The new ROC system aims to simplify the application of third-party payment on the complementary part in hospitals, thanks to the dematerialization of information flows between them and complementary health organizations.
It is a real step forward for all the players concerned:
- For patients, an improvement in the quality of service, with simplified treatment, better information and application of third-party payment in hospitals;
- For establishments, their hospital staff and public accountants, simplification and securing of invoicing and collection procedures;
- For complementary health organizations, an improvement in the overall efficiency of complementary third-party payment.
This new system, co-constructed by representatives of complementary health organizations and all the teams from the Ministry of Solidarity and Health and the General Directorate of Public Finances, marks the culmination of ten years of work.
It will be rolled out at the end of June 2021 in public hospitals, then gradually extended to all establishments – follow-up care, rehabilitation and psychiatry.
Through this approach, the CTIP, the FFA and the FNMF reaffirm the involvement of complementary organizations in improving access to care and the quality of service offered to policyholders.
Marie-Laure Dreyfuss, General Delegate of CTIP: “We are delighted with the signing of the ROC framework agreement which proves the relevance of this project. The CTIP and the provident institutions are pleased to have been the first to experiment with the third-party payment system in hospitals, which constitutes a major advance in access to care. “
Franck Le Vallois, Director General of the FFA: “The signing of this agreement marks the culmination of important work between the teams of the ministries concerned and the federations of complementary health organizations. Thanks to this constructive collaboration, ROC will allow policyholders to benefit from the generalized third-party payment and the services offered by their complementary health care at the end of a hospital stay. This represents a step forward in access to healthcare for our fellow citizens. “
Albert Lautman, Director General of the FNMF: “ROC is the demonstration that it is possible to innovate collectively to improve and simplify our health system, and despite the health crisis we are going through, the project has never stopped and has been successfully completed. It is the fruit of a long work of cooperation between complementary Health, the Ministry of Health (DGOS, DSS), the DGFIP, but also the CNAM and the support of the ANS (formerly ASIP) and the GIE Sesam -Vital. By automating it, ROC facilitates the direct relationship and online services between hospitals and mutuals. With better information for patients and an easier third-party payment, complementary health insurance contributes with ROC to better access to care for all. “
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About CTIP
The CTIP represents all the provident institutions, non-profit personal insurance organizations, with joint governance and specialized in the collective. They cover 13 million people, or nearly one in two assets, through 2 million health and provident companies. The CTIP defends the interests of its 38 members with national and European public authorities and supports them in all technical and legal developments having an impact on their profession. It helps to develop educational information on collective complementary social protection.
About the French Insurance Federation
The French Insurance Federation (FFA) brings together 260 insurance and reinsurance companies representing 99% of the market. Its mission is to represent the interests of the sector with the public authorities and the various partners, in France and internationally. She intervenes in the public debate on societal subjects. The FFA also brings together the forces of reflection and analysis of the financial, technical and legal issues of the profession. It centralizes statistical data and ensures that information is disseminated to partners and the media. It also organizes prevention and training actions.
About the Mutualité Française
Chaired by Thierry Beaudet, the Mutualité Française federates almost all mutuals in France. It represents 518 mutuals in all their diversity: complementary health insurance that reimburses patient expenses, but also hospitals, services dedicated to early childhood and nurseries, dental centers, centers specializing in hearing and optics, structures and services geared towards people with disabilities or the elderly.
Mutuals act as the main financier of health spending after Social Security. With their 2,800 care and support services, they play a major role in providing access to care, in the regions, at a controlled price. They are also the 1is private player in health prevention with more than 8,000 actions deployed each year in all regions.
More than one in two French people is protected by a mutual, or 35 million people.
Mutuals are non-profit partnerships: they do not pay dividends and all of their profits are invested in favor of their members. Regulated by the Mutuality Code, they do not practice risk selection.
Chaired by elected mutualist activists, mutuals also represent a social and democratic movement, committed in favor of access to healthcare for the greatest number of people.
Press contacts
CTIP – Miriana Clerc : 06 74 19 20 50 / [email protected]
FFA – Julie Poissier: 01 42 47 93 13 / [email protected]
FNMF – Alexandre Tortel : 01 40 43 33 42 / [email protected]
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