Phone: 06 496 203 92
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Treatment agreement 2022
Cesar/ Mensendieck, Triggerpoint- and Guasha Therapy.
Linda den Otter, Neumannlaan 27 Eindhoven www.oefentherapie-eindhoven.nl
Sir, Madam
You have indicated that you would like to be treated in my practice. In agreement by the law on the Medical Treatment Agreement (MTA) we ask you to read this letter carefully before treatment. I will keep a signed copy on file. In case of a quality check this agreement will be shown. Also in case of a difference of opinion about the treatment policy, it could bring a solution to the matter.
What I ask from you is;
- To inform me fully and clearly so I can obtain a correct diagnose and treat you accordingly.
- To follow my advice, amongst other things the necessary exercises at home.
- To share any reactions to the therapy, which will give me more insight in your problem. I will able me to give you advise, support and additional treatment if needed.
- To put any complaints, misunderstanding or disagreement about the treatment, also any malfunction in my attitude, to me. I am always open to discussion and like to solve it together with you.
- To co-operate and participate in the customer satisfaction survey used by me on my website. (Is not obligatory)
This is what you can expect from me;
- That I will inform and treat you to the very best of my ability .
- That I will respect and live up to the privacy rules for your protection The privacy rules you also will find on my website. *
- That complaints about your treatment and my maybe incorrect attitude towards you, will be treated according the guidelines of VvOCM.
- That you can find more information about the complaint regulations on the website.
Conditions of Payment;
- The conditions of payment are connected to the MTA, between you as the client and the Cesar Practice.
- The client is responsible to provide the correct health insurance information to me as your therapist.
- The client is responsible for checking her/his insurance if the treatment will be compensated.
- All not, or partly compensated treatments will always will be paid for by the client.
- You will find the treatment fees listed on my website.
- Appointments that cannot be kept, have to be canceled no later than 24 hrs. before the planned treatment by a person to person phone call.
If you do not cancel in time, it will mean that you have to pay the full amount of the agreed appointment. This in spite of the reason and also in case of superior numbers. - The declarations for fees, costs, expenses and deliveries need to be paid in full within 14 days after the invoice date. If not paid in full within this term, the client is in neglect starting the 15th day after the invoice date.
- In the event that the client is in neglect, the therapist stands in her right to call in a debt collection agency or a third party. All costs involved in this measure , which also include extra judicial costs, will be charged to the client.
By signing this contract I also give permission to;
- To exchange information with my General Practitioner. (The G.P. always receives the final report of the treatment)
- To exchange information with another care giver/authority
How much does a treatment cost in 2022.
This practice has a contract with all health insurances for a “basic exercise therapy rate”. Every health insurance has its own rate. We will send the invoice directly to your health insurance ( VGZ, IZZ, IZA, UMC, UNIVé, ZEKUR, bEWUZ,United Consumers, Aevitae-VGZ, CZ, OHRA, Nationale Nederlanden, Just). you do not have to do anything.
Exceptions are; MENZIS-AnderZorg- and HEMA , Zilverenkruis, AON, IAK-AON, Zorg en Zekerheid, DSW, ONVZ, ASR, ENO, Salland, PMA, ONE; we do not have a contract with them. In that case you may declare the invoice personally at your own health insurance.
All treatments require a additional contribution of €13,00 per treatment except the 40-45 minutes intake, those are free in every way. Do you have no supplementary health insurance? Then you pay after every visit with Pin-Tikkie- or cash , €48,75 per 45 minutes. The additional contribution is included.
Or 30 minutes treatment is €40,00 The additional contribution is included.
Or 60 minutes treatment is €65,00. The additional contribution is included.
Why do you need to pay an additional contribution?
When a exercise therapist obtains his papers as a practice therapist, the health insurance pays him compensation, just like I get, the basic therapy fee for every client we work with. But..I have more to offer than the required Licenses and Diploma’s which I have.
The fact is that I have 30 years of working experience in this field. I had additional tutoring and study to become a exercise therapist expert in treating muscle pains, posture and movement, which absolutely contribute to my treatment becoming more effective and giving quicker results. The past 5 years I increased my studies and specialized even further. So therapy in most cases will require less time.
Explanation first Appointment;
The first appointment is always 60 min., of which the intake is 30 min. You will be charged the Basic Exercise rate. The compensation will come out of your supplementary insurance. The intake time is always without the extra contribution. During the intake I will explain to you what the consequences are if you decide to be treated by me in my practice. Also I will explain why I ask for an additional contribution being €10,00 per visit. This can be paid cash, with Smartphone-Bank app-Tikkie-or Pin.
In case you do wish to commit yourself to my practice, the second 30 min., we will then analyze your problem and start treatment. You are free to end treatment at any moment and/or choose not to make a next appointment. If you choose not to be treated by me, then the appointment ends after the 30 min. intake. You may leave, no costs involved. Also I could refer you to a colleague if you wish.
Children up to 17 years old;
Exercise Therapy with children under the age 18 is always a matter of Basic Insurance up to 18 treatments. There is no additional contribution involved.
Cancelling or Altering Appointments;
If you are unable to come to the practice on the date due, you need to cancel 24 hrs ahead of time at no charge, or change the appointment by phone, person to person (06 496 203 92) or email info@oefentherapieeindhoven.nl
Appointments on Monday need to be cancelled/ altered before Friday 18.00hrs. If you don’t cancel or change, under every circumstance you will be charged the full amount, also in case of superior numbers. In case of neglect, the full treatment fee will be charged being; €43,00 plus the treatments from the additional insurance , being €10,00 contribution.
I am not responsible for compensations from your health insurance. Every supplementary insurance package has its own maximum compensation. Take in consideration that most insurances add both Exercise and Physiotherapy together.
Signed by;
Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Signature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Place: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Treatments:
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- Neumannlaan 27
- 5624 KL Eindhoven
- The Netherlands
- +31 (0)6 496 203 92
- info@oefentherapieeindhoven.nl
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