DBC met onbevoegde regie-/hoofdbehandelaar per verzekeraar (N1826): verschil tussen versies
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==== SGGZ 2015 ==== | ==== SGGZ 2015 ==== | ||
<span style="line-height: 20. | <span style="line-height: 20.79px;">Bevoegde hoofdbehandelaren ''(bron: Inkoopvoorwaarden 2015)''</span> | ||
{| style="line-height: 18. | {| style="width: 1088px; line-height: 18.9px;" cellpadding="1" cellspacing="1" border="1" align="center" | ||
|- | |- | ||
| style="width: 410px" | '''Beroep''' | | style="width: 410px;" | '''Beroep''' | ||
| style="width: 118px" | '''CONO-code''' | | style="width: 118px;" | '''CONO-code''' | ||
| style="width: 62px; text-align: center" | '''Achmea''' | | style="width: 62px; text-align: center;" | '''Achmea''' | ||
| style="width: 60px; text-align: center" | '''CZ''' | | style="width: 60px; text-align: center;" | '''CZ''' | ||
| style="text-align: center" | '''DSW''' | | style="text-align: center;" | '''DSW''' | ||
| style="text-align: center" | '''MENZIS''' | | style="text-align: center;" | '''MENZIS''' | ||
| style="text-align: center" | '''MULTIZORG''' | | style="text-align: center;" | '''MULTIZORG''' | ||
| style="text-align: center" | '''VGZ''' | | style="text-align: center;" | '''VGZ''' | ||
|- | |- | ||
| Psychiater | | Psychiater | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">MB.SP.psych</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | X | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
|- | |- | ||
| Klinisch psycholoog | | Klinisch psycholoog | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">PB.SP.klinps</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | X | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
|- | |- | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">Klinisch neuropsycholoog</span><br/> | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">PB.SP.klinneurops</span><br/> | ||
| style="width: 62px" | <br/> | | style="width: 62px;" | <br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | <span style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif; font-size: 13.33px;">X</span><sup style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif;">1,<span style="color: rgb(255, 0, 0);">10</span></sup><br/> | ||
| style="text-align: center" | <span style="font-family: | | style="text-align: center;" | <span style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif; font-size: 13.33px;"> X</span><sup style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif;"><span style="background-color: rgb(255, 255, 255);">1,8</span></sup><br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| <br/> | | <br/> | ||
| style="text-align: center" | <span style="font-family: | | style="text-align: center;" | <span style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif; font-size: 13.33px;">X</span><sup style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif;">1</sup><br/> | ||
|- | |- | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">Psychotherapeut</span><br/> | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">PT.BG.psth</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | X | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
| style="text-align: center" | <span style="text-align: center; font-family: | | style="text-align: center;" | <span style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif; font-size: 13.33px;">X</span><sup style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif;">1</sup><br/> | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
| style="text-align: center" | X | | style="text-align: center;" | X | ||
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| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">Specialist ouderengeneeskunde</span><br/> | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">MB SP.oud</span><br/> | ||
| style="width: 62px" | <br/> | | style="width: 62px;" | <br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | X<sup>1,<span style="color: rgb(255, 0, 0);">11</span></sup> | ||
| style="text-align: center" | <span style="font-family: | | style="text-align: center;" | <span style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif; font-size: 13.33px;">X</span><sup style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif;">1,2</sup><br/> | ||
| style="text-align: center" | <span style=" | | style="text-align: center;" | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">X<sup>1,2</sup></span><br/> | ||
| <br/> | | <br/> | ||
| style="text-align: center" | X<sup>2</sup><br/> | | style="text-align: center;" | X<sup>2</sup><br/> | ||
|- | |- | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">Verslavingsarts in profielregister KNMG</span><br/> | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">MB.SF.vslarts</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | <span style="text-align: center; line-height: 18.9px;"> X</span><sup style="text-align: center; line-height: 18.9px;">1</sup><br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | X<sup>1,3</sup> | ||
| style="text-align: center" | <span style="line-height: 18. | | style="text-align: center;" | <span style="text-align: center; line-height: 18.9px;">X</span><sup style="text-align: center; line-height: 18.9px;">1,3</sup><br/> | ||
| style="text-align: center" | X<sup>1,3</sup><br/> | | style="text-align: center;" | X<sup>1,3</sup><br/> | ||
| <br/> | | <br/> | ||
| style="text-align: center" | X<sup>3</sup> | | style="text-align: center;" | X<sup>3</sup> | ||
|- | |- | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">Klinisch geriater</span><br/> | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">OV.SP.kger</span><br/> | ||
| style="width: 62px" | <br/> | | style="width: 62px;" | <br/> | ||
| style="width: 3px; text-align: center" | <span style="line-height: 18. | | style="width: 3px; text-align: center;" | <span style="text-align: center; line-height: 18.9px;">X</span><sup style="text-align: center; line-height: 18.9px;">1,<span style="color: rgb(255, 0, 0);">11</span></sup><br/> | ||
| style="text-align: center" | <span style="line-height: 18. | | style="text-align: center;" | <span style="text-align: center; line-height: 18.9px;">X</span><sup style="text-align: center; line-height: 18.9px;">1,2</sup><br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| <br/> | | <br/> | ||
| style="text-align: center" | X<sup>2</sup> | | style="text-align: center;" | X<sup>2</sup> | ||
|- | |- | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">Verpleegkundig specialist GGZ</span><br/> | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">VB.SP.vrplsp</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | <br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | X <sup>1,<span style="color: rgb(255, 0, 0);">12</span></sup> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <span style="background-color: | | style="text-align: center;" | <span style="background-color: rgb(255, 255, 255);">X</span><sup><span style="background-color: rgb(255, 255, 255);">1,7</span></sup><br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <span style="line-height: 18. | | style="text-align: center;" | <span style="text-align: center; line-height: 18.9px;">X</span><sup style="text-align: center; line-height: 18.9px;">1</sup> | ||
|- | |- | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">GZ-psycholoog</span><br/> | ||
| <span style=" | | <span style="line-height: 15.33px; font-family: arial, sans-serif; font-size: 10pt;">PB.BG.gzpsy</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | X<sup>1</sup> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | X<sup>1</sup> | ||
| style="text-align: center" | <span style="line-height: 18. | | style="text-align: center;" | <span style="text-align: center; line-height: 18.9px;">X</span><sup style="text-align: center; line-height: 18.9px;">1</sup><br/> | ||
| style="text-align: center" | <span style="background-color: | | style="text-align: center;" | <span style="background-color: rgb(255, 255, 255);">X</span><sup><span style="background-color: rgb(255, 255, 255);">1</span></sup><br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
|- | |- | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);">Sociaal geriater </span> | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);">MB.SF.sger</span> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | <br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <span style="color: | | style="text-align: center;" | <span style="color: rgb(169, 169, 169);">X<sup><span style="text-align: center; line-height: 15.33px; font-family: arial, sans-serif; font-size: 11.11px;">1,2 </span></sup></span> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
|- | |- | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);"><span style="background-color: rgb(255, 255, 255);">K&J Psycholoog NIP</span></span><br/> | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);">PB.SF.kjth</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | <br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
|- | |- | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);"><span style="background-color: rgb(255, 255, 255);">Orthopedagoog generalist NVO</span></span> | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);">OV.OR.gen</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | <br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
|- | |- | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);"><span style="background-color: rgb(255, 255, 255);">Basis-arts</span></span><br/> | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);"><span style="line-height: 14.56px; font-family: arial,sans-serif; font-size: 9.5pt;"><span style="background-color: rgb(255, 255, 255);">MB.BG.basis</span></span></span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | <br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <span style="color: | | style="text-align: center;" | <span style="color: rgb(169, 169, 169);"><span style="text-align: center; line-height: 18.9px;"><span style="background-color: rgb(255, 255, 255);">X</span></span><sup style="text-align: center; line-height: 18.9px;"><span style="background-color: rgb(255, 255, 255);">1,4</span></sup></span><br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
|- | |- | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);"><span style="background-color: rgb(255, 255, 255);">Basis-psycholoog</span></span><br/> | ||
| <span style="color: | | <span style="color: rgb(169, 169, 169);">PB.BI.psy</span><br/> | ||
| style="text-align: center; | | style="width: 62px; text-align: center;" | <br/> | ||
| style="text-align: center; | | style="width: 3px; text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <span style="color: | | style="text-align: center;" | <span style="color: rgb(169, 169, 169);"><span style="background-color: rgb(255, 255, 255);">X</span><sup><span style="background-color: rgb(255, 255, 255);">6</span></sup></span><br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
| style="text-align: center" | <br/> | | style="text-align: center;" | <br/> | ||
|} | |} | ||
<span style="color: | <span style="color: rgb(0, 0, 0);"><sup>1</sup> Enkel onder MDO-constructie</span> | ||
<span style="color: | <span style="color: rgb(0, 0, 0);"><sup>2</sup> Enkel voor deelgebied psychogeriatrie</span> | ||
<span style="color: | <span style="color: rgb(0, 0, 0);"><sup>3</sup> Enkel voor deelgebied verslavingszorg</span> | ||
<span style="color: | <span style="color: rgb(0, 0, 0);"><sup>4</sup> Werkzaam als arts-assistent in opleiding tot psychiater (AIOS)</span> | ||
<span style="color: | <span style="color: rgb(0, 0, 0);"><sup>6</sup> <span style="line-height: 20.8px;">Mits indien werkzaam als GZ-psycholoog in opleiding</span></span> | ||
<span style="color: | <span style="color: rgb(0, 0, 0);"><sup>7 </sup> Alleen specifieke chronische doelgroepen (niet na te gaan d.m.v. data-analyse)</span> | ||
<span style="color: | <span style="color: rgb(0, 0, 0);"><sup>8 </sup><span style="line-height: 20.8px;"> Alleen voor DSM-stoornissen als gevolg van een hersendysfunctie</span> (niet na te gaan d.m.v. data-analyse)</span> | ||
<span style="color: | <span style="color: rgb(0, 0, 0);"><sup>9 </sup><span style="line-height: 20.8px;"> Alleen voor adolescenten: 18 t/m 23 jaar</span></span> | ||
<span style="color: | <span style="color: rgb(255, 0, 0);"><span style="line-height: 20.8px;"><sup>10</sup> Psychiatrische diagnose en neurologische aandoening</span></span> | ||
<span style="color: | <span style="color: rgb(255, 0, 0);"><span style="line-height: 20.8px;"><sup>11</sup> Delirium, dementie, amnestische en overige cognitieve stoornissen</span></span> | ||
<span style="color: | <span style="color: rgb(255, 0, 0);"><span style="line-height: 20.8px;"><sup>12</sup> </span><span style="line-height: 107%; font-family: arial, sans-serif; font-size: 10pt;">De VS als HB in de GGZ is beperkt tot patiënten waar de primaire focus van de behandeling niet meer gericht is op biologische en psychologische factoren, maar meer op de gevolgen van depsychiatrische stoornis </span></span> | ||
<span style="color: | <span style="color: rgb(0, 0, 0);">LET OP:</span> | ||
<br/><span style="color: | *<span style="color: rgb(0, 0, 0);"><span style="color: rgb(0, 0, 0);">Beroepen die door verzekeraars wel worden toegestaan, maar niet binnen de publieke norm, worden in ValueCare-analyses altijd fout gerekend. In de tabel zijn deze als lichtgrijs gemarkeerd.</span></span> | ||
*<span style="color: rgb(0, 0, 0);">Voorwaarden van verzekeraars die niet correct te programeren zijn worden niet meegenomen. Deze voorwaarden zijn rood gemaakt.</span> | |||
<span style="color: rgb(0, 0, 0);"></span> | |||
<br/><span style="color: rgb(0, 0, 0);"><span style="line-height: 19.05px; font-family: sans-serif; font-size: 12.7px;">Elke factuur dient in ieder geval de AGB-code en het beroep van de hoofdbehandelaar te bevatten. Indien de hoofdbehandelaar in de fase van behandeling een andere hoofdbehandelaar is dan in de fase van de diagnose, dan moet ook de AGB-code van de tweede hoofdbehandelaar en diens beroep op de factuur vermeld worden (bron: NADERE REGEL NR/CU-556 (p.18)).</span></span> | |||
==== SGGZ 2016 ==== | ==== SGGZ 2016 ==== | ||