Patient dispute in central Switzerland General practitioner charges for private phone calls and emails
A patient complains to his health insurance company, the ombudsman's office and the health directorate about questionable invoices from his GP. Initially without success.
No time? blue News summarizes for you
- A man is surprised by the bill from his health insurance company. It included e-mails and text messages from his family doctor that had hardly any medical content.
- The man complains and, after much back and forth, finally gets his health insurance company to investigate the matter.
- The health insurance company came to the conclusion that the doctor's invoices were unjustified.
- The doctor is stubborn and is now having the matter legally reviewed.
Doctors can enter consultation services in "Tarmed", the billing system for outpatient medical services in Switzerland, as "telephone consultations". E-mails or text messages can also be billed via this point, provided the communication is linked to a "medical consultation or diagnosis".
A doctor from central Switzerland interpreted this definition quite generously and billed one of her patients for e-mails, text messages and telephone calls over a period of months that had hardly any medical content.
The content was mainly about his private life situation, the man told the "Beobachter". He had been going through a difficult time, was unemployed, looking for an apartment and frequently ill.
He had hoped for competent medical care from his family doctor. "Over time, however, I realized that there was a lot of talk about private matters. Medical matters, on the other hand, were given far too little attention," says the patient.
The health insurance company becomes active after all
He waited in vain for a referral to a skin specialist and the dissolution of the doctor-patient relationship - the man had moved to the canton of Zurich in the meantime - was also protracted. He is still waiting for a comprehensive patient file.
The man complained several times to his health insurance company, the ombudsman's office and the health department. Nothing happened for a long time. Finally, the health insurance company did respond and reviewed the invoices over a period of four months.
In a letter to the doctor, the health insurer then stated: "There is hardly any evidence of medical treatment." The subject matter was "almost exclusively social indications" and "such services cannot be invoiced to the health insurance company".
The doctor now wants legal clarification as to whether she can charge for the services after all.
