Referral procedure proton therapy for domestic patients

Application for proton therapy at PARTICLE

1. For whom?
   1. For patients who show so-called standard indications for proton therapy and who meet the additional criteria (cf. website NIHDI), an application for proton therapy can be submitted to PARTICLE. An overview of these indications and criteria can be found here.
   2. If you doubt whether an indication qualifies for proton therapy - even when it is not on the list of standard indications - you can always contact PARTICLE and/or complete the registration form.
2. By whom? The radiotherapist-oncologist at the referring radiotherapy centre sends a request for proton therapy to PARTICLE.
3. How? This can be done via the following online registration form, available in several languages. If there are any problems with the registration form, send an e-mail to protontherapy@uzleuven.be. PARTICLE will then provide a secure link to deliver this info. Exchange of medical information between healthcare providers can in principle be done via eHealth if the patient has given permission. As this simplifies the administrative process significantly, it is strongly recommended to ask the patient about this.
4. Assessment?
   1. All applications for proton therapy are discussed weekly at the so-called Proton Round. This multidisciplinary meeting takes place every Monday afternoon at 13.30 (except on public holidays).
   2. Only if the registration form has been completed in full and all necessary information is available by noon on Friday will the patient be discussed at the next Proton Round.
   3. The referring radiotherapist-oncologist receives a Teams link for participation in the Proton Round and presents the case themselves. If applicable, the paediatric oncologist is also invited to participate in the discussion.
   4. In some cases, PARTICLE may request additional information before making a decision.

After application to PARTICLE

Application for reimbursement to NIHDI

1. The referring radiotherapy centre contracts the NIHDI to open a file (hadrontherapie@riziv-inami.fgov.be). NIHDI provides a file number pending the complete application file.
2. In case of a positive opinion from PARTICLE, the referring radiotherapy centre sends a complete application file, including the opinion of PARTICLE, to NIHDI (hadrontherapie@riziv-inami.fgov.be). The compulsory questionnaire accompanying this application file can be found on the NIHDI website.
3. The NIHDI sends the application file to the “Akkoordraad” (Agreement Board), which decides whether or not to reimburse the treatment. The Akkoordraad communicates this decision to the referring centre, PARTICLE and the patient.
4. After a positive decision regarding the reimbursement of the treatment, the patient can be treated with proton therapy.
5. If additional treatments are required (for example concomitant chemotherapy), this will be discussed between the referring centre and PARTICLE. Any additional treatments will be carried out at the referring centre as much as possible. In case of questions, PARTICLE can always be contacted via protontherapy@uzleuven.be.

Billing

A few more steps are taken once the treatment is completed.

1. PARTICLE sends the invoice for the proton therapy treatment directly to NIHDI. NIHDI pays the cost of the proton therapy treatment directly to PARTICLE.
2. The referring radiotherapy centre receives reimbursement for coordination of the treatment after it has transferred the required invoice to NIHDI.
3. The medical reports related to the proton treatment are sent to the referring/treating physician.
4. The referring radiotherapy centre is responsible for the mandatory annual registration of follow-up data with the Cancer Registry Foundation.