As the country's first general practitioners begin integrating Immediate Direct Payment (PID), dentists and specialist physicians are expected to follow next year, for those who wish to do so...On December 12, 2023, at 5:12 PM, Patrick Jacquemot published an update on the deployment of Immediate Direct Payment (PID) in Luxembourg. According to the then Minister of Social Security, Claude Haagen, the deployment was "on the verge of becoming a reality." Martine Deprez (DP), his successor, has since confirmed that already about fifteen physicians in Luxembourg have adopted this innovative service.Admittedly, this represents only 3% of the 525 active general practitioners in Luxembourg, some critics will point out. However, supporters applaud this system that reduces the "out-of-pocket" costs for patients during consultations or treatments. This system allows individuals to pay only the portion not covered by health insurance, thereby easing their medical expenses. This approach is similar to the one already in place in pharmacies.While some applaud this initiative, there is still a long way to go before all general practitioners adopt this service. According to the plans, "by the first quarter of 2024," PID should be extended to dental offices and all specialist physicians. The minister has confirmed this ambitious timeline.However, this measure has not been without controversy, especially among healthcare professionals. The Association of Physicians and Dentists (AMMD) has expressed doubts about the reliability of this rapid digitalization. Alain Schmit, president of the AMMD, raised potential concerns about the protection of data transmitted via PID, including medical acts and services provided. He emphasized that "what we send to the CNS is not neutral, if only the fee statements." The future will reveal whether these concerns have been addressed.This discontent even led AMMD representatives to leave the Management Board of the eHealth Agency, responsible for developing PID and the Shared Medical Record. The Minister of Health and Social Security also spoke out to dispel false information that physicians equipped with PID would receive a financial incentive. Although 625 euros are paid for each PID implemented, this amount actually goes to the software publishers.In conclusion, the digitalization of payments in the healthcare sector in Luxembourg is a controversial progress. While the benefits for patients are evident, the concerns of healthcare professionals persist. The path to widespread adoption of PID by all practitioners still appears to be fraught with obstacles.

Understanding Immediate Direct Payment (PID) with Doctipro: A Comprehensive Guide for PhysiciansIn the ever-evolving medical world, financial management of health practices is a crucial element. Immediate Direct Payment (PID) offers physicians an innovative solution to simplify and accelerate reimbursements from the National Health Fund (CNS). As the developer of Doctipro, a cutting-edge software platform, we are committed to providing physicians with a deep understanding of PID and its integration into their daily practice. Here is a comprehensive guide based on frequently asked questions (FAQ) regarding PID:What is PID?Immediate Direct Payment (PID) allows physicians to receive directly from the CNS the portion of the amount covered by health insurance, with an instant transfer to their bank account. Physicians thus receive the corresponding amount in just a few seconds, while any amount to be borne by the patient is settled directly by the patient.Who is PID applicable to?PID applies to all individuals covered by health and maternity insurance in Luxembourg (CNS, CMFEP, CMFEC, EMCFL). The reimbursement body is the CNS.What are the other means of reimbursement?PID is not intended to replace existing reimbursement methods but to complement them. Classic and expedited reimbursements still exist for situations where PID cannot be applied.What are the limitations and exclusions of PID?Currently, PID is limited to general practitioners and certain specific services. Laboratory procedures performed in the office, procedures not listed in the nomenclature or the CNS-AMMD convention, as well as certain specific procedures in the nomenclature, are excluded from PID.How is PID initiated and what are the associated compensations?The entire PID process must be successfully completed for the physician to be entitled to a quarterly compensation for digital costs. The compensation is automatically paid without a specific request from the physician and is calculated based on a current rate of 0.44 EUR (44 cents) per effective PID transaction.How should personal conveniences (CP) be accounted for in PID?Personal conveniences must be accounted for through the software, with a clear indication of the type of convenience billed to the patient. It is important to note that personal conveniences are not covered by health insurance and are entirely the responsibility of the insured.How to contact support for PID-related questions?In case of questions or technical issues related to PID, physicians can contact us by phone or email at info@doctipro.com.Implementing PID with Doctipro:At Doctipro, we strive to provide seamless integration of PID into our software platform. With our technological expertise and commitment to innovation, we offer physicians the ability to use PID smoothly and efficiently in their daily practice.Special Offer:Recognizing the importance of PID for healthcare professionals, we are proud to offer free installation of Doctipro to the first 100 general practitioners and the first 100 specialist physicians who choose to use our platform with PID. This is our way of supporting the medical community in adopting modern solutions for an efficient and effective medical practice.For more information or to take advantage of our special offer, you can contact us at the following email address: info@doctipro.com.

After the pilot phase reserved for general practitioners in September 2023, the CNS opened access to PID to all physicians and dentists starting March 19, 2024.What are the advantages of immediate direct payment for the physician?The portion covered by health insurance is paid directly to the physician.Immediate validation and payment of billed services.Administrative simplification.My billing software is not ready for electronic communication with the CNS. What should I do?If your billing software is not yet capable of using the web services provided by the mySecu, CNS, and E-santé platforms, Doctipro offers a solution suitable for any software configuration. Transition to Immediate Direct Payment (PID) now without any difficulty.What is PID exactly?Immediate Direct Payment (PID) allows physicians to receive the portion of the fee covered by health insurance directly from the CNS. The CNS transfer is made immediately, so the physician receives the corresponding amount in their bank account within seconds. The patient's portion is paid directly by the patient, who only needs to pay their personal share.To which CNS insured individuals does immediate direct payment apply?PID applies to all individuals covered by health and maternity insurance (CNS, CMFEP, CMFEC, EMCFL) in Luxembourg. The CNS is the responsible reimbursement body.What about other reimbursement/coverage options?PID is not intended to replace the current reimbursement method. It complements other types of reimbursement. Classic and expedited reimbursements still exist, particularly:If the physician is not yet (technically) ready for PID.When calls to PID services fail.If the patient does not wish to use PID.In case of disagreement with CNS pricing (physician and/or patient).In other words, any fee statement for which the insured (or a third party) has advanced the costs can be submitted to the CNS for reimbursement.In the context of PID, how should I account for personal conveniences (CP)?You must bill special CP rates, personal convenience, through your software in addition to the other services you provided to your patients. Clearly indicate the specific fees you will charge your patient: CP1 to CP7 for physicians, CP1 to CP8 for dentists. Simply indicating "CP" without specifying the nature of the personal convenience is insufficient.Reminder: CP1 to CP8 special fees are not covered by health insurance and are entirely the responsibility of the insured.When will the CNS make the corresponding payment in a PID transaction?The CNS portion is initiated "directly" and uniformly (one payment corresponds to one and only one fee receipt). The transfer will be made immediately, provided that technical feasibility exists (among other things, the physician's bank must be SEPA Instant Ready and/or part of the PID partner banks).Banks in Luxembourg currently able to receive PID instant transfers: BCEE (Spuerkeess), BGL BNP Paribas, Raiffeisen, BIL, and ING. This list may gradually expand.What measures in the PID entitle the physician to receive a quarterly compensation for digital fees?For the physician to be entitled to compensation under immediate direct payment, the entire PID process must be successfully completed, meaning a PID transaction that has been fully realized and resulted in a payment to the physician. Compensation is automatically paid, and the physician does not need to submit a separate request.The compensation is calculated based on a rate currently of 0.44 EUR (44 cents) excluding VAT per effective PID transaction.According to Article 110 of the Convention between the National Health Fund and the Order of Physicians and Dentists for physicians; and according to Article 111 of the Convention between the National Health Fund and the Association of Physicians and Dentists for dentists.

Physicians' NomenclatureStarting March 19, 2024, physicians can use all the procedures and services from the physicians' nomenclature within the framework of immediate direct payment (PID), with the following exceptions currently:Procedures not included in the physicians' nomenclature or the CNS-AMMD conventionMedical procedures provided under the competence of the accident insurance associationProcedures billed to a person benefiting from social third-party paymentProcedures subject to ACM or APCMInpatient hospital treatments or treatments in a day hospital serviceMedical packages for follow-up in a day psychiatry center (J1 to J4)Horo-kilometric allowances for night service in general medicine (K2)Medical packages for treatments at the National Center for Functional Rehabilitation and Reeducation (J9 and F43)Procedures related to multidisciplinary cancer consultation (P1 to P3)Procedures under the early breast cancer screening program (E20, 8V53)Consultations, examinations, and procedures under the organized colorectal cancer screening program (PDOCCR) (E30, E31, E32, 1G91 to 1G96)Radiotherapy (procedures with codes starting with: KNQ--, KPK--, KQD--, KQQ--, KZQ--, KRQ--, KRB--)Reports to the Medical Control of Social Security (R4, R5, R6, R8, R9, R11, R12)Other procedures: C46, FC45, MR03, R1, R20Laboratories' NomenclatureRegarding the nomenclature of procedures and services of medical analysis and clinical biology laboratories, physicians will also be able to bill via PID (immediate direct payment) for the procedures they can perform in their medical office, namely: BC001, BC002, BC042, BC141, BC202, BC203, BC403, BC602, BD701, BG001, BG002, BG003, BG212, BH503, BH991, BH993, BH994, BH995, BH996.

Since March 19, 2024, dental practitioners have been able to use the services and procedures listed in the dental practitioners' nomenclature within the framework of immediate direct payment (PID), with the following exceptions for now:Procedures not included in the dental practitioners' nomenclature or the CNS-AMMD conventionMedical procedures provided under the competence of the accident insurance associationProcedures billed to a person benefiting from social third-party paymentProcedures subject to ACM or APCMProcedures subject to DSD - except those listed in article 4 of the nomenclature (invoice serves as quotation)Inpatient hospital treatmentPlacement of bone implants on the skull and face (DB95 to DB98)Removable dental prosthesis (DA11 to DA75)Unfinished treatment for removable prosthesis (DA91 to DA96)Fixed prosthesis (DB13 to DB54)Unfinished treatment for fixed prosthesis (DB91 to DB93)Orthodontics (DT10 to DT62)Services reserved for accident insurance (DW18 to DW31)Other procedures: FD45, FD46, DR1For clarity, here are the only DSD procedures included in the PID system (cf. article 4 of the nomenclature, the invoice serves as a quotation): DS18, DS19, DA52, DA64, DB36, and DB37.

Introduction: The CNS launches the digital transmission of medical fee statementsSince July 2025, the National Health Fund (CNS) has officially launched the digitalisation of medical fee statements — a major development introduced in the new CNS–AMMD agreement. This transformation aims to modernise interactions between doctors, dentists, patients and the CNS, while significantly reducing paperwork.At Doctipro.lu, we support healthcare professionals throughout this transition, enabling them to fully benefit from the new digital tools now available.1. CNS Digitalisation: What is Changing in Practice?The CNS has embarked on an extensive project of administrative modernisation.Its objectives are clear:dematerialise healthcare forms,reduce errors linked to paper documents,automate reimbursements,simplify the lives of patients and healthcare providers,harmonise exchanges via a secure digital platform.Since July 2025, fee statements can be transmitted digitally through compatible medical software.This transition will progressively expand:2025–2026: digital fee statements, eConnector NG, PID2026: mandatory digital transmission2026–2027: digital prescriptions, certificates, and quotes2. The Two Available Digital Methods: PID and Digital ReimbursementThe CNS offers two distinct digital solutions.2.1 Direct Immediate Payment (PID)PID enables doctors to:transmit invoices directly to the CNS,remove the need for patients to send anything themselves,and in some cases eliminate upfront payments (depending on agreements).To use PID, the doctor must:have CNS-compatible medical software with PID support, such as Doctipro,activate the MySecu.lu web services.The process becomes fast, secure, and fully digital.2.2 “Digital Reimbursement” (formerly accelerated reimbursement)Digital reimbursement works as follows:The doctor submits the fee statement digitally via their software.The patient finds the document in their secure online space.They can request reimbursement through the CNS GesondheetsApp.Patients may still request a printed version free of charge — although it is no longer necessary.3. CNS Technical Tools: eConnector NG and MySecu3.1 eConnector NG: the new digital gatewayeConnector NG facilitates integration between medical software and the CNS:automatic time-stamping,certified electronic signatures,transmission of native PDF files (from October 2025).3.2 MySecu activation: a mandatory stepTo use PID or digital reimbursement, the doctor must activate MySecu.lu web services once.This ensures:secure data exchanges,proper identification of the doctor,authorisation for the software to transmit data.4. Who Is Concerned? Who Can Request an Exemption?From 2026, the digital transmission of fee statements will become mandatory, except for specific cases.A doctor may request an exemption if they:were born before 1 January 1965,practise alone (not in a medical group),bill less than €100,000 per year.These practitioners must send a written request to the CNS.Even if exempt, they may still use the digital solution if they choose to.5. The Benefits of DigitalisationFor doctorsless paperwork and fewer errors,fast and centralised transmissions,automatic electronic signatures,improved traceability,smoother reimbursement processes.For patientsdocuments accessible directly in the app,reimbursement requests in one click,transparent tracking,fewer documents to manage.For the CNSreduced processing of paper documentsincreased automation,improved compliance,reduced risk of fraud.6. How Doctipro Supports Doctors Through This TransitionDoctipro positions itself as a key player in Luxembourg’s digital healthcare ecosystem.Doctipro enables doctors to:use software compatible with CNS PID in Luxembourg,receive guidance to activate MySecu services,access clear information about CNS digital updates,highlight their modernisation to patients,reduce their administrative workload.For patients, Doctipro:promotes medical practices already compatible with CNS digitalisation,helps them understand how digital reimbursement works,streamlines the patient journey nationwide.ConclusionThe digitalisation of medical fee statements marks a turning point in the organisation of Luxembourg’s healthcare system. The CNS is paving the way for faster, simpler, and more secure exchanges.With Doctipro, doctors can easily adopt these new digital practices and offer a modern, seamless service to their patients.Are you a general practitioner, cardiologist, dermatologist, gynaecologist, paediatrician, neurologist, psychiatrist, surgeon, anaesthetist, radiologist, dentist, or any other medical specialist? Contact us now to try Doctipro for free.