Help please with strange code on invoice from hospital

I’d be grateful please for some help re a code on an invoice from the hospital where OH had a pre-admission day.

I will be phoning them for an explanation but would prefer not to make a complete prat of myself, so would be grateful for some suggestions. Thanks.

He saw over the day a nutritionist, cardiologist, kinesiologist, anaesthetist, coordinating nurse. He paid for a single room. The costs of these consultations are itemised and seem as one might expect.

But then there’s rather a shocking amount of 491.76 € for “GHS” - when I google this I get “Group Homogène de Sejour” and I am none the wiser and I fear I will not (at the moment) understand the answer if I just ask.

Any ideas anyone please?

(I’m hoping it’s a mistake!)

I found this, I hope it’s useful. GHS seems to be the blanket term for a collection of treatment/therapy/services.

Is this the devis for future treatment, or he bill for treatment he had?

If the latter I think this is the combined cost for all the bits and pieces associated with treatment x or y. The specialist costs will be for their consultations, but this is for the other hospitals costs. And this allows the hospital to be recompensed in proportion to what they do. The amount doesn’t shock me hugely!

“A chaque GHS correspond un tarif, qui est déterminé chaque année par le ministère de la santé. Exemple : en 2011, le GHS « tuberculose, très courte durée » est tarifé 478,65 euros. Selon la nature et le nombre de GHS, l’établissement de santé reçoit de l’Assurance maladie une enveloppe proportionnelle à son activité.”

Like the mysterious “consumables” on a garage bill.

Had a Vauxhall dealer try to pull that scam on me years ago.

Asked to see what had been “consumed” as bill already itemised fluids, gaskets and even the new crush washer on the engine sump drain plug on the parts section of the bill.

Got a blank look. Asked to see service manager. Asked to see the “consumed” items O was about to be charged £10 for.

Service manager mumbled something and removed the £10 from the bill. Never used them again, so their attempt to scam £10 from me probably cost them £300-£400 as I kept that car a few years longer and found a local independent 3 streets who was excellent and didn’t try to rip customers off.


Thanks everyone. This seriously is a tough one for us. Any suggestions please if there is a possibility to contest this?

If I may explain the background:

OH is having an op on June 6th and (as with his cataract op a few weeks back) he was told by Agen hospital that he would have to fill in a questionnaire for the anaesthetist and have a pre-op meeting with this person. A date and time (midday) were duly fixed.
Then I received a phone call from someone called a “coordinating nurse” who said OH should be at the hospital at 9:30 and when I asked why, she said OH would be seeing all these other people through the day.
We were (naively) delighted, thinking no more than how thorough the French system and how thorough they are at preventative treatment.
Since, in the end the pre-admission day was to extend from 9:30 to 16:30 we agreed a single room would be nice for him and he paid 70€ for the day including Wifi and lunch.
To take @John_Scully 's analogy - there were no consumables.
OH went to the cardiology clinic when he was summoned - charge for cardiologist: 23€ (he was very young)
He went to the anaesthetist when he was summoned - charge for the anaesthetist: 55 €
The nutritionist came to us and knows less about nutrition than we do and if we’d known we would have refused to see her - 55€
The kine asked my husband to put his hands above his head and out to the side and walk the length of the room - this of a mid-seventies man who walks the dog 50 minutes a day in the morning and gardens two hectares (all on slopes) that was in the questionnaire (again, we would have refused this if we could) - charge for the kine: 42€

At NO stage in the process of setting this up did anyone let us know there would be cost implications above and beyond the consultants fees for their RDVs and the cost of the room (for which he’s already paid). To me (again, perhaps naively) the additional 491 € feels extortionate when the costs of the individual consultations comes to a total of 175€. Nearly an additional 500€! For what?

If we had known, we would have queried who we had to see, kept it to the minimum (no nutritionist, no kine) and (if possible) set up individual appointments.

By the way, our experience with the cataract op in no way prepared us for this scenario. He saw the anaesthetist pre-admission on that occasion and there was no charge for that meeting - her fees were included in the final bill for the op.

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Oh dear @SuePJ ! An alarming surprise.

Will the mutuelle insurance not cover these GHS charges? (Assuming that is included in the mutuelle chosen.)

We do have a mutuelle, but only “medium” cover - obviously I will check just how much (if any) we will get back.

In a way, regardless of whether or not we have a mutuelle - NO ONE warned us, gave us any alternatives.

This feels like staying in a hotel and paying 200€ for the room and 150€ for an nice evening meal and then coming down to pay the bill the next day and finding an additional 500€ on the bill as a “GHS” for the swimming pool, the bar, the staff at reception and the cleaners. Really??? :roll_eyes:


is this a private clinic?

This maybe

I think that might be your problem.

Go into any healthcare institution in France and they will milk you because they know your mutuelle will pick up the tab.

Thanks Flocreen. I’ll have a look when I have the strength. At the moment getting the cottage ready for guests.

Not that I’m aware - mind you not sure I know what “private clinic” means in France. Nor indeed understand what difference that makes.

It’s THE major hospital in Agen.

I’d be interested to know from anyone who has been through this whether this “pre-admission” day is obligatory? And whether we could, in fact, have queried the whats and the wherefores and refused to have gone through the process?

But they don’t know. Because they do not know the details of our individual cover.

Also, whether or not we have a mutuelle I would have thought does not absolve them of the responsibility of giving us quality information about the costs of the day. We did not ask for any of this - it was all put in place by the coordinating nurse - a charming woman by the way - who just went ahead, regardless of our personal financial situation. :roll_eyes:

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Firstly… check with your Mutuelle… to know what is and is not paid by them once Social has paid its bit… and thus, you’ll find out what is left for you to pay.
They’ll probably want to see the document …

and, are you saying the Hospital didn’t ask you about your Mutuelle… frankly, I can’t remember if OH had to show anything first, as it links directly through the Carte Vitale…
but I know that nowadays CVitale/Mutuelle are always asked for…

It is quite normal, before the Op, to see the Anaesthetist and Cardio… and each will charge for that meeting.
(OH had one Cardio chap who looked about 16… so yours is quite elderly… :wink: )

No idea about Nutrition and Kiné… but perhaps that is towards recovering full health and strength… gives 'em a starting point.

the GHS might well be the cost of the bits and bobs involved in the Cardio operation…
My replacement ring-finger joint cost 531€ (just for a bit of bendy silicon…)

Re the document you have received… does it say Facture???
Does it tell you how/where to pay it ???

keep calm and speak with your Mutuelle asap.

Thanks for your thoughts. Anaesthetist and cardio - I’ve no questions about the need to see them - though I was less than impressed with the anaesthetist as all he did was copy onto his computer what we’d written on the questionnaire - we might just as well have not been there! Unlike OH’s cataract anaesthetist who took OH through everything line by line.
Those two, could have been set up as ordinary individual appointments, with none of this silly business of these additional GHS charges.
Yes, they know we have a mutual. But that, quite frankly, is neither here no there - it’s about how we were prepared / informed about the day (or rather not prepared/informed).
I wonder if I’d been French, would I have known to ask more questions, challenge the need for this whole day? Whether I would have demanded to know the cost of it all? (I did try, right at the beginning of this whole process to get an idea about the total cost of the op, consultations, aftercare, in order to decide whether to move up to level 5 mutuelle - I fell at the first hurdle, they shrugged and laughed at me)
I wonder, because we’re Brits, they don’t like to get into detailed discussion? Or whether they just assume we understand the system? Having been here 16 years, it’s true that these days there aren’t many scenarios where I feel as if I’ve gone back to day1 of our arrival. I do at the moment.

Oh that’s rotten…

but I’m still wondering about this document you’ve got and what it actually says…

Isn’t there someone local to you who could look at it and explain it ???

I seem to recall having something horrendous to do with Teeth… and when I asked about it… it needed to be sent to our Mutuelle who would then say how much of it they would cover…

It’s a facture from the hospital and lists all the consultant appointments OH had on the 10th - with a whole series of cryptic codes starting with GHS, which was the only one I hadn’t worked out.
How about CPH, APC, CS, ATM, AMC? :roll_eyes: Thanks for the thought Stella but I don’t need help with these - I’ve already worked out what they mean / who they are. It was only the horrendous 491.76€ which had me stumped.

(I say in my title to this thread “invoice” so there’s no doubt about what this document is. :slight_smile: )

Sorry @SuePJ it’s been one of those days since early morning… and I didn’t notice the heading once I read “Help please”… :wink:

If I received a Facture which bore no sign of my Mutuelle paying anything… I’d hand it straight to my Mutuelle and ask 'em to deal with it… but that’s me…

Over to you…


Just popping in, so not read whole details. But is this what you were actually billed or what CPAM was billed?