Billing Modules
Sophia offers two ways to get reimbursed by the mutuality: eAttest and eFact. This guide explains how each one works, and what the difference is.
Why Does This Exist?
For physiotherapy, the mutuality partly or fully covers the cost of treatment. To do this, the mutuality needs proof that the treatment actually took place: the attestation of care provided. This used to always be a paper document, which the patient brought or sent to the mutuality themselves.
With eHealth, the secure platform for exchanging information between healthcare providers, the government, and the mutualities, Sophia can now send this proof directly and digitally. This has two big advantages: the patient no longer has to submit anything themselves, and reimbursement is faster and has fewer errors.
Which module you use depends on who advances the money:
- Does the patient pay you the full amount themselves first, and does Sophia just handle the proof for the mutuality? Then you use eAttest.
- Does the patient only pay the copayment (the part the mutuality never reimburses anyway), while the mutuality pays the rest directly to you? Then it's a third party payment arrangement, and you use eFact.
TIP
The eFact module used to be called "derdebetalers" (third party payer). That name is still used in Sophia, but now for an individual patient's payment arrangement, or for a separate, older document. The module for digitally requesting reimbursement from the mutuality is now called eFact everywhere.
- eAttest: the electronic attestation, sent per appointment, just like a classic paper attestation.
- eFact: a bundled reimbursement request, for several patients at once, with feedback when something is rejected.