ÖGK: Agreement with private physicians on digital submission

In the dispute over the reasonableness limit of the new law, the Austrian Health Insurance Fund (ÖGK) and the representatives of private doctors were able to reach an agreement. Since July 1, private doctors have been obliged to submit paid invoices for reimbursement of costs via “WAHonline” at the request of their patients.

The new regulation had caused some discontent among the medical profession, particularly because it was not clearly defined for whom the changeover to the new system would be reasonable. The initially proposed limit of 15,000 euros in annual turnover was strongly criticised by private medical practitioner spokesperson Claudia Westreicher. For smaller medical practices, neither the effort nor the high purchase costs – for technical equipment and medical programs – would justify this.

Sales are not the deciding factor

Now they have agreed on a common “interpretation of the law,” as Westreicher said in an interview with the OÖN. According to the ÖGK, those private doctors “who look after more than 300 different patients a year” are now affected. This means that around 80 percent of the invoices will be sent directly electronically, shortening the processing time.

“That is a realistic limit, we can live with that,” says the spokesperson for private doctors. However, it has not yet been finally clarified how to deal with older colleagues who are about to retire. Discussions with the health insurance company are continuing in this regard.

Patient has a say

Patients can decide independently whether they submit their invoices directly to their chosen doctor or themselves. Those who are insured with the BVAEB (Insurance Institute for Public Servants, Railways and Mining) or the Social Insurance for the Self-Employed (SVS) can also have their invoices sent via “WAHonline”.

Furthermore, only 80 percent of the statutory health insurance rate is reimbursed for private doctor bills.