Receipt after every visit to the doctor?

The chairman of the National Association of Statutory Health Insurance Physicians demands more patient receipts. Consumer advocates, however, criticize the model.

(18.08.2010) The chairman of the Kassenärztliche Bundesvereinigung (KBV), Andreas Köhler, demanded more receipts for health insurance patients after the doctor's visit. With this, Köhler hopes for a new cost awareness of the insured with regard to the health benefits of the health insurance funds.

Similar to the private health insurance and insured persons of the statutory health insurance since 2004 have the opportunity to be issued after each visit to the doctor an invoice and submit the costs at the end of the year at the coffers. Hardly anyone of the GKV insured, however, knows such an offer. According to a survey, 80 percent of those insured did not know that such a possibility existed. Only two percent of the cash patients use this model.

This should now be different according to the will of the association chief of the Kassenärzten. Because, "we have a great interest in the receipts being used by the patients," says Köhler. The receipts could raise awareness of the costs incurred after treatment, so hope. Most people would then realize "how affordable the outpatient care in the home or specialist medical practice is, as compared to the restaurant visit," Köhler argued to the "Frankfurter Allgemeine Zeitung".

In the future, according to the ideas of the association chairman, the change to a system of reimbursement will be carried out. Patients should in future use the direct billing model. The issuing of receipts is the right step in the personal responsibility and participation of the cash patients.

The Federal Government is also planning a similar regulation in the course of health care reform. According to a bill, patients should first settle the costs of the treatment themselves and submit them to the health insurance companies at the end of the year. The black-yellow coalition hopes that this new regulation will increase transparency in terms of health care costs.

Clearly criticized the consumer center Thuringia on the model. After all, doctors can use the reimbursement model to settle costs according to the fee schedule for doctors (GOÄ) or dentists (GOZ). This results in higher fees than the non-cash benefit principle. However, many proponents of the model argue that the model would put the sick patient on a par with a privately insured person. However, according to statements of the consumer advocates this does not apply. For additional services that are not included in the catalog of benefits of health insurance, the health insurance companies do not reimburse the costs. In addition, as part of the reimbursement, patients have no direct opportunity to seek out a private doctor or have their treatment performed in a private clinic. Exceptions are also possible in this case only in individual cases - and then only after prior approval by the fund or in an emergency.

Nevertheless, many insured hope that they would benefit from this model. So many assume that they would be preferred for medical treatment or appointment. But that is often not the case. Because a right to a preferred appointment does not exist!

Therefore, insured persons should be aware that when choosing the reimbursement model, they are more likely to pay higher medical and treatment costs. But the health insurance companies only pay the costs that normal cash patients would have to pay with a chip card. The remaining amount must be paid by the insured themselves. (Sb)