Reimbursement for expenses due to illness according to the new DBC-system

Inhoudsopgave

• The DBC system
• What does this mean?
• A-and B segment
• B-segment-DBC and possible financial consequences for you
• Consequences for your reimbursement

The DBC system

The costs for you as a patient, in every hospital in the Netherlands, are calculated according to the Diagnosis-Treatment Combination (DBC).

What does this mean?

Each DBC describes the medical treatment related to your specific care needs. This includes all the steps from the first consultation to your last check up. Costs are related to every treatment. A DBC describes the costs that can be made on a total treatment such as consultation, blood test, x-ray, hospitalization etc.

The price of every DBC applies to the whole treatment, including all interventions during the treatment. The numbers communicated indicate averages.

Therefore in your case the number can be under or over the average. Besides the costs of the treatment also other hospital costs such as buildings, support, staff, etc. are included in every DBC.

A-and B segment

DBC’s are divided in two segments: the A- and the B-segment.

A-segment
At the Netherlands Cancer Institute the focus of this segment lies mainly on revalidation and psychiatry. Prices for these DBC's are set nationwide.

B-segment
Almost every treatment at the Netherlands Cancer Institute is allocated in the so called free segment: the B-segment.
Between the hospital and every health insurance company are contracts and pricing agreements arranged concerning DBC’s. Therefore the price of a DBC can be different for each health insurance company. When there is no contract, so called ‘passers rates’ will be applied. Hospitals are obligated to publish passers rates. You can find the passers rates of the Netherlands Cancer Institute at www.avl.nl .

B-segment-DBC and possible financial consequences for you

In case you need to undergo a treatment from the B-segment, it is important to inform first whether your insurance company compensates this fully. That depends on with which hospitals your health insurance company has made contracts.

Because we are a hospital focusing mainly on the treatment of cancer patients, contracts are being made based on cancer treatments. For this reason the following is not applicable.

For example:

Your health insurance company has no contract for treatment X with het Antoni van Leeuwenhoek, but with another hospital. You still choose treatment at het Antoni van Leeuwenhoek. De price for the treatment is 5000 euro (passers rates). Your health insurance company has a contract with another hospital for the same treatment for 4000 euro. In that case your health insurance company can decide to reimburse you only 4000 euro. You will have to pay the remaining 1000 euro by yourself.

This depends on which kind of insurance policy you have.

Consequences for your reimbursement

• When you are insured in The Netherlands, the invoice of the hospital goes directly to your insurance company. When you need to pay a certain amount of own contribution then you receive a copy of the invoice per post.
• When you are insured outside of Europe, we advise you to consult your health insurance company. The rates per DBC in either the A as well as the B segment are in general a lot higher than you might be used to. This has to do in part with the fact that hospital costs are now a fixed component of every DBC. At Debtor Administration you can request information about the pricing of the DBC that is valid for your situation.
• If you are insured within Europe, please hand in an original filled out E112 form at Debtor Administration. You can request this form at your health insurance company.
• When you are not insured, you need to take into account much higher costs than you are used to. This also had to do with the fact that hospital costs are now a fixed component of every DBC.
• At Debtor Administration you can request information about the pricing of the DBC that is valid for your situation.

In case you are not insured, please notify the registration desk. The employee will get you in touch with someone of Debtor Administration to get to an agreement on payment.

More information

For more information please contact the Debtor Administration: via the general phone number of the Netherlands Cancer Institute: +31 20 512 9111.

Meer informatie

Contact

Telefoonnummer: 020 512 9111.

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Informatie op internet

www.avl.nl

www.avl.nl/mijnavl

www.avl.nl/parkeren

www.avl.nl/gasthuis

Bezoekadres

Antoni van Leeuwenhoek

Plesmanlaan 121

1066 CX Amsterdam

Postadres

Antoni van Leeuwenhoek

Postbus 90203

1006 BE Amsterdam

August 2020