The Health Insurance Fund refused to pay nearly 42.000 euros to the Podgorica Health Center, after they determined that gynecologists unjustifiably invoiced about a third of preventive services.
In the report of the Fund controller, it is written that a total of 70.534 services were controlled, and that 26.782 were unjustifiably recorded and invoiced.
Because of this, the Podgorica Health Center's invoices were reduced by nearly 42.000 euros.
The document that "Vijesti" had access to shows that selected gynecologists unjustifiably invoiced almost half (46,55 percent) of preventive examinations performed during pregnancy.
According to the report, one gynecologist of the Podgorica Health Center recorded a preventive examination of the patient 35 times, with a diagnosis of confirmed pregnancy.
During March alone, he examined the woman as preventively as many as 14 times, that is, practically every other day.
Preventive examination, according to the Rulebook, includes "examination in the first trimester of pregnancy and four control examinations".
The same doctor recorded 38 ultrasound examinations during pregnancy for one insured, which cost the Fund 10,5 euros each, for the diagnosis of normal pregnancy controls. According to the regulations, three ultrasound examinations are allowed at the Fund's expense, except in the case of high-risk pregnancies.
The Fund's controllers also found irregularities when it comes to preventive examinations with counseling of women of reproductive age.
Of the total number of such inspections in 2015, as many as 33,51 percent were unjustifiably invoiced.
It is an examination to detect cancer on the female reproductive organs, which is done once every three years between the ages of 20 and 75, unless the gynecologist determines otherwise.
According to the Fund's report, one doctor recorded 16 such examinations of a patient who allegedly had a diagnosis of pregnancy in three months.
The price of this service costs around 10 euros.
The Department for the control of the Fund emphasized in the report that the management of medical documentation must be carried out in accordance with the current regulations and that the professional services are obliged to control the correctness of the recording and invoicing of services.
The guild of selected doctors for adults is 2.760 euros higher than the real one?
The Fund's controllers also found that out of 7.851 preventive examinations, which were performed by selected doctors for adults at the Podgorica Health Center, about 11,11 percent were unjustifiably invoiced.
Therefore, it was requested that the Health Center reduce the invoiced amount by around 2.760 euros.
In the conclusions of the Fund, it is written that none of the 42 controlled services of "control inspection after preventive inspection" were justified.
According to the Fund's price list, this service costs around eight euros.
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