Insurers say hospitals overcharge €1.5 billion

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19 Aug, 2011 Updated Fri 19 Aug 2011 07:12 CEST
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Wrong medical bills from clinics and hospitals are costing up to €1.5 billion a year, according to Germany’s statutory health insurers.

The association of statutory insurance companies, GKV-Spitzenverband, said an audit showed that nearly half of all invoices submitted for reimbursement had mistakes in them.

“Last year, the proportion of hospital bills that we found contained errors, was higher than ever,” said Johann-Magnus von Stackelberg, from the Spitzenverband. He said it was possible the errors were now being discovered more often because insurance companies were getting more aggressive or because the hospitals were getting worse at submitting their bills.

“But the result is the same – far too many bills are wrong,” he said. A total overcharging of health insurance payers to the tune of up to €1.5 billion was not acceptable, he said. The insurers pay around €59 billion for inpatient care a year.

Incorrect medical bills have been a concern in Germany for years, with the Federal Audit Office even complaining about the problem this spring.

Examples of overcharging include a patient with a severe fungal infection whose hospital billed for an expensive drug when he was actually given one that cost €57,000 less.

In another case, an 82-year-old patient with a pelvic fracture was reported to have been given treatment that he never actually received, a discovery which saved insurance companies €11,700.

Stackelberg called for politicians to ensure, “that hospitals finally have a real incentive to bill properly.” Each incorrect bill should attract a fine of €300 per bill he suggested.

This last proposal was rejected by the German Hospital Federation (DKG) whose manager Georg Baum said the fact was that 96 percent of all cases regarding bills remained as they were despite intensive checks. “The questioned bills are overwhelmingly in cases of clashing medical opinion,” he said.

The effective rate of repayment was less than one percent, he said. The idea that the questioned payments adding up to €1.5 billion could be simply due to erroneous billing was “highly dubious”, he said.

The Local/DPA/mdm



2011/08/19 07:12

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