The terms and conditions for the reimbursement of dietetic services will be defined by the agreement between the CNS and the "Association nationale des diététiciens du Luxembourg" (ANDL), the nomenclature of acts and services of dieticians and specific provisions to be included in the statutes of the CNS. You will find direct links to these legal bases at the bottom of this page.
The conditions for reimbursement are explained in the space for insured persons (Dietetics) on our website. Providers will find below additional information on the procedure for validating prescriptions and on the functioning of billing through the third-party payment system.
Procedure for validation of prescriptions
To be eligible for reimbursement from the National Health Fund or the relevant public sector fund, all dietary acts must be prescribed by a doctor and the prescription must be validated by the CNS. Prior validation allows the provider to have confirmation that the costs of the treatment will be covered by the maternity health insurance before starting a treatment that extends over several sessions.
Application for validation by the insured person
If the insured person requests validation, they must send the original medical prescription by post to the CNS. The CNS will then send the insured person a written confirmation or a reasoned refusal. If the request is approved, the insured person can go to a dietician and hand over the prescription and the certificate of coverage.
In this case, direct payment by the CNS (third-party payment) is excluded.
Request for validation by the dietician
The request for validation by the dietician has several advantages over the request by the insured person, in particular because the exchange between the providers and the CNS is done electronically and thus allows a faster and more reliable data transfer. At the same time, the electronic application and issuing of the health insurance voucher is a necessary condition for the application of the third-party payment system.
After scanning the prescription received by the insured person and entering the information on it using a suitable computer tool, the dietician sends the scanned request to the CNS and receives a return within one working day (except in special cases). The return is also sent electronically and is either in the form of a reasoned refusal or an agreement completed by a number of the reimbursement voucher, the indication of the period of validity of the voucher and details of the validated services.
Billing procedure
Advance payment by the insured person
At the end of the treatment, the dietician presents the insured person with an invoice showing the total amount to be paid, i.e. the part to be paid by the health insurance company and the part to be paid by the insured person.
After payment, the insured person himself applies to his competent fund (CNS or public health insurance fund) for reimbursement of the part payable by the health insurance.
Application of the third-party payment system
The third-party payment system is not applicable when the insured person has applied to the CNS for a claim. In other cases, it must be applied by the provider if the insured person so requests and for benefits provided to persons protected under the jurisdiction of the Accident Insurance Association.
The part that is not reimbursed by the health insurance is billed directly by the dietician to the insured.
In order to obtain payment of the part of the fees that can be claimed from the health insurance company within the framework of the third-party payment system, the dietician transmits his fee statements in the form of a monthly billing file to the CNS. The dietician can include all the sessions provided without having to wait for the end of a serial treatment (several sessions prescribed by a prescription).
The procedures for drawing up and transmitting the billing file to the CNS are set out in the specifications annexed to the agreement between the CNS and the ANDL and are explained in the "Electronic data exchange" section of this site.
After processing, the CNS sends an electronic file containing all the information and reasons for invoices that are not reimbursed or not fully reimbursed and then proceeds to pay the amount due within 30 days.