Fees

Your visit to Parkway Clinic Sommer will be reimbursed in the same way as a visit to the hospital. There are no additional costs involved. Almost all our treatments fall under insured care and are reimbursed by the health insurer. However, please take into account the compulsory excess.

Fees

This is how reimbursement works at Parkway Clinic Sommer:

  1. You have received a referral to Parkway Clinic Sommer.
  2. Once we receive the referral, you can contact us to make an appointment with the relevant specialist.
  3. During your visit to Parkwegkliniek Sommer, a DBC will be opened. Hospitals and clinics work with DBCs(diagnosis-treatment combinations). A DBC provides a record of all the activities and operations a patient goes through during a set period of time.
  4. When a DBC is closed, the DBC will be declared. There are two options here:
    • We send the claim directly to the health insurer.

The health insurer will reimburse the costs to Parkwegkliniek Sommer and settle any excess with you.

  • You will receive the invoice and submit it yourself.
    • you submit the received invoice to your health insurer yourself.
    • You will receive a payment specification from your health insurer. This will show the amount of reimbursement and any outstanding deductible excess.
    • You transfer the reimbursement and any excess to Parkwegkliniek Sommer.
    • The remaining part, often called personal contribution, you not to pay.
    • Please send us a copy of the payment statement.
    • Has your deductible already been used up? Then you do not pay any excess either.


Good to know:
 
The own risk is not same as the personal contribution. For a visit to Parkway Clinic Sommer, you pay no personal contribution.

  • Explanation of excess


Health insurance deductible

The deductible is a threshold amount that insured persons aged 18 and over have to pay when they incur healthcare costs covered by the basic insurance.
The amount of the legally required excess is set annually by the government. In 2024, it will be €385 per insured person.

What is covered by the deductible?

  • Specialist care: consultations, checks, examinations, interventions and treatments carried out by a specialist, such as a dermatologist, gynaecologist, urologist or plastic surgeon.
  • Medicines: drugs prescribed by the specialist.
  • Laboratory tests (on prescription), such as a blood test
  • Health insurers


Should you contact your health insurer, you will sometimes still wrongly receive the answer that no reimbursement will be paid out because we do not have a contract with the health insurer. However, this is not true, you will ALWAYS be entitled to reimbursement provided you have a referral letter from a GP or specialist.

  • FAQ
    • What should I do with my invoice?
  • If you receive an invoice from the clinic, submit this invoice to your health insurer. The health insurer will process this invoice and send you (the patient) a payment specification. This specification shows the reimbursed amount, the amount deducted from the deductible and the remaining amount (own contribution).
    • Do I have to transfer the entire invoice amount?
  • No, you submit the invoice to your health insurer first. Only after receiving the reimbursement and payment specification will you transfer the reimbursement and any excess to the clinic.
    • What should I transfer?
  • You transfer the reimbursed amount and any excess to the clinic. You do not have to pay the co-payment; this is borne by the clinic.
    • Calculation example


Sample calculation with excess:             
You will receive an invoice of: €1000           
Insurance reimburses of this: €500            
The excess is: €200             
The own contribution is: €300            
You then transfer €700 to the clinic (€500 reimbursement + €200 excess).        

Sample calculation without excess:
You will receive an invoice of: €1000 
Insurance reimburses of this: €700
The excess is: €0
The own contribution is: €300        
You will then transfer €700 to the clinic (€700 fee).

The personal contribution of €300 you do not have to pay in either case.                                                                  

  • Who determines the amount of compensation?
  • The rates and amount of reimbursement are determined by the NZA (Dutch Healthcare Authority) and health insurers.
    • Is there a difference in reimbursement with or without excess?
  • No, the amount of the reimbursement always remains the same. If your deductible has not yet been used up, part of the invoice will be offset against the deductible. If the deductible has already been used up, the health insurer will pay the reimbursed amount in full.
    • Why doesn't my invoice go directly to the health insurer?
  • We have payment agreements or contracts with a number of health insurers. With these health insurers, we submit invoices directly. Without the intervention of the patient. However, you as the patient will receive an overview of the invoiced amounts and the reimbursement.
  • With the other health insurers, unfortunately this is not possible and you have to submit the invoice yourself.
    • Why don't you have a contract with my health insurer?
  • Our aim is to conclude contracts with more and more health insurers. It is expected that in the future, we will sign contracts with more and more health insurers, allowing us to settle bills directly.
    • Why is the full amount not reimbursed?
  • Because we do not have a contract with a health insurer, we are reimbursed 60 to 70% of the amount submitted. These are the health insurer's rules. Parkwegkliniek Sommer chooses not to recover the remaining amount (30 to 40%) from the patient. The health insurer calls this amount the own contribution. The own contribution is waived by Parkwegkliniek Sommer and therefore you do not have to pay it yourself.
    • Why can't the clinic contact the health insurance company?
  • Due to privacy laws, Parkwegkliniek Sommer is not allowed to contact health insurers regarding a submitted invoice.
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