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Have you recently requested a reimbursement and have not received anything? You can check the status of your reimbursements at any time via My Helan. You will also receive a notification via My Helan when a reimbursement has been processed. Activate notifications via SMS or email in My Helan. How quickly we can process your reimbursement request depends on the type of reimbursement and the workload at our services. If you have submitted multiple reimbursement requests at the same time, please note that the processing may not occur simultaneously.

The amount you pay to the healthcare provider for the service is the fee. Your health insurance fund contributes to the cost of that service: this is the reimbursement from the statutory health insurance. The difference between the official fee and the amount reimbursed by the health insurance fund is the co-payment. On the certificate of care provided by the healthcare provider and on a hospital invoice, the nomenclature codes are listed, which correspond to the services that were performed.

You can quickly find out how much you will be reimbursed from the statutory health insurance using the calculation tool from the RIZIV. Enter the nomenclature codes, and you will immediately see the rate and the reimbursement to which you are entitled from a contracted healthcare provider.

You can easily look this up using the "Healthcare Provider Search" tool from the RIZIV. You can search for a healthcare provider based on their name, municipality, or discipline. Whether your doctor is contracted or not affects the fee they charge you:

• A contracted healthcare provider accepts the fee agreement with health insurance funds and charges the official rates set in this agreement.
• A partially contracted healthcare provider accepts the agreement with the health insurance funds but only charges the official rate at certain times and/or places. For example, a doctor may be contracted for consultations at a polyclinic but not for private practice consultations.
• A non-contracted healthcare provider does not accept the agreement with the health insurance funds and sets their fee freely.

Healthcare providers are not obligated to join the agreement with the health insurance funds.

Without the healthcare provider's prescription, the health insurance fund is not allowed to process any reimbursement. Did you forget to send the prescription? Send it as soon as possible to Helan Independent Health Insurance Fund, Boomsesteenweg 5, 2610 Wilrijk. Or drop it in a Helan mailbox near you, with a white adhesive stamp. If you no longer have the prescription, contact your healthcare provider. Your doctor can provide you with a duplicate of the prescription.

If your physical therapy sessions cannot be reimbursed, the cause is often related to exceeding the maximum number of sessions allowed.

• You were treated by multiple physiotherapists: perhaps one physiotherapist did not take into account the number of sessions provided by another physiotherapist, resulting in exceeding the maximum number of sessions.
• Your physiotherapist recorded the wrong code on the certificate.
• You have more than one condition, requiring multiple treatments. In this case, you can often still receive reimbursement for your physical therapy sessions.

How do you handle this?

Talk to your physiotherapist about this. If they believe you may be entitled to reimbursement for the extra sessions, they will submit a reimbursement request to the advising physician of your health insurance fund. If not, they will correct the rejected nomenclature codes via a correction document.

Was the reimbursement for physical therapy denied because the prescription is missing? And did you receive a reimbursement last time without including a prescription? That is indeed possible. Physical therapy can only be reimbursed if it was prescribed by a doctor. Therefore, the physiotherapist must indicate on each certificate whether the prescription: is attached to this certificate has already been attached to another certificate In your case, the physiotherapist indicated that the prescription was attached, but we did not receive it.

Did you forget to send the prescription? Please send it as soon as possible to Helan Independent Health Insurance Fund, Boomsesteenweg 5, 2610 Wilrijk. Or drop it in a Helan mailbox near you. If you no longer have the prescription, contact your physiotherapist or the doctor who provided you with the prescription.

The RIZIV decides that certain services can only be reimbursed a limited number of times: for example, once per year or once every 7 years. If the service has already been reimbursed during that period, we cannot reimburse the same service again. Therefore, you can only request a reimbursement again once the period has expired.

For certain reimbursements, you need a medical agreement from the advising physician of the health insurance fund. If you do not obtain a medical agreement for a specific medical service, your health insurance fund cannot reimburse that service. In this case, you can often still receive a reimbursement. How do you handle this? Talk to your doctor about this. If they believe you may be entitled to reimbursement, they will request a medical agreement for reimbursement from the advising physician of your health insurance fund. What about the reimbursement for services provided while awaiting the agreement? As soon as the advising physician grants the agreement, all previously rejected certificates (related to this agreement) will be automatically reimbursed within 5 working days. If you receive original certificates for services provided after receiving the agreement, send them to Helan Independent Health Insurance Fund, Boomsesteenweg 5, 2610 Wilrijk, or drop them in a Helan mailbox, with a white adhesive stamp.

Certificates for services provided, such as a doctor's note, remain valid for 2 years. This means you must submit them to your health insurance fund within two years after the end of the month in which the care was provided. After that, they expire and can no longer be reimbursed.

So make sure to submit all certificates on time!

Exceptions to the expiration are only possible: In cases of force majeure and only with approval from the RIZIV, e.g., in the case of prolonged hospitalization in a coma. If the expiration period was interrupted by registered letter, e.g., due to the seizure of the certificates for judicial investigation.