Paramedical care

Our vision of healthcare: paramedical care

Paramedical care is the collective name for various types of care, each with its own reimbursement schemes. Paramedical care comprises care types dietetics, occupational therapy, physiotherapy, speech therapy, remedial therapy and podiatry (preventive foot care for people with diabetes). Paramedical care is part of the care that is reimbursed under the public healthcare insurance (the Health Insurance Act). 

 

The care we reimburse is provided by care providers with their own surgery and care providers who provide first-line paramedical care and are affiliated with a home care agency, nursing home, institution for the disabled or a hospital. Treatment can take place in the surgery of the care provider but in some cases, also at your home if medically necessary.

Are you a care provider?

HollandZorg is part of Eno Zorgverzekeraar. You will find our healthcare purchase policy and the principles of this policy on the Eno website.

1. Vision of healthcare

Strong first-line care is very important. Within first-line care, the paramedical disciplines, each from their own professional task area, are directly involved in providing care to our insured customers. The added value of paramedical care in first-line care is reflected, among other things, in the good accessibility of care in the area, self-care support and, where possible, the prevention of more expensive second-line care. In addition, the paramedical field in first-line care contributes to answering multidisciplinary care needs and influencing ‘context factors’, such as a patient’s lifestyle and social situation.

 

The basic principle is that our insured customers are in charge of their own lives, health and care. It is not the illness or disorder of our insured customer that is central, but an individual’s possibilities, perceived health and personal wishes for the quality of life to be achieved. Self-management plays an important role in this and we believe paramedical care providers play an important role in helping and facilitating our insured customers in this. It not possible to find a medical answer for every human need. The dialogue between you and our insured customers is crucial in this respect. Together with our insured customers, you determine what is the most appropriate answer to a request for treatment in the individual case.

 

In recent years, care policy has increasingly focused on organising care as close to people as possible, so that people can function in their own environment for as long as possible. This means that more vulnerable elderly people with complex care needs live at home. Demand for care brought to first-line care as a result of this development is growing. The demand for care will also continue to grow considerably in the coming years due to the increasing ageing of the population and the increase in the number of people with a chronic disorder. More disciplines are needed to serve these people optimally. Multidisciplinary collaboration is therefore becoming increasingly necessary. 

 

Paramedical care must be of high quality, is organised close to our insured customers and is low-threshold and widely accessible. Well-designed first-line paramedical care can meet a large part of the care needs of our insured customers and thus limit the right to more expensive second-line care. That is why we believe it is important that first-line care develops and strengthens further with us in order to accommodate more of the increasing demand for care, to play a more effective role in providing insight into the quality of the care provided, to give our insured customers at home or in the area the most appropriate care and to control healthcare costs. A broad, well-functioning collaboration in the area, close to our insured customers, is essential in this regard. This collaboration extends not only within the medical domain, but also to a large extent between the care and welfare domain.

1.1 Why do we conclude agreements?

Within paramedical care, we distinguish contracts for primary dietetics, occupational therapy, physiotherapy, skin therapy, speech therapy, remedial therapy and podiatry (preventive foot care for people with diabetes mellitus) with independent care providers and contracts for first-line paramedical care in institutions and hospitals. We conclude these contracts with independent surgeries, institutions and hospitals.

 

We strive for broad contracting, whereby sufficient good quality care must be available close to our insured customers.

 

When contracting for physiotherapy and speech therapy, we offer a higher remuneration to surgeries that demonstrably offer more and/or better quality and services for our insured customers. In this way, we stimulate care providers to invest in a continuous improvement of the service and quality of paramedical care.

 

We purchase paramedical care for Parkinson’s disease and physiotherapy and remedial therapy for intermittent claudication from care providers affiliated with ParkinsonNet and ClaudicatioNet respectively. We believe that purchasing care from specialist care providers, who are specifically trained to provide expert guidance and care for the aforementioned conditions and who work together in a multidisciplinary way in networks, helps us in our aim to offer our insured customers qualitatively responsible, effective and appropriate paramedical care to the greatest possible extent.

1.2 Things to look out for when purchasing healthcare

When purchasing paramedical care, care providers must meet various requirements to be eligible for an agreement. The table below summarises the general minimum requirements and the additional minimum requirements per paramedical discipline that a care provider must meet.

 

 

General minimum requirements for all paramedical care providers

The care provider must have a surgery (space) that meets the set-up requirements set by the professional association.

The care provider must act in accordance with the guidelines and protocols of the professional association.

Our insured customers can receive their first treatment within 5 working days.

The care provider’s surgery has its own website with, at least, the names of the care providers who work at the surgery, the surgery’s address, the telephone number with times when the surgery can be contacted (all working days), the opening hours of the surgery, the specialist disciplines offered (if applicable) and the complaints procedure.

The care provider’s surgery has an electronic patient file, so the guidelines of the professional association can be complied with.

 

Additional minimum requirements for each paramedical occupational group

Dietetics

The care provider is quality-registered in the Paramedics Quality Register.

Occupational therapy

  • The care provider is quality-registered in the Paramedics Quality Register.

  • Specialist occupational therapy is provided by an occupational therapist who is registered for the relevant specialisation in the Paramedics Quality Register (quality-registered).

Physiotherapy
  • The care provider is BIG-registered.
  • The care provider is registered in the NL Physiotherapy Quality Register (KRF NL) and/or the quality register of Stichting Keurmerk Fysiotherapie.
  • Specialist physiotherapy is provided by a physiotherapist who is registered for the relevant specialist discipline in the NL Physiotherapy Quality Register (KRF NL) and/or the quality register of Stichting Keurmerk Fysiotherapie.

Skin therapy

The care provider is quality-registered in the Paramedics Quality Register.

Speech therapy

  • The care provider is quality-registered in the Paramedics Quality Register.
  • Specialist speech therapy is provided by a speech therapist who is registered for the relevant specialist discipline in the Paramedics Quality Register (quality-registered).

Remedial therapy

  • The care provider is quality-registered in the Paramedics Quality Register.
  • Specialist remedial therapy is provided by a remedial therapist who is registered for the relevant specialist discipline in the Paramedics Quality Register (quality-registered).

Podiatry/foot care for diabetics

  • The care provider is quality-registered in the Paramedics Quality Register.

  • If the podiatrist outsources (part of) the care to (medical) chiropodists, the podiatrist must have a collaboration agreement with the relevant (medical) chiropodist.

 

2. How is freedom of choice arranged?

You may choose any healthcare provider. We conclude sufficient agreements with paramedical care providers who meet the minimum quality requirements. This means there is always a paramedical care provider available near you. Find a paramedical care provider via our Care Finder.

In addition to the paramedical care providers contracted by us, you can also visit a non-contracted care provider. This is care provided by care providers who do not have an agreement with us. This may be the case, for example, if the care provider cannot meet our basic quality requirements or if the care provider has chosen not to enter into an agreement with us.

For paramedical care provided by non-contracted surgeries, we apply maximum reimbursements. We always recommend contacting your care provider to find out if he has an agreement with us. You can also find out using our Care Finder.

As soon as you have found a care provider, it is wise to make arrangements with him/her about your treatment.  What are the objectives? How are these objectives achieved? What can you do during and after the treatment? How can complaints be prevented in the future?

3. Special/innovative arrangements

We encourage care providers to collaborate more and better with other disciplines within healthcare. This is one of the ways in which we try to continue to improve our care provision to our insured customers.

4. More information

We will be happy to provide you with more information about our healthcare providers. If you have any questions or issues, please contact our Customer Service department on +31 (0)570 687 470 on working days. We will discuss your situation and offer you the best advice.