A new study suggests that doctors and hospitals are overcharging by more than one billion francs every year, reported SRF.
Some in the medical profession have questioned the sum, which came from doctoral research done by Larisa Petrov. Petrov is a lawyer and head of legal at the consulting firm Blacklight Analytics. She did the research while working as a lawyer at Helsana Insurance
The excessive charges fall into two broad categories: overpriced treatments and the systematic invoicing of services that are not provided. For some categories of treatment, such as radiology, overcharging was calculated to be as high as 10-15%.
Petrov described the potential savings as enormous. They also appear to be in specific areas. Most service providers are billing correctly, she said. However, some treatments are billed as a package and not all services in the package are being delivered. This often happens in radiology.
What is the solution?
Petrov recommends setting flat rates for standard treatments. In addition, retrospective checks could be done on all invoices. Patients could also help by ensuring there are no unreceived treatments in the invoices they receive.
Systematically checking invoices is complicated. However, digitisation is making this work easier. Some health insurers are already running such checks. For example, the head of auditing at CSS health insurance told SRF that his company checked 23.5 million invoices and found CHF 797 million francs of erroneous or unjustified charges last year.
More on this:
SRF article (in German)
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