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| Regel 1: |
Regel 1: |
| === Referentienummer: === | | [[Bestand:ValueCareLogo2.png|center|250px|link=http://www.valuecare.nl]] |
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| | === Referentienummer: [[N1943|N1943]] === |
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| <span style="color: rgb(0, 0, 0); font-family: sans-serif; font-size: 12.7px; line-height: 19.05px;">Referentienummer Controleplan Onderzoek Controles bGGZ 2014: 33a</span> | | <span style="color: rgb(0, 0, 0); font-family: sans-serif; font-size: 12.7px; line-height: 19.05px;">Referentienummer Controleplan Onderzoek Controles bGGZ 2014: 33a</span> |
| Regel 9: |
Regel 11: |
| === Uitzondering === | | === Uitzondering === |
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| <span style="color:#FF0000;">Instellingen die enkel bGGZ leveren, mogen de deelwaarneming beperken (i.t.t. de beschreven deelwaarnemingsmethodiek) tot 25 prestaties waarbinnen alle behandelaren zonder big-registratie worden getoetst. <br/>Instellingen die zowel bGGZ als gGGZ leveren, voeren controlepunt 11a uit en hoeven controlepunt 38a vervolgens niet uit te voeren. </span> | | <span style="color:#FF0000;">Instellingen die enkel bGGZ leveren, mogen de deelwaarneming beperken (i.t.t. de beschreven deelwaarnemingsmethodiek) tot 25 prestaties waarbinnen alle behandelaren zonder big-registratie worden getoetst.<br/>Instellingen die zowel bGGZ als gGGZ leveren, voeren controlepunt 11a uit en hoeven controlepunt 33a vervolgens niet uit te voeren. </span> |
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| === Doelstelling van het controlepunt === | | === Doelstelling van het controlepunt === |
| Regel 19: |
Regel 21: |
| === Relevante wet- en regelgeving === | | === Relevante wet- en regelgeving === |
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| NR/CU-543 Bijlage 1 | | [[NR/CU-543#page13|NR/CU-543 Bijlage 1]] |
| <br/>De beroepentabel DBC GGZ (zie bijlage). | | <br/>De beroepentabel DBC GGZ (zie bijlage). |
| <br/>De Basis GGZ sluit aan bij de beroepentabel DBC GGZ. | | <br/>De Basis GGZ sluit aan bij de beroepentabel DBC GGZ. |
| Regel 53: |
Regel 55: |
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| Indien (niet BIG geregistreerde) behandelaren tijd hebben geschreven op een prestatie zonder dat ze voldaan hebben aan bovenstaande toetsingscriteria, dan is de door hen geschreven tijd onrechtmatig. | | Indien (niet BIG geregistreerde) behandelaren tijd hebben geschreven op een prestatie zonder dat ze voldaan hebben aan bovenstaande toetsingscriteria, dan is de door hen geschreven tijd onrechtmatig. |
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| === Beroepen ===
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| {| border="1" cellspacing="1" cellpadding="1" style="line-height: 20.8px; width: 500px;"
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| | height="20" width="259" style="height: 15pt; width: 194pt;" | GGZ-agoog
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| | height="20" width="259" style="height: 15pt; width: 194pt;" | Maatschappelijk werkende
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| === Definities relevante terminologie === | | === Definities relevante terminologie === |
| Regel 314: |
Regel 87: |
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| | style="width: 75px; background-color: rgb(173, 216, 230);" | <br/> | | | style="width: 75px; background-color: rgb(173, 216, 230);" | <br/> |
| | style="width: 412px;" | Onderzoeksmassa bepaald door data-analyse | | | style="width: 412px;" | Controlemassa bepaald door data-analyse |
| |- | | |- |
| | style="width: 75px; background-color: rgb(218, 216, 0);" | <br/> | | | style="width: 75px; background-color: rgb(218, 216, 0);" | <br/> |
| | style="width: 412px;" | Deelmassa voor deelwaarneming | | | style="width: 412px;" | <span style="color: rgb(0, 0, 0); font-family: sans-serif; font-size: 12.7px; line-height: 20.8px;">Beoordeling op basis van personeelsadministratie </span> |
| |} | | |} |
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| Regel 325: |
Regel 98: |
| === Berekening financiële impact === | | === Berekening financiële impact === |
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| *De financiële impact is het verschil in waarde tussen de productgroep van de DBC en de productgroep waarin de DBC bij correctie van minuten door niet-toegestane beroepen zou moeten vallen. | | *De financiële consequenties volgend uit het zelfonderzoek kunnen vooraf niet bepaald worden, maar kunnen achteraf op casusniveau worden afgestemd |
| *Macro-correctie indien structurele bevinding. | | *Financiële consequenties worden gecorrigeerd op macroniveau |
| *Indien integrale controle: micro.
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| https://www.normenkaderzorg.nl/images/4/4f/ValueCareLogo2.png
| | [[Bestand:ValueCareLogo2.png|center|250px|link=http://www.valuecare.nl]] |