As of: February 9, 2024, 2:47 p.m
By: Philipp Bräuner
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Serious allegations after research by NDR and Tagesschau: Was a large eye doctor chain systematically charging too much?
© imageBROKER/Oleksandr Latkun/Imago
Employees of an eye doctor chain in Germany are said to have been taught billing tricks.
A co-founder is said to have led the seminars himself.
Munich – Serious allegations are being made against a major eye doctor chain in Germany.
According to research by
NDR
, employees are said to have been trained on how to charge private patients higher fees than necessary.
If these practices were actually used, they could possibly even be criminally relevant, say lawyers.
The affected chain is a leading player in the healthcare industry.
Eye doctor chain is presumably calling for billing fraud via online seminar
In the report, NDR
journalists quote from an online seminar that was allegedly led by one of the company's co-founders.
For example, the seminar leader encouraged the participants to charge the maximum rate for cataract operations.
To this end, the intervention should be presented as particularly complex.
According to the report, this could result in around 250 euros more being billed than usual.
According to NDR,
the seminar also
teaches fraud methods for invoices for retinal surgery.
With a different billing number, around 1000 euros more could be generated.
If the phrase “temporary hump” is used in the final report, the intervention will be recognized by insurance companies as supposedly more complex.
Higher fees could be approved.
Medical Lawyers: Billing Practices May Be Justiciable
This approach could not only be seen as an “overstimulation” of the fee schedule, but could also be relevant under criminal law, the
ARD
magazine
Panorama
quotes the medical lawyer Andreas Spickhoff as saying.
Doctors could even lose their license.
If a large number of doctors were actually involved in such practices, it could even be considered gang fraud.
The
NDR
reports that the eye doctor chain and private insurers responded unclearly to inquiries or even did not answer certain questions.
Therefore, it cannot be proven whether doctors would actually bill to the extent recommended in the article in the online seminar.
(
pkb
)
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