Conventioning
As a conventional doctor, you subject your entire practice (fees and travel allowances) to the conditions of the doctor-health insurance fund agreement.
Conventionalization has several advantages , both for the patient and for the doctor . In addition to a financial incentive for the doctor, it offers patients access to quality care at an affordable price.
Accessible care
By conventionalizing, you offer your patients price certainty and you contribute to accessible and supportive health care for everyone .
Social status
As a partially or fully conventional doctor, you enjoy a social status:
- or an annual contribution as reimbursement of the premiums for life insurance and/or pension and/or disability contracts;
- or a reserved right to a retirement and/or survivor's pension.
More information about the social status can be found on the Riziv website .
Practice allowance and telematics premium
As a general practitioner you are eligible for an integrated premium to support the practice and the use of eHealth services.
More information about the practical premium can be found on the Riziv website .
How to conventionalize?
Any doctor who does not indicate that he refuses to accede to the agreement is automatically considered fully contracted .
Doctors who wish to partially contract must indicate at which places and times they will not respect the rates included in the medical-health insurance fund agreement.
Partially contracted doctors may deviate from the official rates a maximum of three times a week (per block of a maximum of four consecutive hours) and charge supplementary fees for consultations, appointments and services organized in the consultation room.
Additional condition
- The rest of the practice represents at least three quarters of the total and is carried out for the fixed fees in the agreement.
Partially contracted medical specialists may deviate from the official rates and charge supplementary fees a maximum of four times a week (per block of a maximum of four consecutive hours). This is only allowed for services (consultations, appointments, technical services, etc.) to outpatients (non-hospitalized patients and patients outside the day hospital or flat rate).
Additional conditions
- Half of the services provided to outpatients are provided at the agreed fees and at hours that are normally convenient for the patients;
- At each practice location, benefits in kind are provided for outpatients for a certain period at the fixed fees stated in the agreement.
Special patient requirements
If the patient has special requirements, it is exceptionally possible not to apply the provisions of the agreement. The doctor must inform the patient in advance about the financial consequences of his special requirement.
- Non-urgent visits carried out at the patient's request outside the doctor's hours or normal rounds .
- Calls from sick people that entail an unusually long journey for the doctor.
- Calls at night, during the weekend or on a public holiday if the doctor is not on-call and if it has been demonstrated that the local on-call service is sufficient.
- Consultations at the patient's express request after 9 p.m. or on Saturdays, Sundays and public holidays . However, these consultations do not constitute a special requirement if they are part of the organized on-call service and if the GP holds an accessible consultation for personal reasons, receives appointments or makes visits during these hours and days.
- A hospital admission in a single room requested by or for the patient for personal reasons .
- Calls at home , except for consultations requested by the treating physician.
- Consultations at the patient's express request after 9 p.m. or on Saturdays, Sundays and public holidays .
However, these consultations do not constitute a special requirement if they are part of the organized on-call service and if the medical specialist holds an accessible consultation for personal reasons, receives appointments or makes visits during these hours and days.
Even if a patient is requested by the doctor to report to the consultation room during the above times, this is not considered a special requirement.
Information to patients
Every doctor , contracted or not, is obliged to communicate his contract status in a clear and understandable manner . This must be done, among other things, through a clear and visible poster. If the care provider is partially contracted, he must specify the days, hours and places on which he works at the contract rate. The 'Patient Rights' Act also clarifies that the patient has the right to information about the financial consequences of medical actions.
It is important that the patient receives this information in an understandable manner and before medical treatment . This can be done, for example, by clearly stating the financial consequences when making a telephone appointment, by repeating this information in the confirmation email or when an appointment is made via a website. In addition, verbal information about the cost of care and a poster in the waiting room are recommended. In the future it will become mandatory to hang up poster models with the most common rates .
CM provides three posters that can help inform patients about the convention statute .
Patients can also look up your convention status via the 'Find a healthcare provider' application.
Relevant links