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Old 08.05.2021, 18:03
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is my Praxis overcharging me?

I go to a local Praxis and I am often charged like this:
- Consultation, first 5 min
- Consultation, every following 5 min
- Consultation, last 5 min
- Zuschlag für hausärztliche Leistungen in der Arztpraxis. I am not sure what this item means. I asked the Praxis and they explained it was some sort of tax/surcharge.
- Aktenstudium in Abwesenheit des Patienten bei Personen...
- Nicht formalisierter Bericht


I mean, they charge me for everything. Even a quick talk with my GP on the phone is charged into both first and last 5 min items.



My subscription model requires me to reach out to GP first before going to specialized doctor. At the rate I am being charged by my GP, I wonder if it makes more sense to just level up my subsciption so that I can go directly to any doctors and bypass the middle man GP.


From your experience, do these charges justify?
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Old 08.05.2021, 18:32
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Re: is my Praxis overcharging me?

This sounds pretty normal, at least in my experience.

Is it justified - hard to say, but since it's consistent that seems to be the market rate and even if they reduced the minutes and surcharges other prices would probably go up instead.

For any sort of continuing treatment you don't need to keep going back to your GP, so you don't generally have to see them as a middleman that often.
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Old 08.05.2021, 19:20
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Re: is my Praxis overcharging me?

How can we say if you are being overcharged when we don’t know what the charge is??
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Old 09.05.2021, 09:22
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Re: is my Praxis overcharging me?

Perfectly normal.
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Old 09.05.2021, 09:25
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Re: is my Praxis overcharging me?

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I mean, they charge me for everything. Even a quick talk with my GP on the phone is charged into both first and last 5 min items.
?
Do you expect that consultations with your GP which last only 5-10 minutes should be... free? Considering how short the average consultation is, it should be obvious why they charge in 5 minute blocks.
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Old 09.05.2021, 09:40
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Re: is my Praxis overcharging me?

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From your experience, do these charges justify?
Yes. The items you listed from your bill are completely normal for a doctor.

They are not randomly made up by any particular doctor, but are the product of long negotiation between the doctors' professional boards, the various medical insurers and the Swiss health authorities. In other words, they are hard-won standardised items, and there is a tariff for them in a fat tome which specifies the exact rules of how and when a doctor should charge one or any other tariff point.

Occasionally, that leads to apparent anomalies such as this, but even this is allowed:
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Even a quick talk with my GP on the phone is charged into both first and last 5 min items.
and essentially, yes:
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I mean, they charge me for everything.
and rightly so.

As it is, the two types of doctors in Switzerland who earn the least are GPs and psychiatrists.

Last edited by doropfiz; 09.05.2021 at 10:00.
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Old 09.05.2021, 10:04
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Re: is my Praxis overcharging me?

As you mull over making changes to your insurance model:

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My subscription model requires me to reach out to GP first before going to specialized doctor. At the rate I am being charged by my GP, I wonder if it makes more sense to just level up my subsciption so that I can go directly to any doctors and bypass the middle man GP.
While yes, traditional models will cover the costs when you to go directly to a specialist, be aware that there could be a barrier other than the question of who pays.

The various specialists I have seen all require a GP referral before they will see a new patient. This has nothing to do with insurance, rather it's how these specialists manage their patient load. These practices are busy, so require a referral to ensure that a new patient does indeed have a condition that falls within their area of expertise. Without a referral from another doctor you will not get an appointment no matter what insurance model you have.

Now - not all specialists do this. If you live in an area with an abundance of providers you might not run into this. But before you change your insurance model based on wanting to bypass the GP, make sure the specialists you wish to see will accept new patients without a referral.

BTW, one usually only needs the referral for the first specialist appointment. Follow up consultations can be made on your own.

Just a heads-up.
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Old 09.05.2021, 10:51
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Re: is my Praxis overcharging me?

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As you mull over making changes to your insurance model:



While yes, traditional models will cover the costs when you to go directly to a specialist, be aware that there could be a barrier other than the question of who pays.

The various specialists I have seen all require a GP referral before they will see a new patient. This has nothing to do with insurance, rather it's how these specialists manage their patient load. These practices are busy, so require a referral to ensure that a new patient does indeed have a condition that falls within their area of expertise. Without a referral from another doctor you will not get an appointment no matter what insurance model you have.

Now - not all specialists do this. If you live in an area with an abundance of providers you might not run into this. But before you change your insurance model based on wanting to bypass the GP, make sure the specialists you wish to see will accept new patients without a referral.

BTW, one usually only needs the referral for the first specialist appointment. Follow up consultations can be made on your own.

Just a heads-up.
I have not encountered this at all. Some specialist have waiting time but I have never had one say they would not see me unless a GP had referred me.
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Old 09.05.2021, 11:05
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Re: is my Praxis overcharging me?

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I have not encountered this at all. Some specialist have waiting time but I have never had one say they would not see me unless a GP had referred me.
Me, neither, ever. But as melloncollie pointed out, this may be a regional difference, or more specifically a matter of city vs. non-city.

Having said that, if one can find the luxury of an alert, attentive GP, it can be a great advantage to go through that practice, not so much for the referrals, but so that there's some central point at which treatments are coordinated.
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Old 09.05.2021, 11:07
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Re: is my Praxis overcharging me?

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I have not encountered this at all. Some specialist have waiting time but I have never had one say they would not see me unless a GP had referred me.
For example, one of the specialist eye clinics at Uni Zurich requires referral from a GP. Although, I did not not need a referral to see an orthopedist.
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Old 09.05.2021, 11:16
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Re: is my Praxis overcharging me?

As above, I've not been able to see any of the area specialists without a referral. Nothing to do with insurance, as I have the traditional model, rather a question of supply and demand and practice management.

I only bring this up as the OP is considering changing models specifically because he wishes to bypass the GP. In making that decision the OP should first check whether the individual doctors he wishes to see will take a self-referred new patient, or not.

YMMV.
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Old 09.05.2021, 11:19
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Re: is my Praxis overcharging me?

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I have not encountered this at all. Some specialist have waiting time but I have never had one say they would not see me unless a GP had referred me.
I think it depends on where you live and specialist availability in the area plus the choice of the specialist. Some specialists like to rely on GPs as a sort of gatekeeper.

I’m my experience though there is a much shorter waiting time if you go via a GP referral rather than making the appointment yourself.
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Old 09.05.2021, 17:32
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Re: is my Praxis overcharging me?

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Do you expect that consultations with your GP which last only 5-10 minutes should be... free? Considering how short the average consultation is, it should be obvious why they charge in 5 minute blocks.
If you're not accustomed to the model here it can be a bit odd at first.

My GP in the States doesn't charge me for small stuff. I've never been charged for a phone call or letter there. Office visits yes, but not per 5 minutes.

Last time I was in the States I needed a PCR test to get back to CH. The GP doesn't do tests so I went to a local clinic. The documentation from that clinic didn't specifically say "PCR" so I was worried the airline would reject it. I took the info to my GP's office and asked what to do. The staff printed out all the forms showing exactly what test was done and what it means, and attached a letter signed by the doctor. All for free. That wouldn't happen here.
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Old 09.05.2021, 18:59
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Re: is my Praxis overcharging me?

My doctor charged me 15CHF each time I called to change an appointment so I stopped going there. I do find it odd that my hausarzt charges a Zuschlag for hausartzliche services.
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Old 10.05.2021, 13:07
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Re: is my Praxis overcharging me?

As I am not familiar with the doctor practice in Switzerland, my post was trying to make sense and understand it better. I was not trying to downplay doctor's importance or expecting them to work for free.


To put it in context, where I am from, each doctor's charge begins and ends with each visit. The moment I leave the doctor office, I have the invoice in my hand, know how much I am charged, and even signed the invoice in agreement with doctor. There is no such thing as after-charge i.e doctor studying my case without my presence then charge me.



About the quick phone call (since many wondered about that), it was just to update my GP that, the psychiatrist she put me in contact with was not accepting new patients anymore. My GP asked me to keep her updated about that, so I did. Where I am from, such a phone call would not constitute a charge.


But I understand this is Switzerland, and they have their own practice. Thank you for shedding some light on it
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Old 10.05.2021, 13:10
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Re: is my Praxis overcharging me?

You can look up some of these things in Tarmed:

e.g.

https://www.tarmed-browser.ch/de/lei...der-arztpraxis

Whether that brings you any more clarity or just adds more gobbledegook to the mix is an open question.
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Old 10.05.2021, 13:14
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Re: is my Praxis overcharging me?

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About the quick phone call (since many wondered about that), it was just to update my GP that, the psychiatrist she put me in contact with was not accepting new patients anymore. My GP asked me to keep her updated about that, so I did. Where I am from, such a phone call would not constitute a charge.
My GP in Switzerland wouldn’t charge for that either, it does seem a little bit excessive.
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Old 10.05.2021, 13:17
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Re: is my Praxis overcharging me?

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As I am not familiar with the doctor practice in Switzerland, my post was trying to make sense and understand it better. I was not trying to downplay doctor's importance or expecting them to work for free.


To put it in context, where I am from, each doctor's charge begins and ends with each visit. The moment I leave the doctor office, I have the invoice in my hand, know how much I am charged, and even signed the invoice in agreement with doctor. There is no such thing as after-charge i.e doctor studying my case without my presence then charge me.



About the quick phone call (since many wondered about that), it was just to update my GP that, the psychiatrist she put me in contact with was not accepting new patients anymore. My GP asked me to keep her updated about that, so I did. Where I am from, such a phone call would not constitute a charge.


But I understand this is Switzerland, and they have their own practice. Thank you for shedding some light on it
Do remember to pass all of these bills and charges on to your insurance company, even the small ones.
They will count towards your annual franchise.
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Old 10.05.2021, 13:50
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Re: is my Praxis overcharging me?

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As I am not familiar with the doctor practice in Switzerland, my post was trying to make sense and understand it better. I was not trying to downplay doctor's importance or expecting them to work for free.

To put it in context, where I am from, each doctor's charge begins and ends with each visit. The moment I leave the doctor office, I have the invoice in my hand, know how much I am charged, and even signed the invoice in agreement with doctor. There is no such thing as after-charge i.e doctor studying my case without my presence then charge me.

About the quick phone call (since many wondered about that), it was just to update my GP that, the psychiatrist she put me in contact with was not accepting new patients anymore. My GP asked me to keep her updated about that, so I did. Where I am from, such a phone call would not constitute a charge.

But I understand this is Switzerland, and they have their own practice. Thank you for shedding some light on it
You're new in this, and your question is completely reasonable. And thank you very much for this sane and appreciative answer. It's certainly not always easy negotiating a new country's system.

Although your query was about your GP's bill, since you say you were referred to a psychiatrist who has no time to see you, and just in case you still are looking, perhaps this thread could help you to understand the Swiss system about that, with tips on how to find one:
https://www.englishforum.ch/family-m...t-how-get.html
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Old 10.05.2021, 13:55
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Re: is my Praxis overcharging me?

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I go to a local Praxis and I am often charged like this:
- Consultation, first 5 min
- Consultation, every following 5 min
- Consultation, last 5 min
- Zuschlag für hausärztliche Leistungen in der Arztpraxis. I am not sure what this item means. I asked the Praxis and they explained it was some sort of tax/surcharge.
- Aktenstudium in Abwesenheit des Patienten bei Personen...
- Nicht formalisierter Bericht


I mean, they charge me for everything. Even a quick talk with my GP on the phone is charged into both first and last 5 min items.



My subscription model requires me to reach out to GP first before going to specialized doctor. At the rate I am being charged by my GP, I wonder if it makes more sense to just level up my subsciption so that I can go directly to any doctors and bypass the middle man GP.


From your experience, do these charges justify?
Yes correct.
The names they use for the points on the bill are the ones used between insurance and doctors. Each one hast a certain amount of "Tarifpunkte", a payment system set between the two above mentioned.
Leaving the GP out won't change anything. The bill will still look the same, the amount of "Tarifpunkte" might be higher though.

<I mean, they charge me for everything. Even a quick talk with my GP on the phone is charged into both first and last 5 min items. >>
Yeah, these bastards, refuse to work for free, the nerve.
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