Billing in the doctor’s office

Doctors bill their patients for individual health services and treatments for private patients. But do medical billing in Delaware look the same as regular bills or are there any special considerations? And how are the prices actually determined? A simple club shows you all the basics you need to know about creating invoices for medical services!

Billing in the doctor's office explained simply

The technical term for bills that doctors charge patients is liquidation . This is derived from the Latin term “liquidus” for liquid. The medical efforts are therefore liquidated in the form of money. Liquidations are primarily received by privately insured patients, legally insured patients who cannot present their health card and patients who use individual health services (IGeL for short). It is important that liquidations may only be made after the billed service has been carried out. However, the medical service may be part of a larger treatment that is ongoing.

Liquidations are prepared according to the fee schedule for doctors ( GOÄ for short ). This lists all medical services with their respective ratings, which, together with a factor (increase rate for increased time required), results in the price for the respective treatment. In contrast to normal bills that you know from your private purchases, medical bills are not eligible for discounts or discounts.

Billing in the doctor's office definition

Medical bills are called liquidation . The legal basis for the creation of liquidations is the fee schedule for doctors ( GOÄ for short ).

Billing in the doctor's office explanation

Mandatory components

Medical invoices must contain all the components of “normal” invoices that are specified in the Sales Tax Act (UStG for short). In addition, other mandatory components relevant to medical liquidations must be observed in the GOÄ.

Liquidations with and without sales tax

Patients have to access some medical services

• 19 %
• 19 %

Pay sales tax, for others there is no sales tax. Which medical billing management in Delaware are subject to sales tax and which are exempt from sales tax is regulated in Section 4 No. 14 UStG (Sales Tax Act).

Without sales tax

To put it simply, classic medical treatments are VAT-free. An invoice for such a VAT-free treatment could look like this. With sales tax Conversely, medical services that do not correspond to medical treatment are subject to sales tax . These are, for example, cosmetic treatments such as cosmetic surgery or reports. 

Additional documents

In connection with liquidations, two additional documents are sometimes necessary.

Payment form For private liquidations or liquidations to older patients, some practices include a payment form. This means a partially pre-filled SEPA transfer form .

This makes it easier for patients as they only have to enter their own account details. However, issuing pre-filled payment forms is not mandatory for the practice.

Useful pre-entered content:

• Information about the payee (name of the doctor’s practice)
• IBAN of the doctor's practice
• BIC of the doctor's office
• Invoice amount
• bill number

Receipt

Although it is unusual, individual patients may wish to pay their bill in cash .

In these cases, a receipt must be issued as proof of payment !

Information on receipts:

• Payer (patient)
• Reason for payment
• Payee (practice)
• Amount as a number and in words
• Date of payment
• Signature of the payee (practice)

As a rule, receipt blocks are used that only need to be filled out.

When issuing a receipt on a receipt pad, two sheets are created per receipt. The white original sheet is given to the recipient of the receipt (patient), the colored copy remains with the issuer (practice).

Examples of billing in the doctor's office

There are some mistakes that are often made during liquidations.

• Flat rate billing
  All services must be clearly broken down and described according to GOÄ. If this is not done, patients will find it difficult to understand the overview of services and may doubt it. This can lead to failure to pay.
  Tip: List the services in the liquidation chronologically.
• False increase
  If treatment for a patient is more difficult or time-consuming than usual, the doctors should receive more money. That's what the increase rate is for. However, some doctors avoid using higher increment rates for fear of questions from patients or health insurance companies. However, if an increase is justified, it should also be used. But be careful: if the increase rate exceeds 2.30, justification is necessary.
• Liquidations to minors or persons who are legally incompetent
  Liquidations may only be made to persons who are legally competent. When treating minors or patients with dementia, for example, the invoice must be addressed to the legal guardian or official carer. These are also stated as invoice recipients on the liquidation.
• Reimbursement of expenses
  Not only medical services, but also required materials such as bandages or vaccines that go beyond the normal consultation requirements can be billed.

Summary of billing in the doctor's office

Doctors' practices issue liquidations for treatment of private patients . In addition, legally insured patients receive liquidations for the use of individual health services (IGeL for short).

The mandatory information on medical liquidations results from the sales tax law ( UStG for short ) and the fee schedule for doctors ( GOÄ for short ).

The prices are also regulated in the GOÄ. In addition, medical treatments are exempt from sales tax .

In connection with liquidations, you should also know how to fill out SEPA payment forms for cashless payments and receipts for cash payments.