Half of all hospital bills are wrong

Health insurance: Many hospital bills are wrong

18/08/2011

Almost every second hospital bill is wrong, reports an internal report of the statutory health insurance (GKV). The coffers are created by wrong bills Spending in the billions.

According to an internal report by the German Association of Statutory Health Insurance (GKV), almost every second hospital bill last year was wrongly issued. Sickness fund examiners had found errors in 45.6 percent of the bills on samples. The coffers audited accounts from the same period in 2010. The reported „West German Allgemeine Zeitung“ (WAZ Group) in its Thursday issue, referring to the results of the report of the National Association of Health Insurance Funds in Berlin.

Numerous operations could be performed on an outpatient basis
The inspectors were, according to newspaper report found in numerous places. Often, patients were treated longer in clinics than is medically and case-related necessary. Many patients have been hospitalized for medical interventions rather than undergoing surgery on an outpatient basis. At other sites, medicinal products were billed that were not administered to the patient.

Already for the year 2009 the medical service end of the GKV had examined 12 per cent of all hospital settlements. According to the association, two out of five bills included some serious bugs. Special controversial potential still has the „not appropriate coding“ of diagnoses and therapies. So it should come in this context again and again to excessive bills. According to the internal report, each case found would incur damages of around 1,000 euros. If all the false statements are added together, the result is a total loss of just over one billion euros per year. Some clinics even had an error rate of 65 percent in the test report.

Health insurance companies should control hospital bills more sharply
The Federal Insurance Office referred in the last month in its activity report on ambiguity in the hospital bills. The health insurance companies should fundamentally reconsider their treatment of the clinics. When settling accounts should look closer because there is a significant savings volume. The Federal Insurance Office even sees a savings potential per health insurance and year of more than 1.3 million euros.

The German hospital society denies according to the report, the allegations. The coffers would mainly investigate disputes. Finally, 96 percent of the hospital bills were not objected to. The data published by the health insurances are therefore not representative and do not reflect reality. (Sb)

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Picture: RainerSturm