Posted on Tuesday, March 31, 2015
Your patient requests the payment of his care under the provisions of article L.115 of CPMIVG ?
For the acts and services that you dispense or deliver, required by the infirmities for which he is pensioned under the CPMIVG, you can use one of the following three billing media:
The electronic treatment sheet, to be used first
The remote transmission of your invoicing ensures a faster reimbursement of your reimbursement requests.
However, it is imperative that you are equipped with the software version SESAM-Vitale in accordance with CoC 1.40 – addendum 6 to send your invoices for care under article L.115 to the Free Medical Care Department (DSMG) of the CNMSS (cash register 835).
Failing this, your billing and its remote transmission will reach the health insurance organization to which the beneficiary of the care is affiliated: if it is the CNMSS, she will succeed, wrongly, in the identification and services department – 756 or 758 cash registers, with the major consequence, against it, of the deduction of fixed contributions and medical deductibles.
For more information on this possibility, do not hesitate to inquire at the CNMSS, at 04 94 16 96 20.
The paper health insurance care sheet
If you do not have the correct software version, you can establish “paper” invoicing on the certified care sheets, distributed by the health insurance.
In this case exclusively, you must check the box “ Care provided under article L.115 “, on the Cerfa health insurance care sheet.
If it is not possible to use the paper care sheet, or the “Cerfa” care sheet, the free medical care booklet
The free care booklet is issued by the CNMSS to the pensioner at his request.
For more simplicity and speed of payment, favor the first 2 invoicing media
(ESF, if you are equipped and therefore able to teletransmit, or the paper care sheet health insurance, otherwise).