Can you explain where either or both of the above have happened… please ??
We only got more information from my specialist when I asked her explicitly what in her opinion was my problem.
Before that it was go into hospital for the lung biopsy.
Now I know how they will do the biopsy, how long I will have to stay in hospital and, more i portantly, if she is right, there is a medication for my condition.
As usual, it is extremely rare.
I think the fact that @SuePJ received a bill that she had no prior knowledge of illustrates the point very well doesn’t it? Or am I missing something?
The document listed costs from the day in hospital undertaken by an ALD patient.
The costs were broken down into what was covered by the Carte Vitale (100%) and what was not… (ie 70€ for the Room which was discussed and agreed).
But the point remains that these costs were listed after the fact. Great that they are reimbursed by the CV but imagine if they weren’t. Anyway, seems like we have a different view on this, but I certainly see it as a positive eye opener, for which I am grateful👍
Sue’s OH is booked in for surgery… and the Hospital knows this…
The fact that the Patient is ALD means they are in the system (CVitale) and the Hospital will know this too.
Honestly, if there were a risk of proposed work not being covered… I do know from experience that this is discussed with the Patient…
It was just one such conversation which forced an acquaintance to return to UK… and the medical ambulance hired in UK, to repatriate the person, cost a lot of money (paid by the family) but was cheaper than having the necessary work/repairs etc etc done in France with absolutely NO cover…
This is a too simplistic view. Yes, he is ALD, but as I (and @JaneJones above) have explained being ALD far from means that all our costs are covered. The condition my OH has, the French state has designated that they will reimburse to his consultant about half what they pay out for my cardiologist, despite the fact that it will be a very skilled op.
So, in theory (not exact figures) I see my cardiologist, who charges 55 euros. The state is prepared to pay for a cardiologist up to a maximum of 55€. I am ALD and 100% of that 55€ is covered.
OH’s specialist charges 55€. The state considers he is only “worth” 30€ for what he does. OH is ALD and is covered for 100% of 30€, so has to find another 25€. We have a medium mutuelle which only covers for 100% of the 30€ consultation. So no refund.
I had hoped never to have to understand these things. I blithely went into the scenario thinking OH would be completely covered as I am because he has ALD - it is not the case. We have seen his specialist so far 5 times in a matter of months. That is 5 times 25€ that we pay out with no reimbursement either from CPAM or our mutuelle. There is a lot that is not well explained before the process (by all concerned) and only becomes clear to us AFTER the event.
I shall be interested to learn what explanation is given by the Hospital when @SuePJ queries the Facture…
On the other hand… perhaps your OH’s ALD needs to be upgraded… and I’m wondering
Charges are always a difficult subject…
A friend is an Eye Specialist… he offers top-rate services, for “standard” prices, in a sort of Maison Medicale situation.
This was his personal choice right from the start.
But, now he wants to retire and he’s so booked-up it’s impossible… aargh.
what does that mean?
I’m just wondering about the level/classment (whatever it’s called) of ALD which your OH has been awarded.
As you say… he needs the same Specialist as you do… I’m just wondering if his condition has changed since he was first awarded ALD… or even if the fine-tuning of medical beaurocracy has changed … and might now enable him to have higher reimbursements…
If we don’t ask, we’ll never know.
I’m not ALD… don’t quite meet the targets (which, of course, I’m thankful for…)… but I try to keep a close eye on medical news and chat with our Doc…
Being classed as ALD would have financial advantages but for the moment… I’m prepared to forego those
Contrairement à ce que l’on peut penser, l’hôpital, même public, n’est pas gratuit . D’ailleurs, d’ici 2022, pour sensibiliser les patients, les établissements devront leur remettre une note détaillant précisément le coût de leur séjour, avec ce qui est remboursé ou pas.
"Moreover, by 2022, to educate patients, establishments will have to give them a note detailing precisely the cost of their stay, with what is reimbursed or not."
Aha… this could explain why Sue received a detailed facture
and why I received an amazingly detailed facture after my visit to the A&E last September (involving MRI et al) …
“we’re being educated”
You can’t upgrade an ALD. For each of thr qualifying conditions thete is a defined list of what can be reimbursed. And some also depends on how the ALD affects you.
and some folk move in and out of ALD depending on how their Health evolves…
Never a waste of time to ask the question, in my opinion…
Personally it’s possible the mutuelle could have more to complain about.
On the other hand, as all but 70 euros is paid by the health system or the mutuelle, and it seems to be a normal state system hospital, I am guessing the hospital is claiming standard charges on a laid down scale that the mutuelle would expect to pay.
according to the paperwork… of the figures shown, everything is covered by the Health System, except the 70€…
the Mutuelle doesn’t get a mention… so they’ve nothing to complain about…
Just to thank everyone on this thread who helped me. Not least, just talking it through meant I could calm down and look at the form properly.
It would have helped if there had been an accompanying letter/note of explanation (including what all the codes meant)
In fact I finally realised (once I stopped playing the drama queen) - it wasn’t a bill, but a receipt.
As some of you observed, the final column shows all that the patient has to pay. And despite all the scary figures in the other columns the only number that gets as far as the final column is that 70 euros.
Finally, finally, I also realised in one corner there was a faint official stamp, and a hand written date and a handwritten 70€. So yes, this was confirmation that we’d paid.
I got there in the end, but only with your help. Thanks.
Ah well… we all gave the whole thing a thorough thrashing…