Glossary
Reimbursement claim (demande de remboursement)
The administrative process that lets a policyholder be reimbursed for health costs paid out of pocket, on presentation of supporting documents (paid invoice, prescription) within the deadlines set by the contract or the scheme.
A reimbursement claim is generally accompanied by a paid, itemised invoice (nature and amount of the procedures), a prescription for prescribed medicines or procedures, and a care statement (feuille de soins) for care received in France. Most schemes, including CFE, offer online submission, sometimes supplemented by posting the originals beyond a certain amount.
The exact deadlines and procedures vary from one scheme to another and must be checked case by case. At CFE, a reimbursement claim lapses after two years from the first day of the calendar quarter following the date of care, and original supporting documents must be kept for 27 months in case of an audit. With a private insurer, this deadline is set by the contract and often differs from one provider to another.
Example
After a consultation paid for on the spot, the policyholder submits their reimbursement claim together with the paid invoice and, where applicable, the corresponding prescription, then receives confirmation of receipt before the file is processed.
Also searched as: reimbursement file · after-the-fact claim
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