Third-party payment CNAS and CASNOS for Algerian medical practices: what you need to know

In Algeria, two main bodies manage compulsory health insurance: CNAS (National Social Insurance Fund for employees) and CASNOS (National Social Security Fund for non-employees). For a medical practice, understanding how their third-party payment systems work can transform the quality of service offered to the patient — and considerably ease the patient's cash flow.

Here is a practical guide to what you need to know in 2026.

Third-party payment: what is it exactly?

Third-party payment means the patient does not pay the doctor directly for the consultation. Instead, the social body (CNAS, CASNOS, mutual) pays the doctor according to a pre-established agreement. The patient presents their insured card, the doctor enters the act, and billing follows an administrative circuit.

This mechanism is widespread for hospital acts and certain specialized care. It is less systematic in outpatient practice, but it exists.

CNAS — for employees

CNAS covers employees of the Algerian public and private sectors, as well as beneficiaries (non-working spouses, children, dependent parents in some cases).

Approval conditions

A doctor can be approved by CNAS, that is sign an agreement allowing them to practice third-party payment for insured patients. Conditions vary by region and regulatory evolution. Generally:

• Registration with the medical council
• Step with the regional CNAS direction
• Compliance with agreed tariffs (which may be lower than free tariffs)
• Commitment to care quality and timing rules

The administrative circuit

After each approved consultation, the doctor fills a care form (paper or electronic depending on regions) where are recorded: insured ID, act performed, coding, signature. These forms are sent to CNAS for processing and reimbursement to the doctor.

Reimbursement delays vary but can be from several weeks to several months depending on regions and the fluidity of the local administrative circuit.

CASNOS — for non-employees

CASNOS covers traders, craftsmen, liberal professions, individual entrepreneurs and their beneficiaries. The mechanism is broadly similar to CNAS with its own rules, its own tariffs and its own administrative circuit.

Many Algerian patients combine several statuses (e.g. employee + trader), which can complicate care management. The general rule: the main status determines the affiliation fund.

Third-party payment or direct payment: pros and cons

For the patient

Third-party advantages: no upfront fees, so less reluctance to consult for preventive or follow-up care.

Disadvantages: choice limited to approved doctors, sometimes more paperwork for the patient (care card to present, forms to sign).

For the doctor

Advantages: larger patient flow (insured patients prefer approved doctors), institutional legitimacy, secured payment.

Disadvantages: agreed tariff sometimes lower than free tariff, payment delays, administrative burden for billing and reimbursement follow-up.

How to manage third-party payment daily in a practice

Three elements make the difference between draining and smooth third-party payment:

1. Rigorous data entry

Each error (insured number, act code, date) leads to rejection and therefore several weeks delay in payment. Systematically check consistency before sending to the fund.

2. Reimbursement tracking

Keep a table (Excel or software) listing each act billed in third-party, its date, status (sent, accepted, paid, rejected). Without this tracking, unpaid acts can slip through.

3. Proactive follow-up

In case of unusual delay, do not wait: contact the regional fund to identify the blockage. A lost administrative file rarely unblocks itself.

Upcoming evolutions

Algeria has announced several administrative modernization initiatives, including dematerialization of care forms and interconnection between fund systems and medical software. Eventually the doctor would enter the act directly into their practice software, which would automatically transmit to CNAS or CASNOS for reimbursement, without intermediate paperwork.

This evolution is still uneven across regions and funds, but the direction is clear: less paper, more digital, and growing integration between private software and public systems.

What if I do not want to handle third-party payment?

Many Algerian liberal doctors prefer direct patient payment to avoid administrative complexity. It is entirely legitimate — your patients can then get reimbursed themselves from their fund by presenting the invoice.

The right choice depends on your patient base, your administrative tolerance and your business vision: a practice in a working-class neighborhood will benefit strongly from approval, while a high-end specialist practice in the city center will work very well without.

And Hakim-DZ in all this?

Hakim-DZ does not currently offer direct integration with CNAS and CASNOS systems — the API ecosystem is not yet available on the funds side for this kind of interconnection. However you can:

• Track your third-party acts in Hakim-DZ with a custom field
• Generate your invoices and care forms from patient record data
• Track payments and follow up funds from the billing module

When the funds publish their public APIs, the integration will be added to Hakim-DZ. Meanwhile, the practice is properly tooled to manage third-party payment in semi-manual mode.

Start a free Hakim-DZ trial to see how to integrate third-party tracking into your daily routine.