Third-party payment and the patient ID check: what changes for Belgian dental practices on 1 October 2026

What changes on 1 October 2026?

The check becomes compulsory, and a mistake now costs the reimbursement. Since 1 February 2026 there has been a monitoring phase: dentists could add the ID read to the electronic billing file on a voluntary basis, and the health funds checked it, but errors were only reported for information. From 1 October 2026 an error leads to an actual rejection, and the claim is no longer accepted.

The obligation applies at every patient contact for which you apply electronic third-party payment. A service you do not bill under third-party payment is not covered by this rule. The legal basis is the RIZIV/INAMI regulation of 19 May 2025 amending the regulation of 28 July 2003.

RIZIV/INAMI says explicitly that the check is never meant to limit access to care. A patient without a card is not sent home. What changes is how you bill, which is what the rest of this article covers.

RIZIV/INAMI, Dentists: verify the identity of your patients under third-party payment (in Dutch)

Which identity documents are accepted?

For an adult, the Belgian eID or the electronic foreigner card. For a child, the Kids-ID or the ISI+ card. The ISI+ card also exists in digital form, in MyGov.be and in the health funds’ apps, so a parent can show it on a phone.

If the patient has none of these, RIZIV/INAMI asks you to use one of three substitutes.

How do you read the card, and when is manual entry allowed?

You read the chip or, for a document without one, the datamatrix code or the barcode. If the patient has no document with them, identity can also be checked through itsme, if your software supports it.

If none of those reads works and you still bill electronically under third-party payment, you record manual entry of the national social security number (INSZ/NISS) as the read type. That is not a free choice. It is allowed only in the cases RIZIV/INAMI lists:

• The patient only has a certificate of loss or theft of their identity card.
• The document has no chip, or a faulty one.
• Your card reader does not work.
• Your IT system is temporarily down.
• The patient has no identity document at the time of care, but you have established who they are.
• A prosthesis stopped early because the patient died, or for compelling medical reasons in cases of cancer, anodontia or oligodontia.

What does your software record at each read?

Five items go into the billing file for each contact: the kind of identity document and, where available, the card’s serial number; the read type; the reason for using a health fund sticker; the reason for manual entry; and the date and time of the read.

That is your practice software’s job, not your assistant’s with a pen. Ask your vendor before 1 October whether your version fills in all of these fields, supports itsme and reads datamatrix codes. The packages approved for electronic billing are on the page about dental software in Belgium.

Who and what is exempt?

RIZIV/INAMI exempts two groups of patients and three kinds of service:

• Patients younger than 3 months.
• Patients whose compulsory health insurance is paid by a foreign country (CT1 = 18X).
• Telephone advice.
• Analysing the data and drawing up a treatment plan, with annex 60 or its equivalent kept in the record.
• Cephalometric analysis on a reimbursable teleradiograph, except radiographs taken for orthodontics.

What do you tell the patient, and when?

Say it every time you are already talking to the patient: at booking, in the confirmation and in the reminder. A patient who hears it at the desk does not have the card on them, and it becomes a manual entry with a reason, or a certificate to bring later.

For the confirmation after booking, there is a ready-to-copy text among the dental appointment reminder text templates. The three lines below complete it.

RIZIV/INAMI campaign on bringing your identity card to the dentist, with posters in Dutch, French, English and German (in Dutch)

What does Tilcao do about it?

Tilcao does not read cards and does not bill: that stays in your practice software. What it can do is say the line about the identity card when it books an appointment by phone or WhatsApp, and add it to the confirmation and the reminder, in the patient’s language. The patient arrives with the card, and your assistant does not have to explain at the desk why a manual entry needs a reason.