Advice re a feuille de soins form.

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Crazy Diamond
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Advice re a feuille de soins form.

Post by Crazy Diamond » Mon May 27, 2019 1:10 pm

My wife received a feuille de soins form to send for reimbursement for some recent treatment. However there are a couple of typos on the form and I wondered if it is necessary to correct these before returning the signed original. The first mistake is in the spelling of her name: an extra E has been added and the second is her date of birth which is given as 25/10 when it should be 27/10.

Should she correct these on the form and initial the alterations, leave them as they are not major mistakes, or send an accompanying letter politely pointing out the errors? Knowing how fastidious the French can be re form-filling, when sometimes an uncrossed T is sufficient reason to reject a request, we don't want to screw it up.

Syd.
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Re: Advice re a feuille de soins form.

Post by ajm » Mon May 27, 2019 2:00 pm

Why not go back to whoever issued the form and get a revised version.

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Re: Advice re a feuille de soins form.

Post by Mangetout » Mon May 27, 2019 8:48 pm

Just correct the errors. To be honest, even with errors it would still get through the system as long as your ss number is correct.

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Re: Advice re a feuille de soins form.

Post by Crazy Diamond » Tue May 28, 2019 12:59 pm

ajm wrote:
Mon May 27, 2019 2:00 pm
Why not go back to whoever issued the form and get a revised version.
Thanks, I'm embarrassed to confess I hadn't thought of that. Too obvious maybe. Knowing how things work (or don't) in France it could be more expedient to do as Mangetout suggests - thanks for that.

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Re: Advice re a feuille de soins form.

Post by Crazy Diamond » Fri Jul 26, 2019 12:34 pm

After much to-ing and fro-ing regarding apparent non-payment, we've received what I guess is the definitive reply from CPAM which came as a surprise. The form covered a cervical smear my wife had taken for which she paid €27.40. The latest message from CPAM/Ameli says no payment will be made due to: Cet acte a donc bien été remboursé
le 25/06/2019 sans versement sur votre compte bancaire car déduction de
franchises et participations forfaitaires. Vous trouverez le détail de
ces retenues sur votre décompte.

I was under the impression cnacer treatment is provided free in France and although, strictly speaking, a smear can't be described as "treatment", non-reimbursement for this seems weird. Is this normal?
Syd.
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Re: Advice re a feuille de soins form.

Post by Le Démerdeur » Fri Jul 26, 2019 1:12 pm

It was remboursed, you will have the detail that I cannot see so I dont know if the €27.40 was remboursed at 100% or another percentage, what I can see though is the amount, lets call it €20 was swallowed up by the various €1 franchises that you would technically have had to pay each time at the pharmacy, the médecin etc, there are others as well which you will see on your statement.

Basically you have been remboursed but they have kept the money because you already owed them an eqqual amount or more.

I'm aware that my explanations can confuse, if there is any part you want me to explain further please ask.
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Re: Advice re a feuille de soins form.

Post by Catrose » Fri Jul 26, 2019 1:44 pm

Do you have an online account with Ameli? As if you do that will show this in endless detail. As chancer says, they deducted all the outstanding forfaits & franchises you owe them which meant that there was nothing left to give you.

If you don't have an online account do get one as makes it all much clearer.

I did query a cancer test once and doctor firmly told me that “it’s only free if you have cancer - is that what you want?”. I shut up and paid the money!

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Re: Advice re a feuille de soins form.

Post by Crazy Diamond » Fri Jul 26, 2019 3:26 pm

Catrose wrote:
Fri Jul 26, 2019 1:44 pm
Do you have an online account with Ameli? As if you do that will show this in endless detail. As chancer says, they deducted all the outstanding forfaits & franchises you owe them which meant that there was nothing left to give you.

If you don't have an online account do get one as makes it all much clearer.

I did query a cancer test once and doctor firmly told me that “it’s only free if you have cancer - is that what you want?”. I shut up and paid the money!
Le Démerdeur wrote:
Fri Jul 26, 2019 1:12 pm
It was remboursed, you will have the detail that I cannot see so I dont know if the €27.40 was remboursed at 100% or another percentage, what I can see though is the amount, lets call it €20 was swallowed up by the various €1 franchises that you would technically have had to pay each time at the pharmacy, the médecin etc, there are others as well which you will see on your statement.

Basically you have been remboursed but they have kept the money because you already owed them an eqqual amount or more.

I'm aware that my explanations can confuse, if there is any part you want me to explain further please ask.

Thanks for all the replies.
Yes, we both have an online account, though I'm not sure it makes things "much clearer". Trying to reconcile repayments from Ameli and our mutuelle for the same treatment, the details of which we receive independently at different times, frequently months apart, is summat I reckon only a qualified accountant could handle. I don't believe I'm alone in that opinion.

LD what you say is right, in a way it was reimbursed, but "they have kept money because you already owed them an equal amount or more" - I don't believe I'm stupid, but that doesn't make sense as we paid the €27.40, so please explain how we owed Ameli anything. If it will help I'm attaching the relevant extract from my wife's Ameli remboursement summary for treatment which, if I've understood correctly, indicates the €27.40 paid is way above the base de remboursement. I would have thought the €11.90 "montant versé" meant the amount repaid, but as we received zilch, I guess not. Sorry it's all scrunched up, it wasn't when I copied it and I'm not sure how to rearrange it. Hopefully it'll make sense.

Nature/ Date
Montant payé
Base de remboursement
Taux
Montant versé
ACTE TECH MEDICAL
30/04/2019
27,40 €
17,00 €
70 %
11,90 €
participation forfaitaire

-1,00 €

Perhaps the NHS isn't as bad as it's made out to be!
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Re: Advice re a feuille de soins form.

Post by Simonflys » Fri Jul 26, 2019 3:40 pm

LD's explanation is spot on and your Ameli account will show you the full calculation including the deductions made. These deductions (franchises et participations forfaitaires) are cumulative based on your previous and current claims. They are simply reclaimed from you when your CPAM process payments due to you.
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Re: Advice re a feuille de soins form.

Post by Le Démerdeur » Fri Jul 26, 2019 3:43 pm

OK, I think that gives me enough, the gynéco charges more than the base de remboursment, most do, you paid €27.40 but they would only rembourse €17 less €1 participation forfaitaire (remember that) meaning a cancer sufferer would get €16 back, you are refunded at 70% so its €11.90 less the €1 participation so they owe you €10.90.

However every time you have had a docteurs appointment where they dont make you pay because they are connected directly to Ameli or the pharmacy if thats also the case they get paid back the full amount of their charges leaving you effectively owing L'Assurance Maladie €1 each time because they have paid the full amount to the médecin/pharmacie on your behalf, there are other charges as well but ignore them for now as it will complicate things.

You will have had a total of more than €10.90 owing and if you look at the detail on the ameli account you will find all the small amounts, its not easy but easier than on the printed statements that they used to send me.

My médecin is not connected, i pay him in full and they credit my bank account quickly with the 70% less €1, the pharmacy is connected and i only pay the 70%, I'm not sure if the deduction of teh forfaits etc is done there and then or if Ameli take it away from other remboursements which would be unnecessary complicatated but nothing surprises me.

Editted, Simon has just made a much clearer and concise explanation than I :good:
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