Introduction of the ‘zorgprestatiemodel’ as of 1 January 2022
As of January 1, 2022, a new funding for GGZ (Mental Health Care) will be introduced: the ‘zorgprestatiemodel’. This new system was developed by the ‘Nederlandse Zorgautoriteit’. The content of psychological care in GGZ will not change as a result of this new system, only the funding will change.
Change for ‘zorgzwaarteproducten’ and ‘DBC’s’
Since 2014, a distinction has been made within GGZ between the degree of intensity of the problems and the required care. The treatment of light to moderate (non-complex) psychological problems takes place within the Generalist Basic GGZ (GB-GGZ). If there are more serious and more complex psychological problems, the treatment will take place in the Specialized GGZ (S-GGZ). S-GGZ is characterized by a high degree of complexity of the treatment, which requires specialized knowledge.
At the moment, as a client, you do not receive a reimbursement per consultation, but GB-GGZ has ‘zorgzwaarteproducten’ and S-GGZ has ‘Diagnose Behandel Combinaties (DBC’s)’. The ‘zorgprestatiemodel’ will replace the system of ‘zorgzwaarteproducten’ and ‘DBC’s’ as of 1 January 2022. From 2022, funding will no longer be based on a package, but on the actual number of consultations, the duration of the consultations and the type of consultation (diagnosis or treatment). In addition, there is no longer a standard rate per consultation, but each type of practitioner has its own rate. For example, the rate of a clinical psychologist will be higher than the rate of a GZ psychologist.
As a result of this system change, Taytelbaum Psychologen Amsterdam is obliged to administratively close all ongoing treatments as of December 31, 2021. As a client, you will receive a summary invoice as of December 31, 2021, which you can submit to the health insurer. In this way, a start can be made on 1 January 2022 with the new funding system.
Change for declarations
Taytelbaum Psychologen Amsterdam has no contracts with health insurance companies, but the treatments can often be reimbursed in full or in part afterwards. This means that you first pay the bills yourself and then submit it to your health insurer.
At the moment, you can only submit your bills to the health insurer after the entire healthcare process has been completed (within GB-GGZ) or annually (if the process lasts longer than a year within S-GGZ). This way of declaring is going to change. From 1 January 2022 it is possible to claim per session with your health insurer.
Change for deductible
However, this system change may have consequences for your deductible. From 2022, the treatments in the GGZ will count towards the deductible each calendar year. This means that if your treatment started in 2021 and continues into 2022, the treatment may have consequences for the payment of your deductible in both 2021 and 2022.
As soon as more is known about this system change, we will post the information on our website.