As electronic third-party billing becomes standard practice for dental care, patients in Belgium must now present their electronic identity card (eID) or Kids-ID during appointments.
In Plain English: The Clinical Takeaway
- Electronic Identity Verification: Dentists applying electronic third-party billing must read the chip on an official identity document at every patient contact.
- Impact on Reimbursement: Failing to perform or properly record this electronic reading can lead mutual insurance companies to reject the billing claim entirely.
- Required Documentation: Adults need their eID or electronic identity card for foreigners, while children require a Kids-ID or an ISI+ card (including digital versions via apps like MyGov.be).
Mandatory Electronic Verification and Fraud Prevention
Starting October 1, 2026, dental professionals utilizing electronic third-party billing (known as eFac) are required to verify patient identities at every appointment by reading the integrated chip on an eID or Kids-ID. This requirement directly impacts how reimbursements are processed, as the mutual insurance organization will reject claims if the electronic verification is missing or erroneous. Bruno Gonthier, a member of the Société de médecine dentaire, explains that under this system, the patient pays only their out-of-pocket share electronically, while the mutual insurance portion is transferred directly to the practitioner.
By accessing verified patient data, practitioners can reliably match therapeutic histories to the correct individual. However, a major driver behind the stricter enforcement is financial accountability. In 2025, INAMI data revealed that dental and medical providers improperly billed 2,423,000 euros. Out of 47 evaluated fraud files, 43 involved individual healthcare providers—primarily dentists submitting non-compliant billings.
| Patient Category | Primary Identity Document | Alternative Digital or Physical Options |
|---|---|---|
| Adults | Belgian eID / Electronic Foreigner Card | Attestation of loss/theft with manual NISS encoding |
| Children | Kids-ID | ISI+ card, digital MyGov.be app, or mutual fund app |
Protocol Exceptions and Technical Constraints
While electronic verification via chip-reader is the primary mandate, INAMI outlines specific fallback procedures for exceptional scenarios. Manual entry of the National Social Security Identification Number (NISS) is strictly restricted to defined situations, such as hardware failures, system outages, or patients presenting official documentation verifying the loss or theft of their primary identity card. Practice management software automatically logs five specific parameters during each patient interaction: the document type and serial number, the reading method, the reason for any manual fallback, and the exact timestamp of the verification.
Crucially, INAMI stresses that identity verification rules are not intended to create barriers to healthcare access. A patient arriving without an identity document will not be turned away. Furthermore, this regulatory shift among dental practices serves as a precursor to broader implementation across the Belgian primary care network. General practitioners are scheduled to adopt mandatory electronic patient identification under a forthcoming Royal Decree, aligning general medicine with the compliance standards already established for home nursing and dental care.
References
- National Institute for Health and Disability Insurance (INAMI). Regulatory framework on electronic third-party billing and patient identification in dental care.
- Société de médecine dentaire. Clinical administration guidelines for eFac billing.
- Service d’évaluation et de contrôles médicaux (SECM). Annual statistical report on healthcare billing compliance and non-compliant claims.
