Why does my Swiss doctor charge for reading my medical file?
Patients in Switzerland are often hit with an extra charge by the doctors just for reading their medical files or results, which leaves many asking the question "can they actually do this?"
Most people don’t read the bills in detail, but if you have noticed this particular charge, you may find it odd.
After all, a doctor should read any dossiers she or he received from other healthcare professionals regarding your care, so you can receive a follow-up treatment.
Therefore, this task should not be billable — right?
Wrong.
And here is why
Let’s say you are a new patient and the doctor has just received your dossier. He or she must read it in order to acquaint themselves with your medical history.
Or, the doctor may have referred you to a specialist, and they now must read those findings.
The argument for charging patients is that your physician has spent some time reading those notes, so he or she can prescribe suitable treatment for you.
Your doctor’s time, as any professional’s, is valuable so can we expect them to do it for free?
Besides reading your dossier, they may be examining other patients’ files as well, which could be a time-consuming part of their work day.
Allowed by law
The doctors don’t just decide unilaterally to bill you for this service, or set the amount themselves.
According to Tarmed, which sets rates for medical services along with the Federation of Swiss Doctors (FMH), Swiss health insurers associations (Santésuisse), Swiss Hospitals (H+), as well as other official agencies represented within the SUVA Medical Tariff Commission (CTM), this is a legitimate charge.
Listed under the code 00.0140, it is defined as a “medical service in the absence of the patient (including study of file), per period of 5 min.”
This charge “applies to any medical service used for the treatment of the patient, carried out in his absence, verbally or by telephone, for example: obtaining information from third parties, information given to relatives or friends, other contact persons for the patient, discussions with therapists and caregivers, referral to a consulting physician, establishment of prescriptions or prescriptions outside of consultations, visits and telephone consultations.”
In other words, the doctor can bill not only for studying your dossier in your absence, but also for communicating with your relatives, as well as others involved in your care.
Do you have to pay this bill?
As this charge is approved by Tarmed, it will be covered by your health insurance.
The doctor’s office will either send the bills directly to your insurance company (with a copy to you), or else you will receive an invoice that you will have to pay yourself and then send it to your carrier for reimbursement.
It depends on how your insurance provider is set up, with both options being practiced in Switzerland.
Are there any doctor’s bills that the insurance won’t cover and you will have to pay for yourself?
Aside from treatments that the compulsory insurance doesn’t cover — such as experimental drugs, for instance — there is one other charge you will have to pay for yourself.
If you miss your appointment without having cancelled it 24 hours prior, you are likely to receive an invoice from the doctor’s office.
There may be some exceptions, such as if an emergency prevented you from keeping your appointment. Some physicians may also wave this charge for longtime patients who never miss appointments, or if they were able to fill your ‘slot’ with another patient.
The amount for this is set at doctor’s discretion, and could be ‘symbolic’, like 50 francs, or the usual cost of the visit,
You must pay this invoice because the insurance company won’t.
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Most people don’t read the bills in detail, but if you have noticed this particular charge, you may find it odd.
After all, a doctor should read any dossiers she or he received from other healthcare professionals regarding your care, so you can receive a follow-up treatment.
Therefore, this task should not be billable — right?
Wrong.
And here is why
Let’s say you are a new patient and the doctor has just received your dossier. He or she must read it in order to acquaint themselves with your medical history.
Or, the doctor may have referred you to a specialist, and they now must read those findings.
The argument for charging patients is that your physician has spent some time reading those notes, so he or she can prescribe suitable treatment for you.
Your doctor’s time, as any professional’s, is valuable so can we expect them to do it for free?
Besides reading your dossier, they may be examining other patients’ files as well, which could be a time-consuming part of their work day.
Allowed by law
The doctors don’t just decide unilaterally to bill you for this service, or set the amount themselves.
According to Tarmed, which sets rates for medical services along with the Federation of Swiss Doctors (FMH), Swiss health insurers associations (Santésuisse), Swiss Hospitals (H+), as well as other official agencies represented within the SUVA Medical Tariff Commission (CTM), this is a legitimate charge.
Listed under the code 00.0140, it is defined as a “medical service in the absence of the patient (including study of file), per period of 5 min.”
This charge “applies to any medical service used for the treatment of the patient, carried out in his absence, verbally or by telephone, for example: obtaining information from third parties, information given to relatives or friends, other contact persons for the patient, discussions with therapists and caregivers, referral to a consulting physician, establishment of prescriptions or prescriptions outside of consultations, visits and telephone consultations.”
In other words, the doctor can bill not only for studying your dossier in your absence, but also for communicating with your relatives, as well as others involved in your care.
Do you have to pay this bill?
As this charge is approved by Tarmed, it will be covered by your health insurance.
The doctor’s office will either send the bills directly to your insurance company (with a copy to you), or else you will receive an invoice that you will have to pay yourself and then send it to your carrier for reimbursement.
It depends on how your insurance provider is set up, with both options being practiced in Switzerland.
Are there any doctor’s bills that the insurance won’t cover and you will have to pay for yourself?
Aside from treatments that the compulsory insurance doesn’t cover — such as experimental drugs, for instance — there is one other charge you will have to pay for yourself.
If you miss your appointment without having cancelled it 24 hours prior, you are likely to receive an invoice from the doctor’s office.
There may be some exceptions, such as if an emergency prevented you from keeping your appointment. Some physicians may also wave this charge for longtime patients who never miss appointments, or if they were able to fill your ‘slot’ with another patient.
The amount for this is set at doctor’s discretion, and could be ‘symbolic’, like 50 francs, or the usual cost of the visit,
You must pay this invoice because the insurance company won’t.
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