Refused agreement (eAgreement) — causes and solutions

When a resident is admitted, goes on leave, returns or leaves the facility, Resthome automatically notifies their health insurer (insurance organisation, OA) electronically, with the right official document (Annexe 7, 10 or 11). This service — eAgreement Light — is accredited (operational). The health insurer can then accept the agreement, let it become tacit, or refuse it.

This page explains why an agreement is refused and how to fix it and resend it.

Two points where things get stuck

To distinguish

  • Immediate technical rejection — a piece of data is off (NISS, document, required field) and the health insurer or the platform returns an error right away. This is what the table below covers: it can be fixed and resent.

  • Substantive decision from the health insurer — for eAgreement Light, the actual answer (acceptance or refusal on the merits, e.g. the Katz category) usually arrives by post, not electronically.

An acknowledgement of receipt is not an agreement

An electronic “received” acknowledgement means received, not accepted. Do not treat an agreement as granted on the basis of the acknowledgement alone.

Common refusal causes → action

Cause

What you see

Action in Resthome

NISS not recognised

Rejection “unknown beneficiary”; the agreement goes back to Rejected

Check the NISS (identity card / eID), correct it, resend.

Malformed / incomplete NISS

Rejection “invalid identifier” (format)

Re-enter the 11 digits of the NISS, resend.

Unknown health insurer number

Rejection “unknown health insurance fund number”

Check the health insurer and the membership number; prefer identification by NISS; resend.

Insurability (MDA) not confirmed

Resthome blocks the send: insurability not in order

Re-run / update the MDA check, correct health insurer/NISS, try again. (Discharge/death notifications are not blocked by this check.)

Incomplete resident data

Rejection “mandatory data missing” (name, identifier)

Complete the resident record, resend.

Document (annexe) missing or wrong format

Send blocked if the annexe is empty; otherwise rejection “invalid document format”

Regenerate / attach the Annexe as a PDF, check that it opens, resend.

Attachment too large

The send does not go through

Shrink the PDF (reduce the scan size), resend.

Katz assessment missing or not validated

Send blocked: “Katz assessment required”

Create, confirm then validate the Katz; check Annexe 10; resend.

Duplicate agreement

Rejection “record already exists”

Do not resend an agreement that has already been transmitted; correct the faulty data (Resthome then regenerates a new notification).

Wrong annexe / unsuitable type

Rejection “agreement type not allowed / inconsistent”

Redo the correct business action (admission ≠ leave ≠ discharge): one situation = one annexe.

Facility or caregiver not recognised

Rejection “unknown organisation / provider”

Have the administrator check the eHealth configuration (facility / caregiver INAMI number), resend.

Fix, then resend

  1. Read the reason. In case of rejection, Resthome shows the reason in plain language, in French and Dutch, directly on the agreement.

  2. Fix the cause at the source (resident record, health insurer/NISS, MDA, Katz assessment, PDF document, or the right business action).

  3. Resend the agreement once the data is corrected.

  4. Acknowledgement of receipt. It confirms receipt, not acceptance.

  5. Tacit agreement. If the health insurer does not respond within the regulatory deadline, the agreement is tacitly granted (silence = accepted).

The visible statuses: Draft → Sent → Accepted / Rejected, with the reason shown in case of rejection.

Best practices (avoiding refusal)

  • MDA first — check insurability before preparing the agreement: it is the most frequent blocker, and it can be anticipated.

  • Complete resident record — valid NISS (eID), health insurer filled in, correct identity, before any movement.

  • The right document, once — one situation = one annexe (7 admission/return, 10 Katz, 11 discharge/death). Do not resend an agreement that has already been transmitted.

  • Katz validated before sending for admissions and aggravations.

  • Active eHealth certificate and up-to-date facility configuration (INAMI number).

  • Let Resthome do the work — manage the resident (admission, leave, return, discharge); Resthome derives the notification. Most often: check and send.

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