Digitalisation 2027: a checklist for physios

For physiotherapists, digitalisation 2027 means that eAttest, eFact, eAgreement and Member Data become mandatory from 1 January 2027, with specific exceptions. Prepare your access, software and way of working together. This checklist helps you spread the preparation over the months leading up to January. You get a practical timeline, practice scenarios and the official exceptions.

What must you be able to do on 1 January 2027?

Your practice must be able to consult insurability data, send treatment registrations and requests, and certify and invoice electronically. Which service you use depends on the task. eAttest and eFact, for example, are different billing routes, not a double submission for the same session.

Start from the MyCareNet rules of RIZIV-INAMI, the Belgian health insurance institute. If the terms are unfamiliar, first read the difference between eAttest, eFact and eAgreement. The schedule below is a working proposal, not a set of additional legal deadlines.

When should you tackle each part of the preparation?

How do you check your eHealth certificate?

To connect your software to eHealth, you need an eHealth certificate. Check it for each therapist, including in a group practice. A certificate is valid for 36 months and can be renewed from 90 days before its expiry date.

Use the eHealth Certificate Manager and follow the official application procedure. Check your eID, PIN and card reader beforehand. Link the certificate using your supplier's secure method and check that you can log in. Set a reminder for the renewal.

Agree who gets access to which tasks. Keep the certificate and its password safe, and use personal accounts for day-to-day work.

Follow the guide to requesting or renewing your eHealth certificate, with screenshots and separate steps for Windows and Mac.

What should you check with your software supplier?

Ask for a demonstration of the four services based on your type of practice. Besides the calendar, also check how to prepare a request, receive responses and find rejected submissions. Ask which settings you configure yourself and where you will need support.

Check your INAMI number, your status under the national agreement (convention), your practice locations and your payment details. Agree how you record prescriptions and ongoing treatments in the electronic patient record. If you are switching, plan the data transfer and spot-check old records against the new ones. Also read the explanation on switching to other practice software to define the scope of that preparation.

How do you practise the first submissions?

1. Start in a demo or test environment provided by your supplier. Use fictitious records there to get to know the screens and error messages. Do not send fictitious requests to real health insurance funds (mutualités).
2. Practise a complete route: checking insurability via Member Data, preparing the record, getting a submission ready and finding the response. Also discuss a missing prescription or an incomplete record.
3. Then supervise your first real submissions, with actual records and only certificates for care actually provided. Check the patient, the treating therapist and the data before sending.
4. Follow up on the result. An acknowledgement of receipt is not the same as a payment. For eAttest, also check how the supporting document reaches the patient; for eFact, set out how payments are followed up.

How do you get the whole team familiar with the workflow?

Schedule a practice session for everyone who treats patients or handles administration. Have each colleague work through a record themselves, instead of just watching. Also rehearse what happens when someone is absent or when a response from the health insurance fund calls for further action.

Then write a short work instruction: who checks insurability, who processes responses and who follows up on outstanding amounts? Note where error messages are kept and who contacts the supplier. If you work alone, set aside a fixed time each day for that follow-up. Also test your workflow on the devices you actually use, for example during home visits.

What are the official exceptions?

• Age: if you are 67 or older on 1 January 2027, a full exception applies.
• Invoicing away from the practice: paper is allowed when you invoice outside your treatment room and a technical limitation makes electronic invoicing impossible.
• Force majeure: an event that makes electronic submission impossible can justify temporary paper processing.
• Hospital: the obligation does not apply to physiotherapists who work there and bill their services through the hospital's central invoicing.

What do you do in case of an outage?

Keep a small stock of paper certificates of care provided and have your software supplier's contact details at hand. If problems arise, check the eHealth status page and the MyCareNet dashboard; that way you avoid changing local settings while a central service is having trouble.

Keep track of which services have already been processed electronically and which on paper. Never issue both a paper certificate and an electronic certificate for the same session. Also note the error message and the time, so support can investigate the problem. Agree with your supplier in advance how you will check pending records once the service is restored. A contingency procedure only works if you can follow it without having to search.

Your final check in December

• Every therapist can log in with their own access.
• The four services and their responses have been reviewed with the supplier.
• You know who follows up on errors, missing documents and payments.
• The work instruction, contact details and emergency paper stock are within reach.

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