Custom Zorgprestatiemodel integration development
Appfront builds integrations for mental healthcare and forensic care providers that work with the performance-based care model (zorgprestatiemodel). Consultations and other services from your own systems are recorded in line with the rules, checked before claiming, and submitted in line with the Vektis standard via VECOZO. The insurer's return information comes back to the client and the service, so a rejection doesn't sit unnoticed on a list.
What is an integration for the performance-based care model?
Since 2022, mental healthcare and forensic care have been funded under the performance-based care model. Care providers claim per service, such as a consultation, including the practitioner's profession and the duration, rather than per treatment episode. The rules come from the Dutch Healthcare Authority (NZa), and claims are submitted under Vektis's generic claims standard, GDS801, usually via VECOZO to the insurer. An integration connects that to the systems where the work is recorded.
At many providers, the diary sits in one system, the file in another and the claim in a third. A consultation is entered in the diary but registered with the wrong duration or without the correct profession. A claim is rejected, and the return information sits in a list that nobody keeps track of. And how much is still to be claimed only becomes clear to administration at the end of the month.
We build custom software because the integration has to fit your practice or organisation: which diary, which EHR and which apps you use, how practitioners record their work, whether you claim from insurers, municipalities or the justice system, and how your administration runs. The rules of the NZa and the agreements with funders are set by you with your adviser or controller; the integration checks against what you define.
Registration that is accurate
Consultations and other services from your diary, EHR or app, with duration, profession and client, checked against the rules.
Claims in line with the standard
Claims under GDS801, sent via VECOZO, with an overview of what is still to be claimed.
Rejections followed up
Return information sent back to the client and the service, so a rejection can be corrected.
How we build your integration for the performance-based care model
We start with your practice: which systems you use, how practitioners register, whom you claim from, and where things currently go wrong.
Your diary, EHR, apps and claims system, and how practitioners record their work.
Services from your systems, checked against the rules before claiming.
Claims in line with the standard via VECOZO, and return information sent back to the service.
An overview of registration and claims, and management as new rules and versions arrive.
What an integration for the performance-based care model does in practice
The components below come up at almost every mental healthcare provider. Which ones you need depends on your systems.
Registration
Consultations and services from your diary, EHR or app.
Practitioners
Profession and details per practitioner attached to the service.
Validation
Checks against the rules before claiming.
Claims
Claims under GDS801 via VECOZO.
Return information
Rejections returned to client and service.
Reporting
What has been registered, claimed and rejected.
Who we build an integration for the performance-based care model for
The integration is intended for providers where registration and claiming sit in different systems.
Mental healthcare institutions
Many practitioners and systems. Checking before claiming is the core.
Independent practices
A small administration. Rejections matter most.
Forensic care
Claiming from the justice system and insurers. Distinguishing by funder is what's needed.
Mental healthcare software suppliers
Support for the model in their own software. The standard is the core.
Technology and integrations
This page covers recording and claiming under the Zorgprestatiemodel (care service model). For mental health software in general, see our page on mental health software; for messaging with insurers, see our page on a VECOZO integration; and for healthcare in general, see our page on healthcare software. You can read about how we work under custom software development.
If you want to align delivered Wlz care with billing and production agreements, take a look at our software for Wlz production reporting.
Why choose Appfront for your performance-based care model integration?
A rejected claim is care that was delivered but will not be paid. We build around that: registration that is accurate, checks before billing, and rejections that come back where they can be corrected.
Fewer rejections
Registration errors are caught before billing.
Rejections corrected
Return information comes back with the service, not in a list.
Visibility of revenue
What is still to be billed is known every day.
Security and privacy for a performance-based care model integration
The integration processes health data about clients, which is special category personal data. Access is set up by role, data is shared only with those who need it for billing, and every access and message is logged.
The integration runs in a European data centre or in your own environment, with encrypted storage, daily back-ups and two-factor login.
Frequently asked questions about a performance-based care model integration
Questions that mental health care providers ask before getting started.
Since 2022, the performance-based care model has been the funding system for mental health care and forensic care. Providers bill per service, such as a consultation, rather than per treatment pathway. The rules are set by the Netherlands Authority for Healthcare Markets (NZa).
Vektis's generic billing standard: GDS801 for the claim and GDS802 for the return information. Claims usually go to the insurer via VECOZO.
Yes, according to the rules you define, for example on duration, provider type and the data attached to a service. Anything that does not add up goes back to the practitioner or administration before billing.
The return information comes back to the client and the service, with the reason. Administration sees what needs correcting and can resubmit.
Yes, provided those systems have an interface. Services come from the system where they are recorded, so nobody has to retype them.
That depends on your type of care and your agreements with payers. The NZa sets the rules. What applies to you is for you to determine with your advisor or controller; the integration checks against what you define.
Check that first. Many mental health EHRs support the Zorgprestatiemodel, and that is enough if you do everything in that EHR. Custom work makes sense when recording and claiming happen in different systems, or when you have your own app or dashboard.
Registration and billing that line up?
Tell us which systems you use, how practitioners record their work and where billing currently gets stuck. We will show you what the integration would look like.