Usually, or upon request by the insured person, the portion covered by health insurance is directly covered by the CNS.
Third-party system also applies when:
- The insured person receives acts as part of the accident insurance association (Association d’assurance accident AAA),
- The insured person receives acts as part of an in-patient treatment in a hospital or
- Travel allowances as well as travel expenses per kilometre arise.
As part of the third-party system, the insured only pays the portion of the costs not covered by health insurance.
Upfront payment by the insured person
If the third-party system is not applied, the speech therapist issues an invoice, which must be paid upfront by the insured person. The invoice shows the total amount to be paid, in other words the portion of the costs covered by health insurance as well as, if applicable, the portion of the costs to be borne by the insured person. After settling the invoice, the insured person sends a reimbursement request to their competent fund (CNS or public sector fund) in order to be refunded for the portion of the costs covered by health insurance.
In order to be refunded for an invoice issued by a speech therapist, the invoice must:
- show the matricule number of the insured person, their name and surname as well as the number of the certificate of coverage ;
- be paid and receipted ;
- be submitted with the medical prescription and the certificate of coverage.
Coverage rate for acts and services by speech therapists is set at 88%, except for children and youngsters below the age of 18, who are entitled to coverage at 100% for all acts of speech therapy.