1) Application of the latest version of the Catalogue of Tariffs for Physicians (GOÄ)
2) Consideration of the opinion of the GOÄ Committee of the German Medical Association (BÄK)
3) Recommendation for analogous numbers
4) Resolution of the German Medical Assembly (Deutscher Ärztetag) adopted in May 2006 in Magdeburg
More and more frequently doctor’s bills are being reviewed and refused by the Association of Private Health Insurance (PKV).
The reasons for this are funding problems resulting from new legislation and the trend towards reducing medicine to that which can be achieved economically. Moreover, the Catalogue of Tariffs for Physicians is also subject to a ‘necessity test’ (Article 1(2)):
“The doctor may only charge for those services which are deemed necessary as part of a medically prescribed treatment when judged in accordance with the principles governing healthcare practice. In the case of services which are not deemed necessary as part of a medically prescribed treatment, these may only be charged for when they have been requested by the party required to pay for such services”.
For AIRNERGY air therapy I recommend the approach laid down for tariff No. 505 (GOÄ), corresponding to 85 points. The charges to be made are as follows
Single charge rate Euro 4.95
1.8-fold rate Euro 8.92
2.5-fold rate Euro 12.39.
As No. 505 is listed under the so-called ‘small charges framework’, the doctor need supply no explanation for fee charges between Euro 4.95 and Euro 8.92.
An explanation for fees charged must be supplied for amounts charged at a rate higher than 1.8-fold.
Because AIRNERGY air therapy involves specially treated oxygen, I recommend that the term “treated oxygen” be used when providing explanations for patient fees.
Dr. med. W. Grebe, Frankenberg, 28.10.2006