For treatment providers
We have not yet received a payment guarantee, what do we do?
At each clinic, you will be able to login to the portal yourself and subsequently search in Claims report on the policyholder's name or civil registration number. Click on the policyholder's name and you will be directed to the case, where you can press Download and download the payment guarantee and get relevant information.
Exchange of status, orientation of courses, etc. - can we do so in relation to GDPR?
Status and information/correspondence about treatments must be uploaded or entered under Comments in the portal, as the portal is GDPR-secured. We thus avoid sensitive personal information is sent via email.
You, who process, are the data controller for the information that you have obtained and/or pass on. The policyholder gives a written consent to the exchange of case-related information when creating the case.
No contact information on the policyholder - what should we do then?
In this case, you must contact PrimaCare in the comments field on the case.
What does it mean: "There is news to the case"?
In the email with There is news to the case, you will find a link that you must click on. You will then be navigated directly to the place in the portal where the reason for the inquiry will be described.
How long do we wait for the policyholder to return our inquiry (answering machine and email) regarding the 1st consultation?
Wait 1-2 working days and then reject the case in the portal with reason.
We can not take in more policyholders - what do we do?
If you deem it necessary, you will always have the opportunity to put yourself on standby for a given period.
Login to the portal, press my clinic and tick Standby for new customers. In the same connection, highlight the Standby time interval from and to (both from and to date are included) and then press Save.
Portal does not work/during a claim, no policyholder appears - what do I do?
First check that you are not using Internet Explorer, as this browser is not compatible with the portal. Google Chrome should always be used. If you still cannot find a policyholder, you can contact PrimaCare on tel. 78 79 39 40.
How long is the validity date of additional approved treatments?
The validity date appears in the portal.
I have only seen the policyholder once and the he/she does not have to continue with treatment at the clinic - what do I do?
You must enter the portal and complete the process with an adequate justification and send an invoice for a first-time treatment.
What do I do when I cannot continue with the policyholder in terms of treatment?
Here you should always assess whether this is a significant and lasting improvement, as well as whether it is a preventive treatment. When you assess that you can not do more for the policyholder, you go to the policyholder in the portal and justify the health professional in the comments field, which is why you assess that the process must be completed. In addition, a justification should also be written in the portal as to why the policyholder is sent back to the insurance or pension company.
How should we react when the insurance company asks for an elaborate status of the course or diagnostic imaging answers?
Occasionally you experience that we ask for an elaborate status of the policyholder's course. This is because the insurance company has asked for this, in order to be able to help the person with further investigation or other treatment.
We only collect this information if problems arise during the process, if the policyholder needs a further investigation or if the process is on the verge of policy conditions. Here we need your help in relation to what finds out about issues in the individual case, as well as what has been tried of treatment and the effect thereof. In other words, you know the policyholder and are therefore the best to help the policyholder further. We can not do it without you.
Status must be uploaded or entered under Comments in the portal, as the portal is GDPR-secured. We thus avoid that sensitive personal information is sent via email.
Scan responses can advantageously be uploaded in the portal, as the portal is GDPR-secured. We thus avoid that sensitive personal information is sent via email.
You, who process, are the data controller for the information that you have obtained and / or pass on. Exchange of case-related information gives the policyholder written consent to the creation of the case.
How do I send a referral for a scan or further examination?
You can describe evidence of scanning or investigation in a status under the comments field in the portal. Remember that the policyholder must have a referral from their own doctor.
If you as a chiropractor want to refer for an MRI scan, the referral can be uploaded securely in the portal and we can pass it on.
Is an additional benefit such as ultrasound scanning included in the treatment?
When issuing a treatment course, the policyholder always receives an email stating that various surcharges and additional benefits (eg shockwave, tape, ultrasound scan, soles, etc.) are not covered by the insurance and will be self-payment. However, the therapist should always state that this is at his own expense.
The therapist identifies two separate issues that are considered to have nothing to do with each other - what do I do ?
When two separate issues are identified, the policyholder must contact his insurance company to create a new case. At the same time, the therapist must write a short comment in the portal with his or her health professional assessment of the problem.
The policyholder is assessed as completed on the course - what do I do?
When the policyholder is assessed as completed on the treatments, the therapist must enter the portal and close the case with reasons for this in the corresponding comment field. The policyholder need not do further.
What should I do in case of relapse?
If relapse has occurred within the last 30 days since the last treatment, treatment should continue on the same reference number.
If more than 30 days have passed since the last treatment, the policyholder must contact his insurance company for a new payment guarantee. Treatment started without a payment guarantee is not covered by our agreement and thus not covered by the insurance.
You have sent a payment guarantee with a referral, but I do not take in referrals - what should I do?
You should reject the case in the portal with the reason "does not have an external number - please send a new payment guarantee without reference".
You have sent a payment guarantee with a referral, but the policyholder does not have a referral?
You must contact us in the comments field on the case, after which a decision will be made as to whether the policyholder can be covered without reference. Treatments are not covered until this is clarified.
You have sent a payment guarantee with a referral, but I do not have the opportunity to take in a policyholder with referral - what do I do?
As a psychologist, please reject the case in the portal and write "can not give the policyholder time within X number of days" or reject the case in the portal and ask for a new payment guarantee without reference.
As a physiotherapist, you must ask if this is possible. Please write in the comments field that you do not have the capacity and ask if the payment guarantee can be changed to without reference.
For both types of treatment, we will let you know once we have an answer from the policyholder's insurance company.
What do I do when / if the specified number of treatments written in the payment guarantee is used?
Here you must find the policyholder's case in the portal and request further treatment. You must note the number of treatments used, the number of additional treatments, and a brief justification for the additional treatments.
Policyholder need not do further.