Incorrect healthcare billing

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Increase in false healthcare billing. Health insurance companies affected by massive accounting fraud.

As the health insurance company "AOKplus" announced, incorrect billing in the healthcare system has almost quadrupled compared to the previous year. The health insurance company estimated the damage at around 815,000 euros.

Incorrect billing in the health care system causes statutory health insurance spending to skyrocket. As the merged general local health insurance company AOK plus Saxony and Thuringia announced, the over-calculated benefits resulted in total damage of around 815,000 euros. As the health insurance company further announced, the overpriced health services have already been requested back by the service providers. The shocking thing is that the damage has almost quadrupled compared to 2009. The number of unreported cases is likely to be much higher, however, as not all service providers actually report incorrectly invoiced amounts. This could be due to illegal activity or errors in the accounting system.

The Association of Replacement Funds (vdek) in Thuringia reports similar amounts wrongly billed. The association includes, for example, health insurance companies such as the DAK, KKH Allianz and Techniker Krankenkasse. Although fewer suspected cases of manipulated billing were registered, the amount of damage was far higher than in the previous year. In 2009, partners asked for around 30,000 euros back. This year, the sum of the claims was already 100,000 euros. The Vdek state vice chief Arnim Findeklee cited one reason for this. incorrect billing of the emergency services. Here, more personnel costs were billed than actually existed.

In order to minimize fraud, each statutory health insurance association has set up a body to combat misconduct and fraud in the healthcare system in accordance with Section 81a Social Code Book V. These bodies will follow up on appropriate information to minimize the number of fraud cases. Incorrect billing by clinics alone results in total damage of around 1.5 billion euros a year, as the GKV umbrella association announced in April this year. According to the new numbers, the total should be significantly higher. There are still no exact sums available for 2010. (sb, December 18, 2010)

Also read:
AOK plus: school grades for doctors
Clinics: Billions from incorrect billing?
Raid on Hamburg doctor: suspected fraud

Image: Rainer Sturm /

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