11 minutes of consultation and at the end of the day an invoice of… 120.70 euros for the Social Security and my mutual insurance company. We wanted to test the new generation ophthalmology centers that are multiplying and some of which are suspected by Health Insurance of charging him for more acts than necessary. The advantages of these centers are not without interest: quick appointments, including for some on July 14, no waiting on site, a prescription at the exit and "sector 1" prices, so without overrun. The patient does not pay anything.
Appointment is made at Ophtalmologie express (created in 2018, 4 centers in France, including 2 in Paris), avenue Félix-Faure, in the 15th arrondissement, where consultation for a simple "renewal of glasses" is possible in less than 24 hours.
Two exams performed without explanation
I show up at 9:40 a.m. The young woman in a white blouse who takes care of the reception takes my Vitale card and my mutual insurance card and asks me to wait. After three minutes, an assistant makes me take a seat, standing, in front of two devices located in a corridor and where you have to put your chin and forehead. The first is a refractometer doubled with a tonometer to, on the one hand measure the corrections, on the other hand the tension of the eye. The assistant also makes a measurement of the thickness of my cornea (pachymetry) and an examination of the surface of the eye (fluoroscopy). I then move sideways in front of the second machine, which performs OCTs, "examinations of the retina by tomography", a kind of scanner. The whole thing will not have taken more than four minutes, the assistant does not provide any explanation.
Return for two minutes to the waiting room. The orthoptist calls me in his office for a short questionnaire on my background and let me read a few lines of letters on the wall. Duration: three minutes. Return to the waiting room for two minutes. This time, the ophthalmologist receives me. “Everything is fine,” she tells me, “neither AMD nor diabetes, and my eyesight is good. Then she slides a drop of pupil dilator and examines my eyes with the "slit lamp". Finally, the doctor gives me a prescription for my glasses. Duration: four minutes.
At the reception, the young woman gives me Vitale and health insurance cards and tells me that I will have nothing to pay. "Everything is taken care of by the Health Insurance and your complementary", she explains to me. But when I ask for a detailed invoice for the acts, a little moment of panic. The secretary calls her colleague, discussion ... then printing a document. In fact a summary of the measures taken, but not an invoice. The cost of the visit is added by hand: "Safely part 70.31 euros, mutual part 22.10 euros", or 92.41 euros per consultation. For comparison, I last paid 60 euros at an ophthalmologist in sector 2.
The president of the National Syndicate of Ophthalmologists of France, Thierry Bour, looked into these 92.41 euros: "They carried out an examination of the retina by tomography (OCT), at 56.54 euros in sector 1, which does not is done only to confirm a diagnosis, not as a preventive. And they gave you an unbilled pachymetry, but useless when the eye pressure is normal. The surface examination by fluoroscopy was rated 50%: 27.54 euros divided by 2 ( Editor's note: the second examination billed must be 50%, it is regulatory ). Finally the vision test with refraction was rated by the orthoptist 22.10 euros. Since you had no particular pathology, a consultation at 30 euros or 40.20 euros (fluoroscopy + binocular vision) would have been sufficient, "he concludes.
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But a few days later, a new surprise on my Ameli account: it was an invoice of 120.70 euros which was sent to the Health Insurance, it includes 3 "medical technical procedures" (56.54 euros + 13.77 euros + 28.29 euros) and an orthoptic session at 22.10 euros. Do these 28.29 euros correspond to pachymetry? Mystery…