How do I check a resident’s insurability (MDA)?

Create an MDA request (eHealth → Insurability → MDA Requests) with the resident, the pre-filled NISS and the period, then click Send (Sync): the response comes back immediately. For a whole month, run a batch at the start of the month, then Check MDA on the generated period for anyone left, before generating the eFact.

FAQ — Belgium¶

Q: How do I generate an eFact period?

Open the month’s period in Draft state, click Generate, leave Residents empty for all active residents (or pre-fill them with Load MDA Success / Load MDA Pending), then click Generate. The period moves to Generated: the Katz allowance, the INAMI share and the resident share are computed for each resident.

Q: How do I send an eFact period and follow the responses?

From the eFact Cockpit or the batches, click Send all: the batches go to the mutualities through eHealth. Then click Get responses; each batch moves Sent → Acknowledged → Accepted / Rejected, with Resthome reconciling the amounts automatically.

Q: Why is an eFact invoice rejected, and how do I fix it?

The rejection code and reason state the cause (insurability, allowance, dates). Fix it then resend; the Resends counter avoids duplicates and the Reintegration button lets you reintegrate lines into a new sending.

Q: What is an eFact batch per union?

Sendings are grouped by union of mutualities (100 National Alliance, 300 Solidaris, 500 National Union, 600 CAAMI, 900 HR Rail…), not per small individual mutuality. Resthome takes care of the grouping.

Q: How do I score a resident’s Katz?

From the resident file, open Katz, click New and score the 6 criteria (washing, dressing, transfer and mobility, toileting, continence, eating) from 1 to 4, then Confirm and Validate. The category and the allowance update automatically.

Q: How do I invoice a month from A to Z in Belgium?

Open the period and click Generate, then Check MDA, then Generate eFact, then Create Invoices and confirm the resident share; send the eFact batches to the insurance organisations, get the responses, then close the period. The resident share and the mutuality share progress in parallel on the same period.

This page gathers the short answers to the questions that only arise in Belgium: the Katz scale, the NISS, the exchanges with the mutualities over eHealth and the INAMI allowance. Each answer links to the page that details it. The questions valid in every country are in the FAQ.

Getting started in Belgium¶

What does the dashboard show in Belgium?¶

On the Nursing Home dashboard, the pending tasks include the Belgian ones: Katz to do, MDA to check, eFact batches… Click a counter (e.g. “Katz to do”) to open the list of items to handle. → Getting started

Where do I configure the Belgian rooms and rates?¶

In the Configuration application: give each room its type (MR, MRS, single, double…), define the INAMI rates (allowance per Katz category) next to the accommodation rates, and create the mutualities. → Configuration · The INAMI dependency allowance

Residents & Katz¶

What must I enter on a resident’s file in Belgium?¶

The NISS if known, and the mutuality. Without a NISS, the MDA check and the eAgreement agreements cannot be sent, but you can create the resident and complete the NISS later. → Admitting a resident in Belgium

Which stay types exist in Belgium?¶

A stay is MR, MRS or day care (CSJ): the stay agreement carries the type, and it drives the INAMI rates and the annexes sent to the mutuality. → Admitting a resident in Belgium

What does starting a stay trigger in Belgium?¶

On top of what it does in every country, starting the stay creates the admission eAgreement (Annexe 7), if the NISS is present. → Admitting a resident in Belgium

How do I score a resident’s Katz?¶

From the resident file, open Katz, click New and score the 6 criteria (washing, dressing, transfer and mobility, toileting, continence, eating) from 1 (independent) to 4 (totally dependent), then Confirm and Validate. Resthome computes the category in line with the regulation and updates the allowance automatically. → The Katz assessment

What are the Katz categories?¶

O (independent), A (light dependency), B (moderate dependency), C (heavy dependency) and Cd / Cc (heavy dependency with disorientation / special cases). Under the AViQ rates, the allowance amount is the same for every category, including O; the category serves to declare the right profile to the mutuality. → The Katz assessment

What happens as long as there is no validated Katz?¶

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. Validate the Katz and send it through an eAgreement Light request to declare the right category to the mutuality. → The Katz assessment

How do I record a Katz worsening?¶

If the resident’s condition deteriorates, enter a new evaluation with a worsening reason. Resthome then prepares the update of the care agreement (Annexe 10): the reason is carried over automatically, and the clinician’s signature completes the document. → The Katz assessment

How do I transfer a resident MR ↔ MRS?¶

On the stay, use Internal Transfer, give the new type and the date/time, then Validate. Resthome splits the billing on the right date, at the matching rate; this is not a new admission and the INAMI intervention (the allowance) stays continuous. → Internal transfer (MR ↔ MRS)

Insurability (MDA)¶

What is the MDA and what is it for?¶

The MDA checks that a resident’s insurability is in order and identifies their exact mutuality by querying MyCareNet / WalCareNet for you over a given period. It is the essential prerequisite for the eFact sending. → Insurability (MDA)

How do I check a resident’s MDA insurability?¶

Create an MDA request (menu eHealth → Insurability → MDA Requests) with the resident, the pre-filled NISS and the period (current month by default), then click Send (Sync): the sending is immediate and the response comes back at once. Then read the summary and the insurability periods. → Insurability (MDA)

How do I check several residents at once?¶

Launch the check in batch: select the residents (you can paste a column of names/NISS), the period, then send the whole batch. Use Immediate sending (Sync) for small volumes, or Grouped sending (Async) for large monthly batches — the response is then retrieved with Check responses (requires at least 2 residents). → Insurability (MDA)

When should the MDA be done?¶

Do a batch MDA at the start of the month (eHealth → Insurability → MDA Batches): the generation wizard loads its results. Then, on the generated period, Check MDA covers the residents still without a request — always before generating the eFact. This avoids later eFact rejections due to a wrong mutuality or a loss of insurability. → Insurability (MDA)

What does “insured but not in order” mean?¶

If the beneficiary codes come back as zero (insured but unpaid contributions / problematic file), Resthome shows an alert: the resident is affiliated but not in order. This must be clarified with them or their mutuality before invoicing the OA. → Insurability (MDA)

What does Resthome update after a successful MDA?¶

The resident file is corrected automatically: the mutuality (OA) if it differs from the profile, the BIM status, the affiliation number, the identity if fields were missing, and the date of death if the OA reports it. For residents under a special scheme (INIG, CEE, Fedasil, foreign, private…), Resthome does not overwrite the profile’s mutuality. → Insurability (MDA)

What to do in case of an MDA error or no response?¶

For a “No response” answer from the platform, use Retry no-response; if it persists, Report to InterMut. For a rejection by the OA, use Contact the OA (the reason is shown); for a technical error, Report to InterMut. → MDA errors — causes and solutions

What is reintegration (loss then return of insurability)?¶

Resthome compares with the previous check: if a resident goes from not insured to insured, a notification appears and the Reintegration action switches the lines that had been invoiced to the resident over to the OA. Conversely (insured → not insured), their allowance is excluded from the period’s OA billing and invoiced to the resident until it is restored. → Insurability (MDA)

Agreements (eAgreement)¶

What is the eAgreement?¶

When a resident is admitted, is absent, returns or leaves the institution, the mutuality must be informed electronically. Resthome automatically prepares the eHealth notification matching your action; most of the time, you have nothing extra to enter — just to check and, if needed, to send. → Agreements (eAgreement)

What is the difference between eAgreement and eAgreement Light?¶

The eAgreement is the care coverage agreement (linked to the Katz category and the allowance). The eAgreement Light groups the simpler notifications tied to the resident’s movements (admission, absence, departure, return) — these are the ones Resthome generates on its own as you go. → Agreements (eAgreement)

Which document is prepared depending on the action?¶

Start a stay → Admission agreement (Annexe 7); record an absence / hospitalisation → exit notification (Annexe 11); resident return → readmission (Annexe 7); validated Katz worsening → update of the care agreement (Annexe 10); end of stay / death → exit notification (Annexe 11). → Agreements (eAgreement)

What are the statuses of an agreement, and what to do if rejected?¶

An agreement goes through Draft (prepared, not sent), Sent, Accepted and Rejected (with a reason). If rejected, Resthome shows the reason in plain language, in French and in Dutch, directly on the agreement — so you know what to fix (often NISS, mutuality or dates) before resending. → Refused agreement (eAgreement) — causes and solutions

Can a movement be recorded without a NISS?¶

Without a NISS, the agreement cannot be transmitted. You can still record the movement (admission, absence…): Resthome notes it and invites you to complete the NISS as soon as possible. → Agreements (eAgreement)

Electronic invoicing (eFact)¶

What is the eFact?¶

The eFact is the electronic sending of the mutuality share (the INAMI allowance) to the insurance organisations (OA) through the eHealth / MyCareNet network. Resthome builds the files, transmits them and follows the responses — acknowledgements of receipt, settlements, acceptances and rejections. → Electronic invoicing (eFact)

How do I generate an eFact period?¶

Open the month’s period in Draft state and click Generate; in the wizard, leave Residents empty for all active residents (or pre-fill them with Load MDA Success / Load MDA Pending), then click Generate. The period moves to Generated: Resthome has computed, for each resident, the Katz allowance, the INAMI share and the resident share. → Electronic invoicing (eFact)

How do I check a period before invoicing in Belgium?¶

Among the counters at the top of the period, MDA and Katz to do are Belgian: handle them with the others. Then run Check MDA to verify insurability, and Generate eFact — both come before Create Invoices. → Billing a month in Belgium

How do I generate the eFact batches?¶

Once the period is Generated and the MDA requested, click Generate eFact — before Create Invoices; the batches are built from the period’s mutuality lines, not from the invoices. Resthome builds the batches — one electronic file per insurance organisation — then shows the eFact Batches list (OA, reference, month, deadline, status, invoiced/accepted/refused amounts, and code + reason in case of refusal). → Electronic invoicing (eFact)

What is a batch per union?¶

Sendings are grouped per union (the big OA families), not per small individual mutuality: 100 (National Alliance), 300 (Solidaris), 500 (National Union), 600 (CAAMI), 900 (HR Rail)… Resthome takes care of the grouping. → Electronic invoicing (eFact)

How do I send an eFact period and follow the responses?¶

Open eHealth → eFact → Cockpit (or the batches) and click Send all (or batch by batch); the sendings go to the mutualities through eHealth. Then click Get responses: each batch moves Sent → Acknowledged → Accepted / Rejected, with Resthome automatically reconciling the accepted/refused amounts. → Billing a month in Belgium · Electronic invoicing (eFact)

I receive an acknowledgement of receipt (931000) after sending, should I wait?¶

Yes. The 931000 only confirms that the insurance organisation received the batch and passed the first check — it is not the final result. There is nothing to resend: wait for the settlement (920900), which states what is accepted and paid (a few days). In the meantime, a 920098 (warnings, accepted anyway) or a 920099 (global rejection, to fix and resend) may arrive. → Electronic invoicing (eFact) · eFact rejections — causes and solutions

Why is an eFact invoice rejected, and how do I fix it?¶

If a batch (or part of it) is rejected, the rejection code and reason tell you why (insurability, allowance, dates…). Fix the cause, then resend: the Resends counter keeps track of retransmissions to avoid duplicates, and the Reintegration button lets you, where applicable, reintegrate lines into a new sending. → eFact rejections — causes and solutions

What does “deadline exceeded” mean on a period card?¶

The sending deadline of this period has passed. Send without delay — beyond it, some insurance organisations may refuse the batch. → Electronic invoicing (eFact)

Billing in Belgium¶

How do I invoice a month from A to Z in Belgium?¶

Open the period (Billing → Facturation → Billing Periods), click Generate, then Check MDA, then Generate eFact, then Create Invoices and Confirm the resident share. Send the eFact batches to the OAs, get the responses, and finally Close Period. The highlighted button of the period always shows the next step. Resthome runs in parallel the resident share (classic invoices) and the mutuality share (eFact) on the same period. → Billing a month in Belgium

Is the INAMI allowance split between the debtors?¶

No. Split billing only divides the resident share; the INAMI allowance goes to the mutuality through the eFact. → Split billing

Absences & hospitalisations¶

What is the effect of an absence on the INAMI allowance?¶

The INAMI allowance is computed on the presence days; an absence reduces this allowance for the days concerned. The count follows the “noon rule” (Brussels time): it is the presence at noon that determines whether the day counts, hence the importance of the departure and return dates and times. → Billing a month in Belgium

Which absences must be reported to the mutuality?¶

An absence of more than 72 h, or any hospitalisation, prepares an Annexe 11 (exit notification), and the return prepares an Annexe 7 (readmission). Resthome creates these notifications the moment you record the absence and the return; you only have to check and send them. → Absences and hospitalisations · Agreements (eAgreement)

Departure & death¶

What is sent to the mutuality on a departure or a death?¶

Closing the stay prepares the exit notification (Annexe 11) for the mutuality. The INAMI allowance is invoiced in the month it is provided, so the credit note only concerns the accommodation invoiced in advance. → Departure and death · Agreements (eAgreement)

What’s next¶

FAQ — the questions valid in every country.
Glossary — Belgium
The billing journey