The German state is also helping public health insurers hide their dirty secret: in hundreds of thousands of cases, denials were legally flawed and the cases have to be reviewed. They refuse to do so on the behest of politics as a small number of cases will turn out to be intentionally negligent homicides caused by public officials.
A site properly presenting the facts is due for launch in the lead up to Germany's upcoming federal election. Until then, you can find a teaser here:
Any claim related to outpatient treatment which outside the ordinary requires prior approval there. You cannot opt to pay in advance and seek reimbursement later.
In the state of Bavaria the doctors at a government agency have been practicing without a medical license going back many years because their supervisor let this slide. I discovered her problem randomly in the course of litigation and it impacts probably a million case.
The person responsible for her staff of hundreds lacking a current medical license was later hired to lead the qualifications department at the medical board. That is, after I got her fired from her position and then from a job at a hospital (a felonious psychologist is unacceptable risk for patients). Politics would prefer to see her problem covered up.
AF also tried to pull the codeshare thing with me once. Didn't want to go around in circles with customer service and found it easier to initiate litigation. AF then hired a big law firm to defend the tiny case.
A week before a scheduled court hearing their lawyer calls me to negotiate. I tell her there is nothing to negotiate about, and she agrees. We chat for an hour anyway which was surely billed to her client AF. I receive full payment two days later.
One way to think about this: as a founder you charge your seed investors, whose capital you deploy, say 85% (preferences notwithstanding). Why wouldn't you do it all on your own and retain 100%? Capital inflow is a multiplier for your efforts, sometimes a gatekeeper too.