Prio.swiss: some medical specialists exaggerate with Tardoc (cross-border guide)

Context

In brief

• Some specialist doctors are overdoing it with the new Tardoc tariff model.
• Prio.swiss notes that some specialties exceed the limits.
• The director of prio.swiss, Saskia Schenker, speaks of cases of prolonging care to increase revenue.

Key facts

• What: Some specialist doctors are overdoing it with the new Tardoc tariff model.
• When: Data recently collected by prio.swiss.
• Where: Switzerland.
• Who: Prio.swiss, Saskia Schenker.
• Amount: Not specified.

The introduction of the new medical tariff model Tardoc has led to a situation where some specialist doctors "exceed the limits" in billing their services. This is what emerges from the data of the Swiss Health Insurance Association (prio.swiss), as indicated today by its director, Saskia Schenker, on the microphones of the Swiss German public radio SRF during the Samstagsrundschau broadcast.

Mid-last week, the Swiss Association of Family Doctors and Pediatricians (mfe) harshly criticized the new tariff: in its opinion, Tradoc does not value family medicine and the overall costs in the outpatient sector would even have increased.

One of the objectives of the outpatient tariffs was to improve the financial situation of family doctors. However, "from the analysis of the first data, it does not emerge that their situation has actually improved," Schenker said. If by the end of the year no improvement is recorded, further measures will need to be taken.

There should not be excessive differences between family doctors and specialists. This would be "simply unjustified." However, the advantage of the new tariff structure is that it can be constantly adjusted and improved, Schenker argued.

…

Operational details

Analysis of prio.swiss data reveals that some medical specialties are exceeding the limits set by the new Tardoc pricing model. This leads to an increase in overall costs in the outpatient sector, as criticised by the Swiss Family and Children's Physicians Association (Mfe).

The director of prio.swiss, Saskia Schenker, pointed out that, despite the objectives of the new outpatient rates were to improve the financial situation of family doctors, the first data do not show significant improvements. If there are no improvements by the end of the year, further measures will be needed.

Schenker also highlighted that there should be no excessive differences between GPs and specialists, as this would be unjustified. However, the advantage of the new tariff structure is that it can be constantly adjusted and improved.

Data from prio.swiss indicates that some specialties, such as ophthalmologists, are pushing the envelope. This could be due to problems in the fee structure, which could lead some medical specialists to try to increase their turnover, both legitimately and illegitimately.

Schenker mentioned cases where care was extended from one to two days to bill double the flat rates. This behavior is not allowed by the fee structure, and in the event of fraud, insurers require reimbursement.

For

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Key points

For Swiss citizens, it is important to be aware of the implications of the new Tardoc pricing model and the possible exaggerations by some medical specialists. Here are some concrete actions that can be taken:

1. Get informed: Read carefully the data and analysis provided by prio.swiss and other reliable sources to better understand the current situation.

2. Consult your GP: Before undergoing specialist care, it is advisable to consult your GP for a professional and independent opinion.

3. Check the rates: Ask for precise information on the rates charged by the specialist doctors and compare them with the standard rates provided by the Tardoc model.

4. Report any irregularities: If you suspect that a specialist doctor is exaggerating with the rates, you can report it to the competent authorities or to the health insurers.

5. Use comparison tools: There are various online tools that allow you to compare the rates of specialist doctors and choose those that offer a better value for money.

6. Participate in public consultations: If there are public consultations or hearings on the new tariffs, participate and express your views to help improve the system.

7. Monitor Developments: Follow news and updates on medical rates to be always informed about any changes and

Source: swissinfo.ch