgprestaties (care performances)?
Zorgprestaties is the collective name for the various agreements that exist in mental health care. These are the zorgprestaties (care performances) of Psychiatrie Noord:
- Consultation diagnostics – an appointment to map out exactly what care needs you have. At Psychiatrie Noord, the (telephone) intake interviews fall under this type of care performance.
- Consultation treatment – agreements you have with your practitioner. At Psychiatrie Noord, contacts via Teams, the telephone and the patient portal also fall under this type of care performance.
- Groep consultation – appointments that take place within a group. At Psychiatrie Noord, the group treatments fall under this type of care performance.
Care performances have a fixed (average) duration
Thanks to the zorgprestatiemodel we can limit the administration that comes with appointments. The care performances have a fixed (average) duration that we need to justify every year. Sometimes the appointment will take longer or shorter than the fixed time period we use.
Consult by phone - 15 minutes
Treatment consult - 45 minutes
Summary patient information zorgprestatiemodel
In summary, the zorgprestatiemodel provides more insight into healthcare costs and expected treatment duration, simplifies administration for practitioners and allows healthcare insurers to process costs more quickly and transparant.
If you are in care now and will also receive care in 2024, your ownrisk will again be claimed.
Do you have any questions about the zorgprestatiemodel? Ask your practitioner or send an e-mail to info@psychiatrienoord.nl.
