Neurologist bills 26 hours a day!: This is also the reason why our health insurers are becoming increasingly expensive

class=”sc-cffd1e67-0 iQNQmc”>

Health insurance premiums are increasing year after year, sometimes exorbitantly. The reason is often given that patients go to the doctor too often. Research by the “Tages-Anzeiger” now shows that the rate for outpatient services by doctors is also to blame. The newspaper bases itself on data from Santésuisse.

The examples available for the “Tages-Anzeiger” are difficult. For example, a neurologist charged for services that would have required him to work 26 hours each workday! More than 400 physicians billed for 12 hours or more per workday. Only: In most cases the invoices are completely legal.

20 year old billing system

The reason for the high billing is an outdated system. “The rate for outpatient medical treatments was introduced twenty years ago and has never been fully revised since,” Santésuisse director Verena Nold is quoted in the article. It was then determined how long each treatment would last. Many things can be done faster these days, but still get paid immediately.

Nold describes the system as a “money machine” for some physicians who can generate significant revenue from the outdated fees. The problem spans several specialist groups – from radiologists to gastrointestinal specialists to ophthalmologists.

Scanning laser ophthalmoscopy is mentioned as an example in the article. This can now be done much faster, often “in a few seconds” according to advertisements. However, after the Tarmed, she still gets paid for 15 minutes. This allows doctors to bill for multiple scans per day at a rate of 15 minutes.

Tariff structure is in urgent need of revision

Despite a partial correction of individual rates in 2018, there is still an urgent need to revise the entire rate structure, the report continues. The Swiss Medical Association FMH has already developed a new individual service tariff (Tardoc) and fixed outpatient tariffs to tackle the problem. However, the Federal Council decided in the summer of 2022 that the package was not yet ready for approval. The introduction of the new rate is now in the hands of the new Minister of Health Elisabeth Baume-Schneider (60).

There is also skepticism among politicians about the new doctor’s rate, which will not come into effect until 2025 at the earliest. He does not have much confidence in the new rate, says Pierre-Yves Maillard (55), SP Council of States and member of the Health Committee. “In ten years we will be at exactly the same point again, the individual positions are outdated and the pay is too high.”

Actual usage time on the invoice

He therefore proposes to state the actual service time on every invoice in the future. A corresponding proposal was approved in the National Council and will be discussed in the Council of States this year.

Santésuisse says it continually monitors doctors to clarify suspected cases of excessive billing. About 1,700 suspected cases are identified annually. About 60 of them should expect refunds. The neurologist, who charged for 26 hours a day, is already registered with the association and should expect to be reimbursed. (oco)

Source:Blick