Charging patients for inpatient treatment is illegal, says the Health Insurance Organization

Charging patients for inpatient treatment is prohibited, the Health Insurance Organization reminded.

Only in cases where a patient requests a single room without medical necessity is payment justified. Under no other circumstances do GHS hospitals have the right to charge beneficiaries of the System, the Health Insurance Organization reiterated.

The cost of patient care is fully covered by the Organization. According to HIO, reimbursement of incidents related to inpatient treatment is “fully covered by DRG or the fixed reimbursement code ‘Z’ resulting from the coding of the incident.” The reimbursement, according to HIO, “includes, among other things, medical fees, patient hospitalization, use of the operating room, consumables, laboratory and imaging tests, histopathological studies, as well as pharmaceutical and other drugs prescribed during hospitalization.” In addition, “the Organization separately reimburses consumables included in the ‘Z’ list of materials after the required documentation.”

Therefore, “hospitals under no circumstances may charge patients for inpatient/day care services, except for charges related to single rooms requested by the patient when there is no medical necessity.”