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- Title
Voraussetzungen für Abrechnung der hausärztlichen Versichertenpauschale.
- Abstract
The article describes a legal dispute regarding the reimbursement claim of a general practitioner due to billing errors. It is stated that the Association of Statutory Health Insurance Physicians is responsible for the substantive and mathematical correction of the invoices, and that the contested decision is lawful. The article also discusses the plausibility check of invoices in the healthcare sector, where anomalies in the time profiles can serve as indications of the incorrectness of the invoices. The article emphasizes the importance of sufficient documentation of medical services for billing purposes and that missing or inadequate documentation is considered as services not rendered. It also addresses the application of the priority rule of § 103 para. 4c sentence 3 SGB V in the selection of a successor for a medical practice.
- Subjects
HEALTH care industry billing; GENERAL practitioners; INVOICES; HEALTH insurance; REIMBURSEMENT
- Publication
GesR: Gesundheitsrecht, 2024, Vol 23, Issue 5, p314
- ISSN
1610-1197
- Publication type
Article
- DOI
10.9785/gesr-2024-230516