General Terms and Conditions
of PAN Klinik am Neumarkt Betriebsgesellschaft mbH (hereinafter referred to as "the PAN"
Unless otherwise stipulated, these General Terms and Conditions (hereinafter called "GTC") shall apply to the contractual relations between the PAN and the patient for fully residential and semi-residential treatments.
Article 2 Legal Relationship
(1) The legal relations between the PAN and the patient are subject to private law.
(2) These GTC shall apply to the patients as soon as they
(a) have been notified explicitly or – if, due to the way the contract was concluded, an explicit announcement is only possible under exceedingly difficult circumstances – by way of a clearly visible notice at the place of contract,
(b) were able to take note of their contents in a reasonable way, that appropriately takes into consideration a physical handicap of the other contracting party which also the user of the GTC can become aware of,
(c) have consented to their validity.
(1) The fully and semi-residential services of the PAN shall comprise the general services of the hospital as well as the non-medical optional services. The medical services rendered at the PAN clinic in the course of the patient's stay shall not be considered services of the PAN clinic. They shall expressly neither be part of the general services of the clinic nor of the optional services, so that no contract is concluded with the PAN in this respect. Medical services shall exclusively be rendered by external physicians affiliated to the clinic.
(2) Only those services shall be considered general services of the clinic, that are required for a practicable and adequate medical care, taking into consideration the individual efficiency of the clinic depending on the type and seriousness of the respective patient's disorder. On these conditions, the following services shall also be part of the service catalogue:
(a) residential treatment of the patient at the PAN clinic ward,
(b) third party services induced by the clinic,
(c) residential care of the patient.
(3) The following services shall not be part of the clinic's general services:
(a) the services rendered by the external physician affiliated to the clinic,
(b) the services rendered by the external physician affiliated to the clinic himself/herself,
(c) the services rendered by the medical on-call duty staff,
(d) services induced by the external physician affiliated to the clinic and rendered by lower-ranking physicians working in the same area of expertise as the external physician affiliated to the clinic, as well as those services induced by him or her and rendered by physicians and facilities under medical guidance outside the clinic,
(e) aids handed over to the patient after his or her stay at the clinic has ended (e.g. ortheses, underarm crutches, wheelchairs) as well as transportation costs.
(4) The offer to enter into a contract with the clinic shall only apply to those services which the clinic is fitted out for in terms of staff and equipment within the framework of its medical objectives.
Article 4 Admittance, Transferral, and Discharge of the Patient
(1) Within the framework of the clinic's capacity, those persons shall be admitted who require fully residential or semi-residential clinic treatment.
(2) The PAN is a privately owned clinic working with affiliated external physicians. Emergencies that require intensive care units or similar facilities in other hospitals are not treated here.
(3) If necessary for the treatment of the patient for medical reasons, according to the judgment of the affiliated external physician in charge, and if accommodation in the clinic is possible, an accompanying person shall be admitted. Furthermore, an accompanying person may be admitted by request within the framework of optional services, if sufficient accommodation facilities are available, if the operational procedure is not impeded, and if there are no medical reasons that would stand in the way of such an accompanying person being admitted.
(4) The patient shall be admitted for residential treatment in a multi-bed room, respectively in a room without any element of comfort (e.g. bathroom). The patient may take advantage of the opportunity to stay in a single room or respectively in a two-bed room with its own bathroom and other elements of comfort (see exhibit 2 regarding the optional services of the clinic).
(5) If necessary for medical reasons (in particular in case of emergencies), patients may be transferred to another clinic. As far as possible, such transferral shall be agreed upon with the patient in advance.
(6) The decision on the patient's discharge shall be made by the affiliated external physician in charge under consideration of medical aspects. Those patients shall be discharged, who
(a) do not require any further treatment in the clinic according to the judgment of the affiliated external physician in charge or
(b) expressly wish to be discharged.
(7) If the patient insists on his or her being discharged contrary to the physician's advice, or if he or she leaves the PAN without permission, the clinic shall not be held liable for any resulting consequences. An accompanying person shall be discharged, if the requirements according to paragraph 3 are not met.
Article 5 Remuneration
(1) The amount to be paid for the services rendered by the PAN shall comply with the clinic's internal scale of charges following the example of the DRG remuneration system as amended, which is incorporated into these GTC (see exhibit 1 regarding the DRG case-based flat rate accounting system). Due to the characteristic features of the system, a final assessment of the question of which case-based flat rate will be charged is only possible after the treatment has been carried out (after the patient has been discharged). Consequently, any previous classification (e.g. a cost estimate or an advance payment) shall not be binding.
(2) The clinic reserves the right to subsequently invoice services that are not part of the final invoice and to correct potential errors.
(3) The right of setoff against disputed claims or claims that have not been ascertained in a legally binding way shall be excluded.
(4) The invoicing of those services rendered in connection with the medical treatment shall be performed separately by the physician/surgeon in charge, the anaesthetist or the institution commissioned by the physician in charge, based on the GOÄ [Gebührenordnung für Ärzte, German medical fee schedule] and/or the GOZ [Gebührenordnung für Zahnärzte, German dentists' fee schedule].
(5) The PAN shall be entitled to demand advance payment regarding the costs of residential treatment, if the patient's health insurance has not yet confirmed complete cost coverage.
Article 6 Optional Services
The patient shall be admitted for residential treatment in a multi-bed room, respectively in a room without any element of comfort (e.g. bathroom). If requested, accommodation in a single room respectively in a two-bed room with its own bathroom and other elements of comfort will be offered at the respective current rates.
Article 7 Settlement of the Amount to be paid
(1) The amount to be paid for the treatment at the PAN shall be settled by way of making out an invoice to the patient. The PAN has not been generally authorized to treat patients insured under the public health insurance scheme to the account of the statutory health insurance. Therefore, as a general rule, the patients shall be obliged to pay for their treatment at the PAN themselves, unless such treatment is paid for by a private health insurance or if paragraph 2 below applies. It is recommended to obtain a treatment guarantee regarding the planned inpatient stay at the PAN before the treatment is started. Irrespective of such a guarantee, the patient shall be the primary debtor of the PAN.
(2) On the basis of contracts regarding integrated treatment, the PAN participates in the treatment of patients insured within the framework of a statutory health insurance scheme. Consequently, said patients insured within the framework of a statutory health insurance scheme also enjoy insurance coverage. If no insurance coverage by a statutory health insurance is granted or if optional services that are not covered by the statutory health insurance are made use of, the statutory health insurance shall not be obliged to perform according to the applicable statutory provisions. In this case, the hospital considers the patient as direct payer. It is recommended to obtain a treatment guarantee from the statutory health insurance regarding the planned inpatient stay at the PAN before the treatment is started.
(3) Direct payers shall be obliged to pay for the services of the clinic.
(4) The invoice amount shall be due and payable upon receipt of the invoice which is made out after the treatment has been ended.
(5) In case of a default in payment, interest of five percentage points above the base interest rate p.a. (art. 288 BGB [Bürgerliches Gesetzbuch, German Civil Code]) as well as reminder fees may be charged.
(6) The right of setoff against disputed claims or claims that have not been ascertained in a legally binding way shall be excluded.
Article 8 Invoicing of Special Services
(1) Those services exceeding the services contained in the case-based flat rate of the PAN shall be charged separately.
(2) Irrespective of a possible duty of the health insurance to refund the costs, the costs of these special services shall be borne directly and personally by the patient.
Article 9 Documents and Data
(1) The personal data, respectively the data regarding the patient shall be saved electronically and forwarded to third parties by the PAN, if necessary (e.g. by way of electronic data processing), unless the patient's interests are apparently violated by doing so.
(2) The data shall be processed and forwarded with due regard to the statutory provisions, in particular to the stipulations regarding data protection (article 3 of the Bundesdatenschutzgesetz [German Federal Data Protection Law]), medical confidentiality and social secret.
Article 10 Limitation of Liability
(1) The clinic shall not be held liable, if items brought in are lost or damaged, unless such loss or damage was due to willful misconduct or gross negligence.
(2) The PAN shall neither be liable for the services rendered by the affiliated external physicians nor for the services rendered by third parties charged by the affiliated external physician.
(3) The PAN shall not assume liability for accidents, damages, etc., if patients leave the area of the clinic during an inpatient stay without the prior written consent of the physician in charge.
(4) Patients who stay outside from time to time shall not be entitled to claim a refund credit slip for missed accommodation and catering services, not even if such temporary absence has been approved by a physician.
Article 11 Entry into Force / Severability
(1) These GTC shall enter into force on 1 May 2008. The treatment contract used so far shall simultaneously lose its effectiveness for the future.
(2) If any term or provision of these General Terms and Conditions is or becomes invalid, the validity of the remaining provisions shall not be affected thereby.