Why are medical billing codes so expensive

Excessive bill at the doctor

Clarification of costs is mandatory

Before starting an examination or treatment, doctors must not only provide information about the medical aspects, but also provide information about private costs - in writing. It is not enough to point out that it is a self-payer service. Doctors are obliged to state the "estimated costs" in advance in writing and as precisely as possible.

IGeL are billed as private services according to the private fee schedule for doctors. This stipulates that the amount of the costs is based, among other things, on the effort and degree of difficulty. If there are sometimes significant price differences for chargeable extras compared to the consultation or the cost estimate, patients do not have to accept this.

When can it get more expensive?

Cost estimates or written information on prices are generally binding. However, if circumstances arise in the course of the treatment or diagnosis that could not be foreseen in advance (e.g. unforeseeable complications), the invoice amount may exceed the amount of the costs communicated in advance. However, there are limits to this. A Exceeding up to 20 percent the estimated cost is possible. In the event of major deviations, the doctor must inform the patient in good time before the treatment or before the next treatment step, so that the patient still has the opportunity to refrain from the treatment.

Using the example of professional teeth cleaning, this means: With a preliminary estimate of approx. 100 EUR, the final price may not exceed approx. 120 EUR, otherwise the dentist would have had to explain the increase in advance.

Why are there no flat rates?

A flat rate for treatment would be safest for patients. The fee schedule for doctors (GOÄ) as the basis for billing private medical services, however, forbids doctors to set a flat rate beforehand. The doctor must try to estimate the costs as accurately as possible.

Our tip

After the treatment, compare the invoice amount with the written cost estimate. If there are any discrepancies, you should speak to the doctor and ask for an explanation. If that doesn't help, an invoice check at the State Medical Association is a good option.