We check hospital bills with your interests in mind
When the JSIS agrees to direct billing of hospital expenses, the hospital sends its invoice direct to the PMO.

Verification of the invoice
The Direct billing and invoice settlement department which receives the invoice checks various things before paying: whether the amounts invoiced correspond to national scales (for example, INAMI scales in Belgium); that there is no duplication of invoicing; whether the supplies being charged for are compatible with the illness; if, where appropriate, the agreements between the JSIS and the hospital have been observed, etc.

These checks may lead to a correction which the PMO will then claim from the hospital. In this case, the amounts you have been charged will be reduced. This is therefore in both your interest and that of the JSIS.

Calculation of the rate of reimbursement
The bill is then examined by the appropriate department which draws up a statement of charges. This statement shows the total amounts paid, broken down into those to be paid by the JSIS and any for which you are responsible.

In the case of direct billing, the part of the bill for which you are responsible constitutes an advance, as the JSIS has paid the full amount of the invoice to the hospital. This advance will be deducted from the reimbursement of your future medical expenses.

NB: If the hospital stay for which the JSIS has granted you direct billing is at an establishment where the costs exceed the ceilings laid down in the rules, the amounts you must pay will be higher. The JSIS takes these ceilings into account when determining the amount to be reimbursed and the amount you will be charged.

The principle of freedom of choice
As you know, our joint sickness insurance scheme (JSIS) is based, inter alia, on the principle of free choice of hospital, doctor, etc. by the member.
Under this same principle of free choice, you, the Member, must where appropriate address and settle any conflicts, disagreements or disputes with the hospitals, clinics and doctors by whom you have chosen to be treated.
Our services cannot intervene in this regard.

Agreements with hospitals in the Brussels Region: attention to excessive costs

At its meeting held on 20 and 21st May, the JSIS' Joint Management Committee (composed of representatives from the administration and staff of the Commission and all Institutions) has adopted a resolution concerning the agreements signed between the PMO and several hospitals of the Brussels area.

PMO would like to take this opportunity to advise its members to pay careful attention to the estimates which they are asked to attach to their requests for direct billing for hospitals in the Brussels region that have not signed any agreement with PMO. In some cases the amount which remains at the charge of the member, taking into account the reimbursement ceilings and the potential application of a factor for excessive costs, can be substantial.