Fee report
The fee report takes a position on controversial issues relating to the application of fee or fee regulations, for example in the case of disputed bills from doctors and dentists, lawyers or architects, which are based on the provisions of the Fee Schedule for Doctors (GOÄ), the Fee Schedule for Dentists (GOZ), the Lawyers' Remuneration Act (RVG) or the fee schedule for architects and engineers (HOAI).
The starting point is usually different opinions between the service provider and the service recipient about the professional quality or classification of the service to be rewarded. Fee reports therefore regularly comment on these subject-specific questions and are thus intended to avoid legal disputes in civil proceedings or to end them by means of expert evidence.
The different interpretation of the fee schedule by doctors or dentists on the one hand and private health insurance companies on the other often leads to disputes in billing issues. In some cases, unclear formulations by the regulatory authority in the fee schedule give rise to differences in interpretation.
Fee reports prepared outside of legal proceedings are paid for by the client. Often, however, you can have them made free of charge by your own interest group .
Controversial problem areas
The following contentious points are often at issue:
- Choosing the right billing number
- Admissibility of calculating several billing digits side by side
- Traceability of justifications when the average multiple is exceeded
- Appropriateness of the fee ( Section 3a (2) RVG)
- Admissibility of the analog power calculation (§ 6 Abs. 1 GOÄ)
- Medical necessity of the billed service (§ 1 Abs. 2 GOÄ)
- Compliance with the formal requirements (§ 10 GOÄ)
- Permissibility of the calculation of expenses (§ 3 GOÄ)
- Differentiation of necessary services and demand services (Section 1 (2) GOÄ)
- Plausibility of the billing numbers for the services provided
- Definition of the performance content of the calculated individual performance figure
- Delimitation of the calculable performance when the target performance principle is applied
- Appropriateness of the dental laboratory costs
Billing Comments
There are numerous billing comments, part of the German Medical Association , the German Dental Association , the state medical associations , the state dental associations and private commentators. Standard comments are the comment on the fee schedule for doctors (GOÄ) from Brück and the fee schedule for dentists (GOZ) from Kastenbauer / Pillwein / Rat and von Liebold / Raff / Wissing.
Collections of judgments
Both the medical and dental associations and private health insurances (PKV) have extensive collections of judgments for calculating fees.
Individual evidence
- ↑ Deutscher Ärzteverlag, Brück - Commentary on the GOÄ ( Memento of the original from February 20, 2006 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Spitta-Verlag, Kastenbauer, Pillwein, Rat - The correct fee billing of the dentist
- ↑ Asgard Verlag, Liebold / Raff / Wissing Commentary on BEMA + GOZ ( Memento of the original from June 17, 2008 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Collection of judgments on the GOZ of the North Rhine Dental Association (PDF; 1.8 MB)
