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The chairman of the National Association of Statutory Health Insurance Physicians calls for more patient receipts. Consumer advocates, however, criticize the model.
(2010-08-18) The chairman of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Köhler, asked for more receipts for health insurance patients after visiting the doctor. Köhler is hoping that the insured will be able to become more cost-conscious with regard to the health services provided by health insurance companies.
Similar to private health insurance, insured persons of the statutory health insurance companies have also had the option since 2004 to have an invoice issued after each visit to the doctor and to submit the costs to the insurance companies at the end of the year. However, hardly anyone of the GKV insured knows such an offer. According to a survey, 80 percent of the insured did not know that there was such a possibility. Only two percent of the health insurance patients use this model.
According to the head of the Association of Statutory Health Insurance Physicians, that should now change. Because, "we are very interested in the fact that the receipts are used by the patients," says Köhler. The hope that the receipts could raise awareness of the costs incurred after treatment. Most people would then recognize "how inexpensive outpatient care in general practice or specialist practice is, compared to visiting a restaurant, for example," Köhler argued to the "Frankfurter Allgemeine Zeitung".
In the future, according to the chairman of the association, the switch to a system of reimbursement will be carried out. In the future, patients should use the direct billing model. The issuance of receipts is the right step in the personal responsibility and personal contribution of the health insurance patients.
The federal government is also planning a similar regulation as part of the health care reform. According to a bill, patients should initially pay for the costs of the treatment themselves and submit it to the health insurance companies at the end of the year. The black and yellow coalition hopes that this new regulation will increase transparency with regard to health costs.
The Thuringian consumer center expresses clear criticism of the model. Because doctors can use the reimbursement model to bill the costs according to the fee schedule for doctors (GOÄ) or dentists (GOZ). This incurs higher fees than the benefit in kind principle. However, many proponents of the model argue that the model would put the insured patient on a par with a privately insured. According to the consumer advocates, this is not the case. The insurers do not reimburse the costs for additional services that are not included in the health insurer's service catalog. Patients also have no direct opportunity to see a private doctor or have treatment carried out in a private clinic as part of the reimbursement of costs. In this case, exceptions are only possible in individual cases - and then only after prior approval by the health fund or in an emergency.
Nevertheless, many insured people hope that this model will give them advantages. So many assume that they would be preferred for medical treatment or when making appointments. But that is often not the case. Because there is no right to preferential appointments!
Insured persons should therefore be aware that they are very likely to have to pay higher doctor and treatment costs when choosing the reimbursement model. However, the health insurance companies only cover the costs that normal health insurance patients with a chip card should have paid. The insured must pay the remaining amount themselves. (sb)