I'm publicly insured and had an initial orthodontic consultation a couple of weeks ago regarding a slight jaw discrepancy. The doctor said she needed to take impressions, x-rays, and photographs to better analyze my case. I understood that – but I was never explicitly informed that these were additional private services that I would have to pay for out of pocket and that they would not be covered by my statutory health insurance. At the end of the consultation, I was told that they would call me to the practice to propose the solutions for my jaw issue after their analysis and I would have the choice to either proceed with them or not.

The first communication I receive from this practice after the initial consultation is an email stating the cost for the diagnosis and that I “agreed to cover the additional costs myself” (1st image) – totaling approximately €313.
They also claim that I was informed about the option of completely free orthodontic treatment (according to BEMA) and that I voluntarily chose private services instead. But that’s not accurate – all the doctor told me was that these procedures were necessary, without any explanation about insurance coverage or out-of-pocket costs.

For context, I haven’t received any documents or results related to the services provided – not even a treatment and cost plan for my jaw discrepancy (listed in the services list, 2nd image).

I’d really appreciate your thoughts on the following:

  1. Should I have been clearly informed in writing that I would be receiving private (self-paid) services? Does this document need to be signed by me to be valid?
  2. Is this document a request for payment now for services already provided, or would I only need to pay if I choose to move forward with the treatment?
  3. Am I within my rights to email the clinic and ask for proof that I explicitly consented to private services instead of those covered by public insurance?

by GovernmentTime7788

10 comments

  1. This to me seems like a Kostenvorschlag and not the actual bill. 

  2. Not bill dw
    It’s estimation if you continue the treatment

  3. Which doctor told you the treatment was necessary? Your dentist? That’s the one sending you to the orthodontist if necessary.

  4. That’s really shitty of them not to tell you. I also paid for these services but they specifically told me I would have to and that it would be added to my total treatment price if I proceed with it, or I could pay for it separately. Yeah you should definitely ask for proof that you consented.

  5. I’m publicly insured, but have taken paid options multiple times with doctors. In all cases, I was not only informed that my insurance would not cover it, but was given the cost before I verbally agreed to anything. To add, public health insurance usually doesn’t cover most (or even all) cosmetic procedures. Whatever “slight jaw discrepancy” means, it sounds like an optional cosmetic procedure.

  6. Both pages talk about future costs. And the last paragraph of page one literally asks you to sign for consent of additional costs. If you don’t sign this there shouldn’t be additional costs.

  7. > The doctor said she needed to take impressions, x-rays, and photographs to better analyze my case. I understood that

    I’m not clear on whether or not you had that work done. You talk about an “initial consultation” — you mean you only discussed what needed to be done?

    In which case, this is an estimation of how much those extra services will cost you and you’re notification that it’s possible to have the procedure done in a way that your health insurance will cover.

    If you don’t want these extra costs, don’t sign this document and instead chat with your dentist again.

  8. In order to write an orthodontic treatment plan you need models and X-Rays. All of this will be billed, regardless if you decide to go through with the actual procedure. This is what this treatment plan is about.

  9. In general dental and orthodontic treatment is often only partly covered by statuary health insurance even for the most basic procedures. A ‘slight jaw discrepancy’ is therefore very likely not covered at all (neither diagnostics nor treatment).

    —

    Did you have the x-rays, photographs, etc, taken yet? This is crucial information to understand what is going on.

    The way I understand it is this:

    I agree with the others that this does not seem to be a bill but an estimate for the future diagnostic analysis (=x-rays, photos, etc.). If you did not have this diagnostics done yet, you don’t need to pay anything yet. But if you’ll proceed with the diagnostics with this doctor, the estimate says how much it’ll cost you.

    The actual treatment itself is not part of this estimate so there will be more cost for that. How much will be determined in another estimate (referenced in the current estimate as the last item for 32,34€) after diagnostics is finished.

  10. If they didn’t inform you then you should contest the costs. You can even go to the local dentist kammer

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