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Old 31.08.2021, 11:44
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Re: GP refusing to do a medical referral without the specialist name on it

First of all I'm overwhelmed by all the the useful and interesting answers I got. Not all of them are constructive of course but, anyway, EF is as usual great.

After the answers on some of these posts and lots of forth and back, with sometimes a bit of lost in translation, I could better understand what's going on:

- About the insurance model: yes, I took this insurance model being aware of the savings it gives and reading the webpage I already sent:

Quote:
  1. See his GP. Done
  2. Phone the Qualimed. Done
  3. Qualimed then gives him the names of 3 of their recommended specialists, and helps him to get the appointment.
Wrong, devil is in the details. The reality is unfortunately different than what marketing tells. First, they ask the Überweisung from my GP, otherwise they won't talk about any specialist. And then, yet another step: they ask you to fill a long form (count at least 10 to 15 mins) telling them everything (which I of course already did with my GP!) which is a massive bureaucratic hassle.

They told me about getting valid referrals from online places such as Medgate (which is billed since this is not the Telmed model). So, the entire model is thought to reduce costs by going into online stuff as much as possible. It is a new model (just available on german speaking cantons if I understood well). At the time I decided for this model I didn't know my particular GP needs always a specific name or practitioner to write the referrals to. I luckily use to have good health and poor experience with the swiss health system. I "just" checked that my GP was in the list of the insurer's valid GPs.

That said, I've to admit their attention on the phone is great, they call you back always and they don't hesitate to spend 20 minutes trying to help you to move forward though bureaucracy kills unfortunately the good job their employees do on the phone.

All in all, lesson learnt and there's a reason this insurance model is cheaper.

- About my particular case: thanks to the valuable posts of some people here I insisted and got a copy of the referral my GP did for one specific specialist. The document is an Anmeldung form made for that specific place and I'm trying now to make this pass as a valid referral which could be ok since the observations and the requests of my GP are there.

I could also clarify things with my GP and I understood that this insurance model is simply too new and just not the way he's been working for several decades. This was the first time he had heard of this model, that makes his initial reaction something understandable. As he explained "I just prefer to know where I'm sending my patients so I can better follow up".

To sum up: there's obviously a reason some health insurance models are much cheaper, beware of them. And people are usually not acting in a particular way because of bad faith but because of ignorance or just because of the imposed bureaucracy.
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  #22  
Old 31.08.2021, 12:22
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Re: GP refusing to do a medical referral without the specialist name on it

I never go to the doctors so pick a low cost insurance, but i always pick a standard, none of this telmed/qualimed nonsense. nobody wants to deal with this kind of hassle.
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  #23  
Old 05.09.2021, 05:06
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Re: GP refusing to do a medical referral without the specialist name on it

https://youtu.be/CdDtwc9HA7s
Kenneth Williams, English actor and comedian (1926 - 1988) on modern medicine and medical specialists.
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