The resident’s file in Belgium

In Belgium, the resident’s file carries what the health insurers and eHealth need: the NISS, the mutualité, the sector of the stay (MR, MRS) and the Katz category. This page gathers what the Belgian pack adds to the country-neutral record described in Manage a resident.

The NISS

The NISS field holds the resident’s national number: 11 digits from the National Register, in the format YYMMDD-XXX-CC. It is also a search key: you can find a resident by typing their NISS.

  • National number — a birth month from 01 to 12.

  • BIS number — issued by the Crossroads Bank to someone who is not in the National Register (month shifted by 20 or 40). Every eHealth service accepts it where a NISS is asked; a BIS holder usually has no mutualité.

  • Not a valid number — the NISS type field flags a number that has neither shape.

The NISS is required for eHealth

Without a NISS, insurability verification (MDA) and agreements (eAgreement) cannot be sent. You can create the resident without a NISS, but remember to fill it in as soon as possible.

The NISS identifies the person for life; the ID Card Number identifies the card, which expires and is renewed. The admission file keeps both.

Reading the eID card

Rather than typing the identity in, you can read the resident’s eID card. Resthome fills in the name, the date of birth, the gender and the NISS from the card itself — no typo, no transposed digit.

  • From an existing record, the eID reading updates that resident.

  • From the New Partner via eID menu entry, Resthome looks the person up by NISS and creates the record if it does not exist yet.

A card reader must be connected to the workstation.

The mutualité (OA)

The Health Insurance field points at the resident’s mutualité — the federation, not one of its local contacts. Around it, the record keeps:

Field

Purpose

Code OA

The 3-digit INAMI code of the mutualité: 1xx CM, 3xx Solidaris, 5xx MLOZ, 6xx CAAMI, 9xx HR Rail.

Insurance Member Code

The resident’s membership number with the mutualité.

Holder Code

The holder’s code for billing, when it differs.

BIM Status

Beneficiary of increased intervention.

Insurance Regime

Standard (Belgian mutualité), INIG (war invalid), CEE (European institution), Fedasil (asylum seeker), Foreign / cross-border, Private insurance / revalidation.

Special insurance regimes

A resident under a non-standard Insurance Regime is left out of the MDA batches, and MDA never overwrites their Health Insurance: MyCareNet would otherwise return a standard Belgian mutualité for a resident actually covered by INIG, CEE or Fedasil.

Checking insurability (MDA)

Before billing, check that the resident is properly insured:

  1. Open the resident record, or the month’s billing period.

  2. Run the MDA check (MyCareNet/WalCareNet insurability): Verify Insurability in the header of the record — shown once the NISS is filled in — or Check MDA on the period, for every resident at once.

  3. Resthome automatically updates the Health Insurance and the BIM Status where applicable.

The MDA History button on the record lists the resident’s past requests.

See Insurability (MDA). When a CPAS pays for the resident, the invoice can be addressed to it — see CPAS coverage.

The sectors: MR, MRS and short stay

The Stay Type of a Belgian stay is the sector the home is accredited for:

  • MR — maison de repos;

  • MRS — maison de repos et de soins, which only takes Katz categories B and above;

  • the day care centre (CSJ), when the home runs one — see Day care centre (CSJ).

A short stay (court séjour, 90 days at most) is not a sector: it is a modality of an MR bed, carried by the Short stay box. At admission, Resthome offers it as CS beside MR and MRS, and turns it into an MR stay with the flag ticked. It has its own AViQ pseudo-codes (123214 to 123516), its own forfait, and the “Court Séjour OUI” toggle on the Annexe 7. Resthome refuses the flag on any other sector.

MRS and the Katz category

Resthome refuses to put or keep a stay in MRS for a resident assessed at O or A — at admission and at transfer time. A room change is not blocked; the banner on the record and the MRS → MR badge flag the resident until the transfer is entered — see The Katz assessment.

The Katz category on the record

The resident’s record shows the Katz category (O, A, B, C, Cd) as a badge, next to the stay type. It is the category declared to the mutualité for the INAMI dependency allowance.

As long as no validated Katz exists, the resident is in category O by default, and a “Katz to do” reminder appears on the dashboard. Scoring, renewal and worsening are described in The Katz assessment; the allowance itself in The INAMI dependency allowance.

Validated assessments — Katz and the geriatric scales alike — cannot be deleted: health data must be retained under the GDPR and the INAMI rules.

Annexes at admission and transfer

The stay has two dates. The stay start date starts the accommodation billing; the Admission Date is the start of the INAMI intervention — the “date d’entrée” of the Annexe 7, from which the forfait is paid.

Event

What Resthome prepares for the mutualité

Start of the stay

The admission eAgreement (Annexe 7), when the NISS is present.

Room change

Nothing: the INAMI intervention stays continuous, the Admission Date is unchanged, no new agreement is requested.

Internal transfer (MR ↔ MRS)

An end-of-stay notice (Annexe 11) then a new request (Annexe 7); the Admission Date moves to the transfer date.

Worsening of dependency

The agreement update (Annexe 10), with the new Katz assessment.

Absence / hospitalization

The forfait is adjusted, and an eHealth notification (Annexe 11) can be generated.

The Stay Type is read-only once the stay is confirmed: a bare edit would produce no document for the mutualité. The Internal Transfer button is the only way to change sector — see Internal transfer (MR ↔ MRS).

What’s next