Sunday, October 9, 2016

TK-in-chief: health insurance companies cheating in billing – Südwest Presse

Rumored to be a long time. But frankly, no one has it: in Order to get more money from the health Fund, health insurance companies, their patients sicker than they are.

the Legal health insurance companies cheating according to the technician health insurance (TK) in the billing of services.

your CEO Jens Baas admitted in an interview with the “Frankfurter Allgemeine Sunday newspaper”: “It’s a competition between the sickness funds is created, who creates it, to bring Doctors to document for the patients as many of the diagnoses.” Then there is more money from the risk structure compensation.

“The funds to pay, for example, premiums of ten euros per case for Doctors, if you make the patient on the paper sicker.” There are even agreements with doctors associations, which have more and more serious diagnoses to target. The funds were also in this direction of business consultants for advice, explained Baas.

Particularly intensive would operate the regional funds, this can be considered cheating. “You can get 2016 expected to be a billion euros more than for the care of their Insured.” Baas mean, apparently, the coffers of the AOK, the newspaper writes. But its Fund could not escape the, acknowledged the TK-boss.

For all of this, would have spent the funds in 2014, one billion euros is missing for the treatment of patients, said the head of the largest German statutory health insurance. Without the manipulations, the rate of contribution of TK 0.3 percentage points might be low. “I would like that the System is resistant to manipulation is made,” said Baas to justify why he is making the cheating of his and of the other funds open to the public.

The risk-structure compensation (RSA) has a Fund of money from the health Fund, depending on the Severity of the illness of the Insured. He is lots of funds since a long time a thorn in the eye. Some of the replacement, operation, and Guild health insurance funds had been closed at the beginning of March to the RSA, Allianz and financial reform in this legislative period demanded. You see, in particular, the General local sickness funds by the current System advantage.

The Executive Board of the German Foundation for patient protection, Eugen Brysch, said, this Cheat could also meet the definition of fraud. And if this were so, one had to speak of organised fraud. “Then it would be time to look at the health insurance on the Finger. The parity-encrusted Japanese self-control is a Farce. For years, the Supervisory bodies are in a deep sleep. However, the Minister of health of the Federal government and the countries look the other way”, said Brysch.


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