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Carte Vitale re-payments

Posted by Sue-188228 - Created: 14 years ago
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Why does my Carte Vitale re- pay the pharmacy direct but the doctor still has to be paid up front?  I gather that if I had a mutuelle too, then at the pharmacy I wouldn't have to pay anything as the mutuelle would repay them direct as well.  How do people on very low incomes manage?

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3 replies (Showing replies: 1 to 3)

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Posted by Sue-188228 - 14 years ago

Gosh Legend, don't you know a lot of stuff!!!  What would this site be without you? Thanks to both of you for your responses.

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Posted by legend_in_my_lunchtime-182603 - 14 years ago

It's all down to overhead costs.  Setting up with the S.S. to have "prise en charge" takes quite a commitment to a permanently online computing system plus an ongoing need to have someone reconciling the accounts and dealing with the exceptions that are generated on the payments.  I guess pharmacies already have this for their orders, etc. so hooking it up to the S.S. is not a great deal of extra commitment.  It sure is for a solitary M.D. who has neither the time nor the money to get into all that - in fact those I've known have a hard enough time just dealing with uploading the electronic "feuilles de soins" once a day.  That having been said - I have known a couple of practitioners that had a "prise en charge", leaving me to pay only the "ticket moderateur" part of the transaction.

When the Mutuelle automatically picks up the ticket moderateur balance, this is known as "tiers payant".  Not all mutuelles do this.  Typically you will pay more for a contract with a mutuelle offering tiers payant than for one which doesn't.

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Posted by szozu - 14 years ago

I think it depends on your doctor. Some don't have the machine that reads the card, others charge more than the standard fee. I have seen a doctor where I didn't pay anything at all, but then I'm on 100% coverage.

Lana