During the consultation, the doctor can
- either make a paper invoice. The patient should pay the costs, and be reimbursed later by health insurance
- or generate an electronic invoice. The patient will not have to pay fees if the doctor makes the third-party payment by remote transmission
There are 5 steps to create an electronic invoice: reading the CPS, reading the Carte Vitale, clarifying the billing context (the reason for the visit to the doctor), specifying the medical act, signing.
Card reading: identification of the parties (steps 1 and 2)
During the initial software setup, the physician configured their billing status using their CPS. The first time he performs a billing action, a PIN code (carrier code) is requested by Billeo to confirm his identity. Billeo then retrieves the patient data from the Carte Vitale. This includes their identity information, social security number, health insurance plan, the identity of the people attached to the card and whether or not the patient is exempt from paying for the consultation.
What if you forget your Carte Vitale? The doctor can make an API call ADRi (Integrated Rights Acquisition) to the health insurance fund with your social security number only.
Billing context and medical act: creation of valid invoices via the user interface (steps 3 and 4)
In Doctolib Desktop Version, the doctor fills in the information relating to the consultation. This includes why and what kind of care was provided.
Our mission is to make the app as easy as possible to use so that doctors save time. For example, through the user interface (UI), some fields are pre-populated using information taken from the last invoice for the same patient. The SESAM Vitale specifications govern much of the information we provide in the software. Certain fields (for example “Is this an accident under common law or private life?” – “Is this an accident under common law or private life?”) Must be filled in manually by the doctor for each consultation in the framework of the attestation.
By default, we offer a simplified view. There is an advanced view for complex invoices which can be activated dynamically if the doctor gives certain answers. A question-and-answer session takes place under the hood between the billing engine and the front-end, checking for potential errors and missing items. When the doctor answers a question, it is sent to Billeo to verify that the combination of all the answers leads to a valid invoice. The doctor cannot generate an invoice until the status is valid.
Then, the doctor fills in the information relating to the payment: whether he applies the third-party payment and the final cost.
Signature (step 5)
The last step before teletransmission to the health insurance funds is to secure the invoice with a signature. There are several levels of security. The higher one needs the two physical cards. With the combination of the Carte Vitale and the CPS in the reader, the invoice is “SESAM Vitale secure”.
If you forget your Carte Vitale, the security of the bill would be in degraded mode (paper bill to be sent) or “SESAM sans vitale” (for teleconsultation).