The problem for dentists with contracts with the Health Fund is that they are not contracts. We do not enter into any relations with the Fund, and sign some kind of binding contract. By definition, it is a fair contract between the parties, but there is no other party involved. we are contractors who don't ask, but sign it. When signing, even if you do not agree with some things, you do not have the right to object. Our obligation is also to sign a series of documents in which we waive a number of rights to object, to the price...
Dr. Anđelka Duborija, president of the Professional Union of Dentists, said this in the Morning Colors on TV Vijesti.
Dentist Dr. Amela Šehović Medenica said that the prices on the market set by dentists are free, because the Dental Chamber has not yet determined the lowest price for certain services.
"The real market price of a filling is from 15 to 70 euros. On the other hand, the Fund pays us 5 euros per filling according to their price lists, but even that is not a fixed price because they constantly change them, so we never know until the end of the month what the price will be fillings or tooth extractions to be," explains Šehović Medenica.
He says that monthly invoices from the Fund vary from the lowest of 480 euros to the highest of 3.300 euros.
"It does not depend on the number of services you performed. The more services you perform and the more patients you have, the point is reduced and you receive a reduced invoice. The dentists who suffer the most are those who have the largest number of registered patients and the largest number of services due to the needs of patients. On the other hand and because of the Fund's levy, because we are obliged to have eight-hour working hours with insured persons who have free services, that the scheduled patient may not wait more than 7 days for the scheduled service and that he may not wait more than 15 minutes in the clinic," says Šehović Medenica.
He points out that the prices of the materials do not follow the prices of the services that the Fund reimburses them.
Duborija states that they do not have any plan, development of the structure for the last 20 years, specialization, and that they are a profession that has drastically regressed.
"The system doesn't recognize us as healthcare workers, we don't have any methodology, systematicity in our actions, planned development, training of personnel... What you can get from the Fund for the services you provide is only to pay for the survival of the company, it's about existential amounts". says Duborija.
The Fund sent a written reply to the Boja jutra editorial office.
"Pdental health care is paid for the service, by invoicing the Fund for each service provided, with the fact that the maximum amount of the monthly invoice cannot exceed the amount of funds determined by the Decision on the distribution of funds and the method of payment for dental health care, i.e. it cannot be higher than the maximum monthly value of the team (financial limit), which is defined in the contract on the provision of dental services.
In case of exceeding the financial limit for the services provided, when a larger amount than the maximum possible amount is invoiced, the value of the point is reduced. This means that the maximum determined amount of funds and the actual number of points for the services rendered are recognized, but the value of the point is reduced.
Also, the contract defines that the Fund is obliged to determine the maximum amount of the monthly invoice by the 10th of the month and inform the service provider about the maximum amount of the monthly invoice for the current month, as it is determined according to data from the Fund's information system on the realization (number of services provided ) for the previous month".
Dr. Duborija said that dentists still do not know the methodology of the Fund, that they struggle to find out about it in order to be paid for their services.
Šehović Medenica believes that a large number of residents have the right to a free service.
"The fund has placed a large population in the categories entitled to free health care. These are children up to 18 years of age, students up to 26 years of age, pregnant women, women who have given birth up to one year and over 67 years of age, and patients with special diseases. This is a large number of the population that has the right to a free service and every resident wants to get that service for free, then the market for us shrinks and for existential reasons we are forced to enter into that contract with the Fund," she says.
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