In certain situations, doctors and dentists can charge additional fees for personal convenience (CP), provided the insured person was previously informed and gave their consent. The additional fees for personal conveniences are not reimbursed by the CNS; the insured person will bear the full cost.
Personal protective equipment is not a personal convenience.
The personal protective equipment imposed by the measures introduced to limit the spread of COVID-19 cannot be charged to the patient either under a CP8 code or for personal convenience in general.
In the context of the COVID-19 pandemic, the Direction de la Santé (Health Authority) imposed - by order of 28 April 2020 - the respect of safety measures and recommended hygiene rules, in particular with regard to personal protective equipment, hand washing and disinfection rules. In this respect, the Health Authority organised distributions of adapted materials.
Types of conveniences
Personal conveniences linked to an appointment
The personal conveniences relating to appointments are billed under the codes CP1 to CP7.
The doctor or dentist has the right to charge additional fees when the appointment was scheduled at your request at a specific time you asked for and if the doctor meets your request.
The following situations are provided for in the doctors' and dentists' convention:
- CP1: appointment scheduled at the request of the insured person at a specific date and time, provided that your appointment was respected by the doctor.
- CP2: appointment scheduled at the request of the insured person on a Saturday morning and given by a doctor who works from Monday to Friday.
- CP3: when the insured person is late for his appointment without providing a valid excuse.
For doctors who only see patients with an appointment or for those who see patients on an appointment-based system for one day or half a day:
- CP4: appointment scheduled at the request of the insured person at a specific date and time after two proposals made by the doctor were not accepted.
- CP5: immediate examination of the insured person without a previously scheduled appointment, except in a case of emergency.
- CP6: when the insured person receives healthcare during an emergency consultation or visit as specified in the doctor's and dentists' nomenclature, and if the urgent nature is not recognised by the doctor.
- CP7: when the insured person asks for medical advice over the phone, only if the conversation lasts for at least 10 minutes.
Personal conveniences linked to a treatment received
The personal convenience relating to a treatment is billed under the single code CP8 and can only be used by dentists.
- CP8: Dental services and supplies agreed with the insured person and delivered beyond the tariffs covered by health insurance or the accident at work insurance.
For personal conveniences, the doctor or dentist writes one of the following codes on the invoice: CP1, CP2, CP3, CP4, CP5, CP6, CP7 or CP8.
CP codes must be invoiced on the same fee note together with the other services provided. The invoices must clearly mention the amount billed for the personal conveniences in order to avoid undue reimbursements by health insurance.
It should be noted that the tariff for additional fees for personal conveniences is not fixed.
Doctors and dentists are however required to set these fees "with tact and moderation".
Personal conveniences in case of hospitalisation in a first-class room or a single-bed room
It is also considered a personal convenience if, at the insured person's request, and in case of an in-patient treatment, the insured person receives healthcare in a first-class hospital room or a single-bed room. In this case, the doctor or any other health professional involved in the treatment (anaesthetist etc.) have the right to apply an increased tariff of sixty-six percent (66 %) based on the official tariff applied for second-class consultations, visits and medical acts and services.
However, the tariff cannot be increased if hospitalisation in a single-bed room was made necessary for medical reasons.
Services provided in the operating room can also be increased if the insured person only occupies the first-class room within 48 hours of the surgical operation or within 48 hours of leaving the intensive care unit.
These additional fees are not covered by health insurance.
In case the insured person misses their appointment
If the insured person misses their appointment without previously providing a valid excuse, the doctor may invoice - by way of compensation - the tariff of a normal consultation not covered by health insurance. However, in case of an important treatment, the doctor can charge an amount equal to the prejudice he or she suffered, set with "tact and moderation". The invoice indicates the amount claimed for the consultation and is marked with "non-observed appointment".
The indemnity for failure to keep an appointment is due if the appointment was not cancelled 24 hours in advance for a consultation and 2 working days in advance for a more important treatment. The insured person must have been previously informed about the importance of the treatment as well as the applicable cancelation deadline when they accepted the appointment.
If the insured person believes they were charged for a CP for no valid reason, the should contact the doctor directly to clarify.