Some medical specialists exaggerate with billings (cross-border guide)

Context

In a nutshell

• Some medical specialists exaggerate with billings.
• Saskia Schenker, director of Prioswiss, criticizes billing practices.
• Ophthalmologists and dermatologists under the lens for excessive billing.

Key facts

• What: Some medical specialists exaggerate with billings.
• When: Not specified
• Where: Switzerland
• Who: Saskia Schenker, Director of Prioswiss
• Amount: Not specified

BERN - Despite the introduction of the new Tardoc medical tariff model, "some specialist doctors exaggerate the billing of their services". Their data proves it, Saskia Schenker, director of the Prioswiss health insurance association, told SRF's Samstagsrundschau. Last week the association of family doctors and paediatricians Switzerland had harshly criticised the new Tardoc medical tariff, as it would not enhance basic medicine and the overall costs in the outpatient sector would even increase. One of the objectives of the outpatient fee would have been to improve the financial situation of family doctors. But "from the analysis of the first data", it would not be so. If there is no improvement even by the end of the year, then further action should be taken. There shouldn't be too big a difference between GPs and specialists, Schenker explains: “It's just not justified.”

Operational details

Practical analysis

The current situation highlights a significant disparity between GPs and specialists, with the latter appearing to take advantage of the new fee structure to increase their billings. This leads to an increase in overall costs in the outpatient sector, which goes against the initial objectives of the new tariff. Saskia Schenker's critique underlines the importance of a fair and transparent tariff system, which adequately values both basic medicine and specialisations.

Implications for patients

For patients, these over-invoicing practices can result in higher insurance premiums and potentially compromised quality of care. It is critical that health authorities intervene to ensure that medical specialists comply with current regulations and that fees are applied fairly.

Corrective measures

If there is no improvement by the end of the year, further corrective action will be required. This could include updating tariff data to better reflect innovations in the medical sector and introducing stricter controls to prevent fraud. Prioswiss called on specialist medical societies to immediately provide the information needed to restore balance with primary care providers.

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Key points

Action: What to do

For patients and physicians, it is important to be informed about billing practices and rights that result from the new Tardoc fee schedule. Here are some concrete actions that can be taken:

Invoice verification

Patients should carefully check the bills of medical specialists to ensure that they comply with current regulations. If you suspect over-invoicing, you can contact your health insurance company for further clarification.

Request for information

Specialist physicians should provide patients with clear and transparent information about the rates applied and treatment times. This helps to prevent misunderstandings and to ensure that invoices are correct.

# Using site tools

For more information and to compare medical rates, you can use the calcolatore stipendio and comparatore CHF/EUR available on the site. These tools can help you better understand the costs associated with medical care and plan accordingly.

Conclusion

The current situation requires immediate action to ensure that the new Tardoc tariff works as intended and that costs to patients are fair and transparent. With the collaboration of doctors, patients and health authorities, it will be possible to improve the system and ensure a better quality of medical care in Switzerland.

Source: tio.ch