Elective Doctor (Austria)
Elective doctors are private doctors established in Austria who do not have a contract with the statutory health insurance companies , but who base their fees on the health insurance tariffs. In contrast to the regulation in Germany , for example, those with statutory health insurance in Austria also receive benefits from their social insurance in the form of reimbursement for the treatment of elective doctors. After submitting the paid doctor's bill, the statutory health insurance companies will reimburse up to 80 percent of the fee that would have been incurred for contract doctors according to the fee schedule of the respective health insurance company. The reimbursement is handled differently, however, health insurance companies can also set their own alternative doctor's tariffs, which differ from the tariffs for statutory health insurance doctors.
For services that statutory health insurance doctors can only bill with special additional qualifications, the same evidence is usually required from elective doctors. Regulations that certain services (such as radiological examinations) can only be provided on referral from another doctor also apply to elective doctors. Any obligation to obtain approval for services continues to apply.
The free choice of doctor is also restricted by the planning of large equipment. For examinations on magnetic resonance tomographs or computed tomographs that are classified as large equipment by the ÖBIG and are not operated on any permanent position in accordance with ÖKAP / GGP , the public health insurance institutions must deny their patients cost reimbursement in accordance with Section 338 (2a) ASVG ( elective doctor's ban ). In 2018, 64% of specialists across Austria were elective doctors.
Individual evidence
- ↑ Regionalmedien Austria: Styrians pay a lot with elective doctors. Retrieved July 27, 2016 .
- ↑ Elective doctor's department of the Medical Association for Vienna ( Memento of the original from September 27, 2012 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.
- ↑ § 338 ASVG
- ↑ https://www.wienerzeitung.at/nachrichten/politik/oesterreich/2049128-Massiver-Anstieg-von-Wahlarzt-Ordinationen.html accessed on February 7, 2020
