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Health insurance companies: Many hospital bills are wrong
Almost every second hospital bill is wrong, according to an internal report by the statutory health insurers (GKV). The cash registers incur billions of dollars in expenditure due to incorrect billing.
According to an internal report by the Association of Statutory Health Insurance (GKV), almost every second hospital bill in the last year was incorrectly issued. Health insurance examiners had discovered errors in 45.6 percent of the invoices. The health insurance companies checked accounts from the same period last year. This was reported in the “Westdeutsche Allgemeine Zeitung” (WAZ group) in its Thursday edition, referring to the results report of the umbrella association of health insurance companies in Berlin.
Numerous operations could be carried out on an outpatient basis
According to the newspaper report, the inspectors found what they were looking for in numerous places. Patients were often treated in clinics longer than is medically and case-related necessary. In many cases, patients were admitted to the hospital for medical interventions instead of performing the operation on an outpatient basis. Drugs that were not administered to the patient were billed at other sites.
For the year 2009, the medical service had already checked 12 percent of all hospital bills at the end of the SHI. According to the association, two out of five statements contained serious errors. The “improper coding” of diagnoses and therapies still has particular potential for controversy. In this context, excessive bills should always occur. According to the internal report, each case found is usually damaged by around 1000 euros. If all the false statements are added up, there is total damage of a good billion euros a year. Some clinics even had an error rate of 65 percent in the test report.
Health insurance companies should check hospital bills more closely
In its activity report, the Federal Insurance Office already referred to ambiguities in hospital billing last month. The health insurance companies should fundamentally rethink how they deal with the clinics. Examiners should take a closer look at the billing, since there is a clear saving volume here. The Federal Insurance Office even sees potential savings per health insurance fund of more than 1.3 million euros per year.
According to the report, the Deutsche Krankenhaus Gesellschaft denies the allegations. Disputes are mainly investigated by the health insurers. After all, 96 percent of the hospital bills were not objected to. The data published by the cash registers are therefore not representative and do not reflect reality. (sb)
Read on:
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