Glossary¶
The terms and acronyms used in Resthome and in Belgian nursing-home billing, explained simply. Each entry links, where useful, to the page that covers it in detail.
Annexe 7¶
eHealth admission agreement document (coverage) sent to the health insurance fund at the start of a stay or on a readmission after an absence. See: Agreements (eAgreement)
Annexe 10¶
Care-agreement update document, prepared upon a validated Katz aggravation (the aggravation reason is carried over into it; the clinician’s signature completes it). See: The Katz assessment
Annexe 11¶
Discharge notification sent to the health insurance fund on an absence of more than 72 h, a hospitalisation, or an end of stay / a death. See: Absences and hospitalisations
BIM (status)¶
Increased-reimbursement beneficiary: a social status granting the right to better reimbursement. The MDA pulls it automatically onto the resident’s record. See: Insurability (MDA)
eFact Cockpit¶
Monitoring view for electronic billing: the status of all batches and transmissions at a glance (transmitted, accepted, rejected, pending). See: Electronic billing (eFact)
eAgreement¶
Care coverage agreement (linked to the Katz category and the package), exchanged electronically with the health insurance fund via eHealth. See: Agreements (eAgreement)
eAgreement Light¶
The simple notifications tied to the resident’s movements (admission, absence, departure, return) that Resthome generates automatically as you work. See: Agreements (eAgreement)
eFact¶
Electronic transmission of the insurer’s share (the INAMI package) to the health insurers over the eHealth / MyCareNet network, with tracking of acknowledgements, statements, acceptances and rejections. See: Electronic billing (eFact)
eHealth¶
Belgian platform for secure electronic exchanges in healthcare. Resthome uses it for the MDA, the eAgreement and eFact (via MyCareNet / WalCareNet).
Supplements envelope¶
The monthly grouping of a resident’s supplements (products and services outside the package). Any change automatically updates their invoice. See: Supplements
Anticipatory billing¶
A billing mode where a month’s accommodation is invoiced the previous month, while the INAMI package and the supplements are invoiced in the month they are provided. See: Billing overview
INAMI package¶
Daily amount covered by the health insurance fund for care, determined by the resident’s Katz category and calculated on their days of presence. See: The Katz assessment
INAMI¶
National Institute for Health and Disability Insurance (in Dutch: RIZIV). The federal body that sets the rules and the packages for health-care insurance.
Katz (scale)¶
Scale measuring a resident’s degree of dependency across 6 criteria (washing, dressing, transfer and mobility, using the toilet, continence, eating), each rated from 1 to 4. It determines the category (O, A, B, C, Cd / Cc) and therefore the package. See: The Katz assessment
eFact batch¶
An electronic file grouping the packages of one eFact transmission. Resthome builds one batch per insurer union. See: Electronic billing (eFact)
MDA (insurability)¶
Member Data — the check of a resident’s insurability and of their exact health insurance fund with MyCareNet / WalCareNet for a given period. An essential prerequisite for eFact. See: Insurability (MDA)
MR / MRS¶
Rest home (MR) and rest and care home (MRS) — the two types of residential facility for the elderly, with distinct care levels and packages. In Dutch: ROB / RVT (grouped under the term woonzorgcentrum).
MyCareNet / WalCareNet¶
The health insurance funds’ electronic gateways (via eHealth) that Resthome queries for the MDA, the eAgreement and eFact. WalCareNet is the Walloon counterpart.
NISS¶
Social Security Identification Number (the national register number). Essential for sending a resident’s MDA and eAgreement agreements. See: Managing a resident
Credit note¶
Document that cancels or refunds all or part of an invoice. Resthome prepares one automatically, for example on a departure partway through a month that has already been invoiced (accommodation billed in advance). See: Departure and death
Insurer (OA)¶
The resident’s health insurance fund, recipient of the INAMI share via eFact. Insurers are grouped into large unions. See: Insurability (MDA)
Billing period¶
The billing month in Resthome, which moves through four states: Draft, Generated (calculated), Invoiced and Closed. See: Billing a month, step by step
Reintegration¶
Shifting lines from the resident to the health insurance fund (or the reverse) when insurability changes between two MDA checks (loss then return of insurability, for example). See: Insurability (MDA)
Noon rule¶
Day-counting convention: it is presence at noon (Brussels time) that determines whether a day counts toward the package, hence the importance of departure and return dates and times. See: Absences and hospitalisations
Third-party payer¶
Mechanism where the health insurance fund pays its share directly to the facility (via eFact), the resident settling only their own share. In Dutch: derdebetaler.
Insurer union¶
The large families of insurers used to group eFact transmissions: 100 (Alliance nationale), 300 (Solidaris), 500 (Union nationale), 600 (CAAMI), 900 (HR Rail)… See: Electronic billing (eFact)