Reimbursements

No deductible or co-pay

If you have a referral letter from your general practitioner (huisarts) or youth healthcare doctor (jeugdarts), then the care provided by the pediatrician is always covered under your basic insurance. For children under 18, there is no deductible or co-pay required, so all costs for your visits are always completely covered.

No extra costs

The Pediatric Practice doesn’t yet have any specific contracts with the various health insurance companies, but this is in our plans. Because we don’t yet have these contracts, some insurers, dependent upon your policy, may not reimburse the entire invoice. But because we believe that all children should be able to take advantage of the healthcare we provide, we charge you only the amount that your insurance company reimburses. There are thus no extra costs associated with the care that we provide.

Non-reimbursed costs that are your responsibility:

  • Costs incurred because you cancelled an appointment less than 24 hours ahead of time. These costs are not reimbursed by your insurer.
  • The deductible or co-pay for young adults (18 or older)

The invoice

Because the Pediatric Practice does not have direct contracts with the health care insurers, the payment process works differently than in a hospital:

  • If you are insured by the VGZ group (Bewuz, Unive, umc, Zekur, IZA, IZZ, Aevitae, United Consumers), ZorgenZekerheid or ONVZ then we can submit the invoice directly to your insurer. If there are any unreimbursed charges, you don’t need to pay those (with the exception of the deductible or co-pay associated with patients 18 or older).
  • If you are insured by one of the many other insurers, then we’ll send the invoice directly to you. You can submit this invoice to your insurance company. Once you have been reimbursed, you pay us just the amount that you have been reimbursed. If there are extra unreimbursed costs, you don’t need to pay them. So, you don’t have to pay us until you have been reimbursed, and you don’t need to pay more than you have been reimbursed (with the exception of the deductible or co-pay associated with patients 18 or older).

 

Fees

The fees for medical care for children are set by the Dutch Healthcare Authority (NZA). The Pediatric Practice strictly follows the applicable regulations. According to these rules, the Pediatric Practice must wait 90 days after your initial visit to send you an invoice. The amount of this invoice depends on the number of contact moments that you’ve had with the pediatrician during this 90 day period. The invoice will be sent by secure email.

Does the amount of the invoice surprise you?

Our invoice looks just like the invoice that a hospital would send to your healthcare insurer. You pay us the same amount that you receive from your insurance company. By organizing it this way, we can plan to spend more time with your child than would be the case in a hospital. Click here for more information on how your invoice is prepared. (Note: information is in Dutch)

Reimbursements of partner fees

The Pediatric Practice works closely with a number of other health care providers, e.g., dieticians and physical therapists. Much of this healthcare is included in the basic insurance for children. Other healthcare is reimbursed from the supplemental insurance or from the municipality. The pediatrician will inform you about coverage possibilities before referring you to one of our partners. Our partners will inform you about their fees. Check with your insurer regarding exactly what is covered in your insurance plan.