How can I reduce my medical bills

Patient rights - "How do I check my medical bills?"

After a recent visit to the doctor, an "Espresso" listener from Kloten (ZH) was amazed. The doctor didn't send the bill to her, but to the health insurance company. The woman could only see how much the treatment had cost from the final bill from the health insurance company.

“But I would like to check my medical bills,” she writes to the consumer magazine “Espresso” from Radio SRF 1. When she asked whether she could get a copy of the bill, the doctor replied that she had to contact the health insurance company.

The doctor has to take care of the copy of the invoice

However, this information from the doctor is incorrect. If a doctor bills the health insurance company directly, he or she must, in accordance with the Health Insurance Act, send his or her patient a copy of the invoice without being requested to do so. It is not the patients who have to worry about a copy of the invoice, but the doctor. In addition, a doctor is obliged to inform a patient about the type of billing before the first treatment. Patients do not have the right to choose the billing modalities of a doctor. However, anyone who does not agree to a form of billing can change doctors.

There are different systems for medical bills

In Switzerland there are different billing modalities for doctor and hospital bills:

  • After treatment in the hospital, the hospital sends the invoice directly to the patient's health insurance company. The law calls this system of settlement "tiers payant".
  • It is different with outpatient treatment. In many places there, the doctor still sends the patient the bill. The patient is then reimbursed the amount from the health insurance company. This system is called “Tiers garant”.

In recent years, however, many health insurance companies have asked doctors to switch to the "tiers payant" system for outpatient treatments. All private practices in the cantons of Schwyz and Uri already use this system for accounting.

Patients have no right to choose

Patients have no say in the choice of billing. If a doctor or a canton decides to use “tiers payant” billing, this model is used for all patients. Exceptions for individual patients are not possible.

If a patient does not want to use the "tiers payant" model, he only has two options:

  1. He can sign a so-called assignment agreement for his doctor. In this, the patient assigns his claims from the health insurance to his doctor. The doctor then sends his bills to the health insurance fund and is compensated by it. The patient then receives an invoice from the health insurance company for the co-payments (franchise, deductible).
  2. If he doesn't want that either, the only thing a patient can do is change doctors.