Changelog
Stay up to date with our latest changes and improvements.
Generic Claim Standaard (GDS801) 2.0
The Generic Claims Standard (GDS801) 2.0 simplifies and improves healthcare claims. Starting January 1, 2025, this new standard will be mandatory for paramedical care. Older claims will still be processed via the PM304 standard.
Flux ensures a seamless transition and provides support to align your processes fully with the new requirements. This guarantees smooth and uninterrupted claims processing. As a healthcare provider, several changes have been introduced with the new GDS standard:
- Treatment Information
- Treatment Plan
- Reimbursement Note
- Administration
- Claim Date
- Healthcare Provider Identification
- Claim Codes
- Performance Lists
- Modules
Treatment Information
Distinctions such as left, right, or bilateral are now included where relevant for conditions in the GDS. These distinctions can now be recorded within a treatment plan, as this information is required for claims.
Treatment Plan
The treatment plan has become significantly more important for claims under the GDS. To clarify which services are associated with a specific treatment plan, Flux assigns each plan a unique care plan number. This number is automatically included in every GDS claim, ensuring consistent identification of the plan.
Flux now includes the following information in the claim file:
- Unique treatment plan number
- Treatment plan start date (first appointment within the plan)
- Diagnosis code
- Location indicator (left/right/bilateral)
If any of this information changes, all services within the plan must be credited and resubmitted.
Reimbursement Note
With the introduction of the GDS standard, all invoices for patients follow a fixed format. This format is designed to ensure uniformity and accelerate processing by insurers. The standardized design enables easier automatic processing, resulting in fewer rejections and fewer questions from patients.
Significant adjustments to these invoices are not possible. However, certain elements, such as logos and payment texts, can still be customized.
Administration
For patients with chronic care plans, managing the first 20 sessions has been simplified. Practices can now send a secure email detailing the number of sessions performed, which is useful when transferring a care plan from another practice.
Additionally, counting the first 20 sessions, which are billed directly to the insured, is now easier. These sessions can be invoiced directly to the patient without first submitting them to the insurer.
Claim Date
If a healthcare request continues while a patient transitions to a new provider, the original claim remains valid. The second provider must adopt the start date of the original care plan when opening a new plan.
To ensure compliance and validity of the claim duration, insurers must be informed of the original claim start date. The second provider is required to include this original date.
Healthcare Provider Identification
The AGB code of the actual healthcare provider is always included in the invoice line, with exceptions for interns or occasional substitutes, for which the responsible user’s code is used.
Claim Codes
The CSI code has been renamed to claim code. The following changes are automatically implemented in Flux:
- Pediatric physical therapy and exercise therapy: Codes
004to 007are replaced by code 003. - COPD: A single new code (
022) covers all COPD claims. - COVID-19 recovery care: The scheme is discontinued; new claims can only be submitted through supplementary insurance (code
009). - Rheumatoid arthritis: Claim code
022for long-term exercise therapy.
Performance Lists
Each type of care now has a specific Performance Code List (PCL) for claims. Flux automatically processes these codes and generates the correct claim based on your appointment type.
Modules
For patients with the supplementary insurance "Basis Plus Module" from Zilveren Kruis, care under this module must be claimed specifically according to the GDS. This includes care such as physical therapy for cancer, cardiovascular diseases, and strokes. Additional conditions apply to ZorgTopics and the Fitkids care product from Zorg & Zekerheid.