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Remboursements

I had a biopsy on 14 February, I paid 189 euros om my mutuelle card.i have an affection de long duree.i received a payment of 117 euros from my mutuelle. Today I have received 22.50 euros from CPAM.I have no idea what this relates to.The English help line didn't work.The response to my email to CPAM was a very unsatisfactory phone call which hasn't helped.All I want to know is how the system works.It would good if I knew when I was going to be reimbursed.

Brian

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Hello Brian,

Unfortunately, because of safety and confidentiality issues, we can’t reach any of your information or file from this forum.

I'm therefore not able to check what was reimbursed to you.

If you need help regarding this request, you can try again to contact the CPAM’s English Advice Lines. A counselor could explain the amount refunded.

More information in the following topic: How to call the French Health Insurance Advice Lines?

I wish you a nice day.

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Elryn

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Do you have ameli account?
You can check everything CPAM refunds to you.

About your biopsy, you have "ALD" which means, CPAM will refund you 100% of the legal price of biopsy. Sometimes doctors ask more than legal price.
The first thing is to know, what are those 189€? Because in ALD, doctor are not supposed to make you pay the legal price (CPAM refund them directly) so maybe it's the extra price that only mutuelle refund.
If it's legal price + extra, then it's possible that the 22.50€ are the legal price. or at least a part because you had a debit to CPAM ("franchises" and "participations forfaitaires" which are "taxes" that are applied on all medical things you have).

It's a bit difficult to explain you.

But first really, check your ameli account and what are those 189€ (with the doctor).

Brian

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I am not sure I understand completely.Do I have to send a "feuilles de soin' every time I have a hospital procedure or investigation. I also had an operation in November 2022 is it too late to check that I have been reimbursed fully.

Hello Brian,

Indeed, each care requires sending a "feuille de soins" to get the refund if you don't have a Vitale card.

To obtain reimbursement from your CPAM, your "feuille de soins" must not have been established more than 2 years and a current quarter ago. You can check the amount refunded with your CPAM.

Have a nice day.