DBC

Changes in Health Care

What has changed?
As from 1st January 2005, the way in which the medical insurance companies pays the Hospital for Health care has changed. The Hospital registers so-called Diagnosis & Treatment Combinations (DBC's) for which per diagnosis the required activities and treatments are described. An example of this is a patient requiring an artificial knee. The DBC would be approximately as follows:

The patient was referred to the orthopaedic surgeon. The orthopaedic surgeon has diagnosed wear & tear of the knee and in consultation with the patient decided that an artificial knee was needed. After the admission and operation, the patient has had a number of check-ups.
The DBC code relates to the whole procedure, from the first out-patient visit to the last check-up after the operation. For this DBC, one single price is decided which includes all activities. In addition, as from 1st February 2005,  medical insurance companies  are no longer obliged to make agreements with every hospital and independent treatment centre for a limited number of nonemergency hospital treatments (the B segment). Also, the prices for these treatments are no longer legally determined.  

Why has it been changed?
It is the government’s intention to stimulate market forces in Health Care. By allowing medical insurance companies and health care contractors to negotiate about part of the care (the B segment), a first step in that direction is being taken. By working with DBCs, the hospital also gains more insight into the costs and the activities required by a particular diagnosis. The expection is that this will allow care to be planned and organised better in future.

What does this mean for you?
The treatments in our Hospital for which your medical insurance company has agreements with us (the B-segment), are always reimbursed to the maximum. It could be that your medical insurance company has no agreement with Bronovo Hospital. Then it is possible that you will have to pay the treatment yourself either partially or in full. How can you decide whether these regulations affect you?  

Our advice to you
For treatments after 1st February 2005, decide in the first place whether you are coming to Bronovo Hospital for one of the diagnoses below (complaint or illness).

Specialism	Diagnosis
General Surgery	Hernia Varicose veins
General Medicine	Diabetes Diabetes with attendant problems Diabetes with insulin pump Gestational Diabetes
Ear, Nose & Throat surgery	Tonsils
Plastic surgery	Breast reduction or breast lift
Gynaecology	Abnormalities of the cervix Incontinence and prolapsed womb
Ophthalmology	Cataracts
Neurosurgery	Simple herniated disc Repeated herniated disc
Reumatology	Gout Spondylitis Ankylopoetica (SA)
Orthopaedics	Wear & tear of hip Wear & tear of knee Back hernia
Urology	Bladder tumour/swelling Kidney stones Urethral stones
Neurology	Shooting pains in the left or right leg
Chest Diseases	Fine particle lung abnormalities

Are you coming to Bronovo Hospital for one of these diagnoses?
Then you should ask your medical insurance company whether they have a contract with us for the treatment of the complaint. In that case, the medical insurance company will reimburse the whole treatment. If not, you can still of course be treated at Bronovo Hospital  but it is then possible that you will have to pay for the treatment yourself either partially or in full. So please, consult your medical insurance company to avoid unpleasant surprises!   Bronovo Hospital has agreements with almost all (Dutch) medical insurance companies. Click here for al list of contracted insurers.  

Why can’t the hospital tell me whether my treatment will be paid for or not?
You can imagine that it would be very complicated for us to check for each patient whether there is a contract with his / her insurance company and to what extent a treatment would be reimbursed. It concerns many different treatments, patients with different medical insurance companies and with different insurance terms and conditions. In addition, changes are continually taking place in the insurance sector so we cannot guarantee that our information would be reliable.   In short, your medical insurance company can answer your questions about contracts and reimbursements much quicker and better!  

Price list
Price lists for the treatments relating to the diagnoses mentioned in the table.  

More information about Dutch Health Care?  
More information about the Dutch Health Care can be found on www.denhaag.com