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Can doctors in Germany charge a fee for cancelled or no-show appointments?

The Local Germany
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Can doctors in Germany charge a fee for cancelled or no-show appointments?
A doctor uses a laptop. Photo by National Cancer Institute on Unsplash

Germans value punctuality - and that means also showing up for commitments. So what happens if you miss a doctor's appointment or cancel at late notice?

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Sometimes cancelling an appointment is unavoidable due to illness or another urgent reason. Or sometimes it can be the case that people forget that they have a doctor's consultation in their diary. But it can be tricky to know if you'll be charged a fee in Germany for an appointment cancelled close to the day, or for not turning up. 

Can doctor's charge a cancellation fee?

This question can't be answered with a blanket "yes" or "no". There are various court rulings on this, but they don't offer the same outcome.

In the past, German courts have assessed the situation regarding compensation for missed medical appointments differently. Whether a cancellation fee has to be paid for a missed appointment, i.e. whether the doctor is allowed to charge the costs as compensation, depends on various factors and on the facts of the case in question.

According to the German Consumer Rights Centre (Verbraucherzentrale), fees from medical practices for patients who miss or cancel doctor's appointments are only allowed in exceptional cases. But that doesn't mean that practices don't issue fees. According to consumer rights experts, this does happen often.

READ ALSO: 7 things to know about visiting a doctor in Germany

As a comparison - in neighbouring Austria, doctors are legally allowed to demand a fee if patients don't show up. The cost varies but it can't be higher than €200. 

What should you do to avoid a fee in the first place?

It goes without saying that you should try and cancel doctor's appointments that you can't attend in good time (usually with at least 24 hours or ideally 48 hours notice). You can do that by phone, email or an electronic appointment booking system if that's in place. Note that as a patient, you have a right of cancellation at any time in the treatment contract, according to law. 

But by giving medical practices the heads up early that you can't attend, you give other patients the chance to get the appointment. You can also use this opportunity to make a new appointment if needed. 

A patient undergoes a consultation with his doctor.

A patient undergoes a consultation with his doctor. Photo: picture alliance/dpa/AbbVie Deutschland GmbH & Co. KG | AbbVie Deutschland GmbH & Co. KG

If a doctor's appointment is postponed by mutual agreement, the prerequisites for a cancellation fee do not exist according to previous court outcomes. This means that you do not have to think about fees for the postponed appointment.

A claim for compensation by the doctor's practice can only be considered if the office has incurred a loss of earnings due to the cancelled appointment. This is the case if the practice was unable to treat other patients during the time in question.

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However, doctors have to be able to prove that this was actually the case and that no other patients were able to "stand in" for the appointment. And this is where it gets more complicated, because this proof is sometimes not so easy to provide.

Meanwhile, many medical practices try to include the obligation to pay cancellation fees in their general terms and conditions.

As you can tell, the law around this is a little sketchy. So the best thing to do is to make sure you cancel doctor appointments in plenty time or call them on the day if a situation arises and you can't go at late notice. It will also ensure you keep up a good relationship with the doctor in question. 

READ ALSO: 'It works': Your verdict on the German healthcare system

Haven't there been calls for fees for missed appointments?

Yes, this debate has been raging for a long time in Germany, with various stakeholders calling for uniform fees on no-show appointments at different times. 

In the latest call, the head of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Gassen said this week there needed to be a penalty for no-show appointments.

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He said seven out of 10 medical practices complain about missed appointments by patients. 

In 2019 Gassen said there were several reasons why patients miss consultations, however, he said some purposely “hoard” several dates to ensure that they can make it to one.

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