Posted on Monday, October 27, 2014
You provide healthcare services to a person, beneficiary of article L.212-1 (ex L.115) of the code of military invalidity pensions and war victims (CPMIVG).
Two situations can be distinguished:
- Healthcare services come under article L.212-1 (ex L.115) that is to say thatthey are in direct medical relationship or concern illnesses or injuries, mentioned on the description of the infirmities for which she is pensioned; then, their assumption of responsibility falls on the State, under the right to reparation. The CNMSS you will be reimbursed for it in the name and on behalf of the Ministry of Defense.
In this case exclusively, you have to tick the box “Care provided under Article L.115”, on the Cerfa health insurance care sheet
- Healthcare services are not in a medical relationship with his infirmities pensioned under the CPMIVG and therefore do not fall under article L.115; you must not tick the aforementioned box, because their coverage is the responsibility of its health insurance fund, under this same risk. However, in her capacity as beneficiary of article L.115, she will be exempt from the co-payment for her care.
This distinction is very important, so that the expenses relating to his care are correctly charged to the budget to which they must fall (health insurance or budget dedicated by the Ministry of Defense to care falling under Article L.115) and thus allow faster payment of your invoices. You are strongly advised to use this care sheet (unless you are able to remotely transmit your care invoices under article L.115 to the CNMSS – fund 835 (free medical care), due to the fact that you are equipped with software complying with Addendum 6 of the SV 1.40 specifications), if your healthcare services relate to a beneficiary of article L.212-1 (ex L.115) and come under this same article. She compensates
in this case to the sheet of the free care booklet that it could present to you to bill your services. It belongs to the holder of a military invalidity pension ( PMI ) to make known, in advance, his status as beneficiary of article L.212-1 (ex L.115) of
to his health insurance affiliation fund, to be exempt from the co-payment for his care without a medical relationship with his disabled pensioners.