Reimbursement

Fees and billing

At ADHDcentraal, we will tell you in advance how much time is scheduled in the calendar for your appointment. This is also reflected in the ADHDcentral app. This way, it is transparent in advance what to expect. Only if the actual time differs by more than 15 minutes (more or less minutes than pre-planned), you will see that the duration has been adjusted on the bill.
If you have unplanned contact with your practitioner about the content of the treatment in between (for example, by phone or via eHealth), you will see it afterwards. Again, the bill will show exactly who this contact was with and the time charged for it.

Reimbursement from health insurance

Specialist medical care provided by ADHDcentraal is reimbursed from your health insurance’s basic package.
ADHDcentraal does its best to make agreements with all health insurance companies every year regarding reimbursement for our diagnostics and treatments.
For 2024 we have signed contracts with most insurers.
If there is an agreement, the costs of diagnostics and treatment will be reimbursed from your health insurance.
Of course, an obligatory deductible excess does apply.
The health insurer will only reimburse after a valid referral from the general practitioner for Specialist Mental Health Care (GGZ) or a referral from your primary care practitioner in GGZ.

The overview below shows which insurers we have an agreement with:

**As of July 1, 2024, ADHDcentraal has a contract with health insurer Menzis.
What does this mean for reimbursement?
For payment of healthcare costs for treatments that take place after July 1, 2024 ADHDcentraal will handle everything directly with Menzis.
Please note that you will receive an invoice from Menzis for any outstanding deductible.
For payment of health care costs for treatments that took place before July 1, 2024 the following steps are still applicable:

1. You will receive the invoice(s) for treatment(s) that took place before July 1, 2024 through Infomedics
2. You yourself send this invoice/invoices to Menzis
3. You will receive a billing statement from Menzis.
   This will show how much you will be reimbursed by them.
4. You send this summary to vergoedingen@adhdcentraal.nl.
5. You will receive (at the latest within 5 working days) an email from ADHDcentraal with the amount you have to pay to Infomedics.
6. You pay this amount to Infomedics.
   Should there be a remaining amount, ADHDcentraal will take care of it.

*** We are unfortunately unable to process new applications. Notified past patients currently on the waiting list may still enter care after the waiting period expires.

Reference

A referral from your primary care physician or directional mental health practitioner to Specialist mental health care is required.

Own risk

Everyone has a legally required deductible per year with their health insurance. If your deductible has not yet been used in the year in which the claim is submitted to the insurer, your deductible will be withheld. The date of your first appointment with the practitioner determines your deductible. The deductible also applies to other care providers within the GGZ.
In all cases, the statutory deductible is used in full if you attend the diagnostic day and/or treatment with us.

Own contribution medication

Medication has an important place in the treatment of ADHD. This medication will be prescribed by us and provided by your pharmacist. Depending on the drug prescribed, there may be a co-payment from the health insurance law. The law states that this can be a maximum of €250. This co-payment will be charged to you by your insurer. This goes beyond ADHDcentric.

You may have supplemental insurance for these costs. Check with your insurer for this. Some manufacturers have a refund policy for this co-payment. For that, see the following links:
Repayment scheme Tentin
Repayment scheme Elvanse

Reimbursement for non-contracted care

If we do not have a contract with your Dutch health insurer, we will cover part of the unreimbursed costs. With this grace period, we keep our care widely accessible.
In the case of this non-contracted care, it matters which policy you have. With a restitution policy, the health insurance company reimburses 100%, but with a natura policy, it reimburses less. Thus, for the portion of unreimbursed costs, the goodwill rule applies.

You pay part of the cost yourself in the case of non-contracted care: the personal contribution. If you come to us for treatment after the diagnosis day, the personal contribution is €250. If you are referred back to your GP by us after the diagnosis day, for example because the diagnosis of ADHD cannot be made, a personal contribution of €100 applies.

An example:
You are insured with a health insurance company with which ADHDcentraal has no contract.
With this insurance company you still have € 300 deductible outstanding at the time you enter treatment.
You are diagnosed with ADHD and enter treatment. You will then pay the personal contribution of €250. You will not be prescribed medication for which a co-payment applies.
You will then pay in total, the deductible to your health insurer plus the co-payment to ADHDcentraal, € 300 + € 250 = € 550.

The date of the diagnostic day will determine if a personal contribution is applicable in your case. The personal contribution is charged in one lump sum after the diagnosis day.
More information on paying the personal contribution can be found at Payment of contribution.

For patients with foreign insurance, it always applies that the patient must pay the entire cost of diagnostics and/or treatment himself to ADHDcentraal. The patient will have to arrange any reimbursements themselves with the foreign health insurer.

If you are insured with one of the labels that ADHDcentraal has a contract with, you do not pay a personal contribution. You do pay your outstanding deductible if applicable.

Payment of personal contribution

In the case of uncontracted care, ADHDcentraal will charge you or your health insurance company for the cost of treatment on a monthly basis. This depends on the agreements we have with your health insurance company, with which we ourselves have not entered into a contract.

If there is no contract with your health insurer, but there is a payment arrangement with your health insurer, ADHDcentraal can handle the billing directly through your health insurer. In these cases, a co-payment (the personal contribution as mentioned above) does apply for diagnostics and treatment. ADHDcentraal will invoice you directly for the personal contribution.

If there is no contract with your health insurance company and no payment arrangement, you will receive invoices directly from ADHDcentraal. This is done monthly through Infomedics, after which you have to submit / declare it to your health insurer yourself. From your health insurance company, you will then receive a note or claim statement. You send these to ADHDcentral. ADHDcentraal calculates the actual amount you have to pay Infomedics on this basis. Look here for more information about Infomedics.

Specifically, we have a payment arrangement and no contract with ONVZ. There we do bill directly to health insurance companies, but the patient does receive an invoice for the personal contribution afterwards (if natura policy).

Deductibility of medical expenses

Healthcare expenses may be deducted in the tax return under certain conditions. More information on this can be found here.

About the rates

The rates for the care provided by ADHDcentraal are in accordance with the tariff decision as drawn up by the Dutch Healthcare Authority (NZa).