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Questions about bills issued by healthcare providers

If you disagree with the bill which your healthcare provider has issued to you, you will find information here as to what you can do about it.

If you have undergone healthcare services as a private patient in Germany, such as medical or dental services, you will have received a bill for this from your doctor, dentist or hospital.

Bills from doctors in private practice (out-patient care)

In the out-patient area, the individual items of the bill are charged in accordance with the Fee Code for Doctors, which regulates what costs your doctor may bill. As a matter of principle, the fee may be between once and 2.3-times the fee rate, depending on the extent of difficulty and work involved. In exceptional cases, 3.5-times the fee rate or, on agreement with you, also a fee rate going beyond this may be charged. The higher fee rates must be explained by your doctor in writing.

Bills from hospitals (in-patient care)

If you have been in a hospital in Germany as an in-patient, the remuneration of the general medically-necessary hospital services (such as medical treatment, care, food and board) are in line with a benefit-orientated, flat-rate remuneration system. This means that case flat-rates are charged. The amount of a case flat-rate is in line with the nature of the illness, the seriousness of the disease and the diagnosis. A patient with a less serious illness therefore pays less than one with a serious illness which is laborious to treat.

The amount of the lump-sum costs incurred for this do not differ from those which may be billed for persons with statutory health insurance.

If you would like additional services over and above the general medically-necessary hospital services, such as treatment by the head physician, these are billed in accordance with the Fee Code for Doctors or the Fee Code for Dentists. You need to conclude a separate agreement for the additional services. Before undergoing in-patient hospital treatment, we therefore recommend that you should determine the extent of the benefits which you wish to take up and what it is to cost in a treatment contract with the respective hospital.

You will find further information on the topic in the brochure entitled “Preisfindung bei einer privaten Behandlung im Krankenhaus” (Private Hospital Treatment Pricing, in German) from the German Hospital Federation (see below).

Contacts for checking a doctor’s or hospital bill

You should contact your doctor or hospital if you do not agree with the amount of the bill or are unable to understand the individual items of the bill.

Furthermore, the various medical associations have set up expert units which submit recommendations as to which individual items of a bill can be regarded as suitable. These recommendations are not legally binding. They are used for reaching out-of-court agreements in disputes between the doctor/hospital and yourself. If you disagree with the recommendation of an expert unit, you can naturally still take the matter to court. The civil courts which have jurisdiction however rarely rule against the recommendations of the expert units.

Dental bills

In out-patient care, the individual items on the bill are in accordance with the Fee Code for Dentists, which regulates the costs which your dentist may bill. As with doctors, the fee may be between once and 2.3-times the fee rate, depending on the difficulty and scope. 3.5-times the fee rate or, on agreement with you, a higher fee rate than this may also be charged in exceptional cases.

If you have any questions on dental bills, you should first of all contact your dentist. If no satisfactory explanation is forthcoming from your dentist with regard to the individual items of the bill in these discussions, you can turn to the dentists’ self-government advisory units. These are also responsible for questions related to dental bills.

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