Wrong billing at the Berlin Charité?

Berliner Charité: Settlements are being checked

24/03/2012

Irregularities in the billing of medical services have been recurrent in Berlin's medical care centers for a long time. Now the suspicion also falls on the Berlin Charité.

The prosecution's initial suspicion of billing at the University Hospital Charité, which the media reported recently, does not exist, explained the clinic's management. However, billing audits have been commissioned for which a report will be submitted in the coming days. According to its own statements, the Charité commissioned an external auditor to check the accounts of the contractual medical services from the years 2010 and 2011.

Berliner Charité has bills for contract medical services examined
after the „Berlin newspaper“ had reported on prosecutorial investigation for billing fraud at the Berlin Charité, said the largest German university hospital, citing the information of the prosecutor's office, that currently no corresponding investigation run. However, the suspicion of billing irregularities is currently being investigated by external auditors. According to its own statements, the Charité commissioned an auditing company to audit the accounts for the contractual medical services from the years 2010 and 2011. After completion of the examination, the Kassenärztliche Vereinigung Berlin will be presented with a report. In this regard, the Deputy Chairman of the Board of the Association of Statutory Health Insurance Physicians, Dr. med. Uwe Kraffel, opposite the „Doctors newspaper“, that is not yet clear, „ about which order of magnitude we speak.“

Medical care centers with irregularities in billing
In principle, medical care centers (MVZ) can be set up by all health insurance providers licensed under the fifth Social Code (SGB V), such as physicians, pharmacists, or even hospitals. In Berlin, some clinics have made use of the opportunity to achieve a closer cooperation of the different disciplines, a relief of administrative tasks and the saving of costs through synergy effects. However, in the medical care centers of Berlin, irregularities in the billing of medical services have recently increased. In February, for example, the state-owned hospital group Vivantes had filed several self-reports for incorrect billing and the medical care centers of the DRK clinics in Berlin have since been closed again. At the Helios clinics is reportedly the „Berlin newspaper“ currently being investigated against 14 suspects on suspicion of billing fraud.

Irregularities in billing not an isolated case
The billing irregularities in the medical care centers seem to be by no means an isolated case, with the question being raised whether in all cases targeted billing fraud took place or the persons concerned simply made more mistakes due to the extremely complex coding in the billing sheets. As the „Doctors newspaper“ reported, the investigations in Berlin also provide evidence of similar irregularities in settlements at other sites. So explained Dr. Uwe Kraffel opposite the paper: „I assume that not only Berlin is affected.“ In Berlin, however, the Association of Statutory Health Insurance Physicians has been working intensively on the problem for a long time, with the authorization already being withdrawn from a medical care center. The Federal Social Court only confirmed this withdrawal last week, which according to Kraffel is to be judged as a precedent. (Fp)

Read about:
Billing fraud: DAK calls for two million euros
Billing fraud at the Schwerin Helios Clinic?
Health insurance companies grant fewer and fewer cures
Wrong bills in health care

Picture: Rainer Sturm