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Why do I have to pay extra to my doctor?

Posted by steve the painter - Created: 3 years ago
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10 replies (Showing replies: 1 to 10)

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Posted by tigre-979768 - 3 years ago

Really pleased you now have it sorted Steve. You know what they say about insurance companies, always read the small print, a lesson to us all, mind you your doctor did give you a hint by saying it would be reimbursed by your mutuelle.

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Posted by jjp47 - 3 years ago

No problem, glad you got it sorted! Looks like I know what to do now too.

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Posted by steve the painter - 3 years ago

No, I'm quite fluent, actually. I just didn't think to ask AXA, as it had always been automatic in the past. I changed my Mutuelle in October, and I've not had to do this before.

But thanks to everyone for their help.

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Posted by tigre-979768 - 3 years ago

Yes, well done you three for steering Steve in the right direction. Steve, first point of contact should always be your insurance provider, let's face it you pay them enough, may be you are held back with the lack of the French language that's all I can think as to why you didn't contact them in the first place!

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Posted by steve the painter - 3 years ago

As this was the first time I had to pay the doctor the 7 euros, I really did not know how to claim it back, or whether I would get it back at all. One lives and learns, even if you know the sytem well. Now that I have been advised to go onto my personal space on RSI, I see that the doctor has in fact been re-imbursed his 16 euros, and therefore I will send this attestation to AXA for re-imbursement from them. This is completely new to me - and in all other cases when I have presented my CV, it is re-imbursed automatically. Now I know, thanks to Chrissyxx, JJP and SG for their very  helpful comments. Sorry I did not get back quick enough for some people but I am often busy.

Steve

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Posted by tigre-979768 - 3 years ago

Yes you did, as I did and jjp47 in previous posts in so many words. It's just unusual for a top up insurance not to pay back automatically, but  you would have thought Steve would know if his mutuelle doesn't do this as he has been in the system for some years now and wouldn't have had to ask on this forum, but if this isn't the case it may not be obvious as you suggest.

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Posted by chrissyxx - 3 years ago

Yep! I think that's what I said. Except that I didn't actually mention RAM. but hey ho !! seems to work the same way as CPAM except for the reimbursement from the mutual. Think this is quite obvious!

 

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Posted by tigre-979768 - 3 years ago

Chrissy, read the posts again, Steve is not with CPAM but RAM, he pays his doctor 7euros so it appears that the doctor is paid directly by RAM 16euros  then Steve's 7 euros makes up his fee. It seems more likely that jjp47 has come up with the answer and Steve has to claim back through AXA his top up insurance, of course we won't know iunless Steve let's us know if this is the case, he claims that he knows the system very well ( RAM, RSI & CPAM) so should be able to sort it out. It would be nice to know the outcome of his query as several members have been good enough to respond to his original request.

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Posted by chrissyxx - 3 years ago

Hi, Just reading thro this posting, I have noticed that no one has mentioned that when you pay 23 e. to the doctor , only 16 e is actually refunded by CPAM. 6e. is reimbursed by your mutual assurance. . and 1 e. is paid by theyourself.. It looks as if you are being charged the 7 e that CPAM does not refund the doctor.Your doc is probably reimbursed 16e from your health company (if not CPAM) but you might have to claim your refund of 7e. from your mutual yourself. as CPAM automatically informs the mutual .Maybe this will help.

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Posted by SG-404468 - 3 years ago

I too think you are being charged 23 euros not 30, and that the 7 euros is the ‘top-up’ part of the charge. When we changed mutuelle provider a few years back, we found that we weren’t automatically receiving reimbursements and we have to email our RSI statements through to the insurance company in order to effect payment of the ‘top-up’ part. It may be that you need to do the same thing?