GENERAL TERMS OF TREATMENT (ABB)

§1 SCOPE OF APPLICATION

Unless agreed otherwise, the ABB apply to the contractual relations between Westfalenklinik GmbH, specialist clinic for plastic and aesthetic surgery (hereinafter the “Clinic”), and patients in respect of outpatient and inpatient clinic services.

§2 LEGAL RELATIONSHIP

The ABB form part of every treatment offer made by the Clinic. The ABB are always handed to patients together with the individual treatment offer, either in person or by electronic means. They become legally effective for patients once these have accepted the Clinic’s treatment offer, namely either

1. by paying a deposit on the treatment amount of currently €1,750 into the Clinic’s stated bank account, or
2. by approval of the patients’ financing application, required for the treatment amount, by the Clinic’s respective current financing partner.

§3 SCOPE OF THE CLINIC’S SERVICES

(1) The outpatient and inpatient services of the Clinic comprise the general clinic services required to carry out the treatment agreed in each case, i.e. medical, anaesthetic, nursing, ward and catering services and, where applicable, individual optional services. The medicines and benefits in kind required to carry out the treatment are also included.

(2) General clinic services are those services which, taking into account the Clinic’s capacity, are necessary for medically appropriate and sufficient care. Under these conditions, this also includes services of third parties arranged by the Clinic.

(3) Aids that are given to the patient at the end of the stay in the clinic (e.g. girdles/support bras) are not part of the general clinic services, unless something else has been agreed in writing between the Clinic and the patients.

(4) The Clinic’s contractual offer extends only to those services for which the Clinic is equipped in terms of staff and facilities within the scope of its medical objectives.

§4 ADMISSION, TRANSFER AND DISCHARGE

(1) Within the limits of the Clinic’s capacity, anyone who requires full inpatient treatment in the clinic is admitted.

(2) Where medically necessary (in particular in emergencies), patients may be transferred to another hospital. The transfer is agreed with the patient beforehand, as far as possible. A transfer to a hospital close to the patient’s home that takes place at the patient’s request, without medical necessity, at the expense of the German statutory health insurance fund is, in accordance with § 60 SGB V, subject to the consent of the statutory health insurance fund where a case-based flat rate is billed. If the statutory health insurance fund refuses its consent, the transfer takes place only at the express request and at the own expense of the patient. The Clinic informs the patient of this.

(3) Anyone who, in the judgement of the Clinic’s treating physician, no longer requires treatment by the Clinic, or who expressly requests discharge, is discharged. If the patient insists on being discharged against medical advice or leaves the Clinic without permission, the Clinic is not liable for the resulting consequences.

§5 TREATMENT COSTS

(1) The fee to be paid by patients for the Clinic’s treatment costs in accordance with the Clinic’s treatment offer is set, where applicable, in deviation from the Gebührenordnung der Ärzte (GOÄ, the German medical fee schedule).

(2)Neither the general clinic services nor any optional services of the Clinic are covered by German statutory health insurance. In accordance with the statutory provisions in force at the time, there is accordingly no obligation to pay benefits on the part of a public-law payer (e.g. a health insurance fund). Vis-à-vis the Clinic, patients are therefore always self-pay patients, meaning that they themselves are obliged to pay the treatment amount for the Clinic’s services used.

(3) The full treatment price, in accordance with the total amount stated in the treatment offer, falls due for payment 7 days before the treatment to which consent was previously given by way of the down payment.

(4) In the event of late payment, default interest of 5 percentage points p.a. above the base rate valid at the time (§288 BGB) and reminder fees of €10 for each reminder letter to be sent may be charged.

(5) Set-off against disputed claims or claims that have not been established with final and binding effect is excluded.

§6 CANCELLATION AND PROCESSING FEES

(1) If a patient cancels (“withdrawal”) or if a patient wishes to postpone a treatment offer that has already been accepted within the meaning of §2, the Clinic charges a processing fee and, in the case of cancellation by a patient (“withdrawal”), additionally a cancellation fee.

(2) The processing fee is charged for administrative handling and amounts to €250.

(3) The cancellation fee is charged to compensate for preliminary services already rendered and as financial compensation. It is graduated and depends on the time remaining between the time of cancellation and the treatment appointment committed to by the patients in accordance with the Clinic’s treatment offer. In the event of cancellation, it amounts to

more than 14 days before the treatment: €300;

14 days to 8 days before the treatment: 30% of the invoiced treatment price, but at least €300 and at most €1,500;

7 days to 1 day before the treatment: 50% of the invoiced treatment price, but at least €300;

in the event of cancellation, postponement or absence on the day of treatment: 80% of the invoiced treatment price, but at least €300.

The day of treatment itself is not to be included in the calculation of the aforementioned periods. If a postponement on the part of the patient first takes place and a cancellation (“withdrawal”) follows, (1) to (3) apply accordingly in such a case. However, the basis for calculating the amount of the fees incurred is then the period between the time of the first postponement by the patients and the treatment appointment originally committed to by the patients in accordance with the Clinic’s treatment offer (first treatment appointment). Processing fees charged in the interim are thus not offset.

(4) The cancellation fee is to be set higher or lower if the Clinic can prove a higher loss or the patients can prove a lower loss.

(5) In derogation from (3) and (4), in the case of serial treatments (e.g. multi-stage combination operations, serial liposuction or lipoedema operations, serial minimally invasive treatments, among others), instead of a cancellation fee, those parts of the services are invoiced that had already been performed by the Clinic at the time of cancellation (“withdrawal”) or postponement, as the case may be, by the patient. The list price valid in each case for these individual parts of the services at the time of cancellation (“withdrawal”) or postponement, as the case may be, by the patient is decisive for the calculation.

(6) All fees and/or additional claims for parts of the services rendered fall due immediately upon cancellation of the respective treatment. If the amount of the fees and/or additional claims exceeds the payments already made by the patients, the patients are obliged to pay the difference.

(7) A cancellation or postponement by patients must always be made in text form. The date on which the cancellation or postponement is received by the Clinic is the basis for calculating the fees.

(8) If the treatment appointment agreed on the basis of the accepted treatment offer has to be postponed because of illness, the fees under (1) to (3) are waived only if the patients submit a medical certificate to the Clinic, at least in digital form, no later than the second working day following notification of the necessary postponement. The patients must then agree a new treatment appointment and pay a reduced processing fee of €150 to the Clinic for it. If the patients subsequently withdraw from their treatment definitively, (1) to (3) apply accordingly in such a case. However, the basis for calculating the amount of the fees incurred is then the period between the time of the first postponement by the patients and the treatment appointment originally committed to by the patients in accordance with the Clinic’s treatment offer (first treatment appointment). Processing fees charged in the interim are thus not offset.

(9) If a treatment appointment has to be postponed for internal operational reasons of the Clinic, the Clinic undertakes to inform the patients of this without delay and to propose a new treatment appointment.

§7 COST CONTRIBUTION FOR CONSEQUENTIAL ILLNESSES

Patients of the Clinic are informed, and must be aware, that the medical services offered by the Clinic are measures that are not medically indicated. The patients are informed and advised about the provisions of the Gesundheitsreformgesetz (Health Reform Act) that came into force on 1 April 2007. In particular, the following statutory clause of SGB V §52 para. 2 is known in this regard: “If insured persons have contracted an illness through a measure that is not medically indicated, such as an aesthetic operation, a tattoo or a piercing, the health insurance fund must require the insured persons to contribute to the costs to an appropriate extent and must refuse or reclaim the sickness benefit, in whole or in part, for the duration of this treatment.”

By accepting the Clinic’s treatment offer, the patients are aware of the economic consequences of this provision and understand the statutory framework.

§ 8 OBLIGATION TO PAY IF A MEDICAL CONTRAINDICATION IS FOUND

The determination of a medical contraindication (e.g. taking blood-thinning medication, not having fasted on the day of treatment, for example due to food residues in the stomach) which prevents the Clinic from carrying out the treatment is rare in the course of treatment, but not ruled out. If, following such a medical assessment, the planned treatment cannot be carried out, the Clinic charges a treatment fee of 20% of the agreed treatment amount for the expenses incurred up to that point. No further invoicing of the agreed total treatment amount takes place, provided that, at the time of the medical decision, the patient has not made use, and is not making use, of any other general clinic services or optional services of the Clinic, in part or in full. The invoice is issued immediately after the procedure.

§9 MEDICAL PROCEDURES

(1) Interventions affecting the patient’s physical and mental-psychological integrity are carried out only after the patient has been informed about the significance and scope of the procedure and has given consent.

(2) If the patient is unable to give consent, the procedure is carried out without express consent if, in the opinion of the responsible clinic physician, it is required without delay in order to avert an imminent danger to life or because of an imminent serious impairment of the patient’s state of health.

(3) The patient consents to those preliminary examinations that the treating physician considers necessary for the purposes of medical treatment and out of consideration for the treating staff. The patient expressly consents to a blood sample being taken for the purpose of testing for the presence of an HIV infection if this test is indicated from a medical point of view. From a medical point of view, examinations are indicated for the differential-diagnostic clarification of complaints for which an HIV infection is also a possible cause, for the inclusion of any immune deficiency in the assessment of whether

1. a particular therapy (in particular an operation) should be carried out,
2. for the protection of clinic staff from HIV infection (e.g. needlestick injury or blood/ skin contact with infected patients),
3. for the protection of patients from possible infection.

This information informs the patient about the nature, extent, significance and scope, as well as the reason for carrying out the HIV test, and about its possible consequences.

§10 UNFITNESS TO DRIVE AFTER OUTPATIENT TREATMENTS

By accepting the Clinic’s treatment offer, the Clinic’s patients accept that alertness, speed and reliability of reaction, and the ability to coordinate and concentrate may be impaired on the day of treatment to such an extent that driving a motor vehicle or using other technical equipment is not possible on the day of the procedure after the treatment. In this respect, in particular treatments involving anaesthesia services of the Clinic (including so-called sedation using Propofol, Dormicum and/or Midazolan) can only be carried out on an outpatient basis if the patients are collected by an accompanying person after an appropriate rest period at the Clinic.

§11 IMAGE DOCUMENTATION

The patient consents to images being taken for the documentation of nursing and therapeutic measures during the patient’s inpatient stay in one of the Clinic’s private clinics. The patient further consents to the images taken being used for study purposes and for publications in the context of continuing education and training and/or medical papers.

§12 RECORDS AND DATA, DECLARATION OF CONSENT AND RELEASE FROM MEDICAL CONFIDENTIALITY

(1) Patient files and patient histories, in particular documentation of the course of treatment, examination findings, recordings made with diagnostic medical devices, image documentation and other records, are the property of the Clinic.

(2) Patients have no right to the surrender of the original documents. Deviating statutory provisions remain unaffected.

(3) The right of the patient, or of a person authorised by the patient, to inspect the records and, where applicable, to be provided with copies at the patient’s expense, and the duty of the Clinic’s treating physician to provide information, remain unaffected.

(4) By signing the information and consent documents, the patient consents to the electronic storage of their data in the Clinic’s hospital information system (KIS), to the (digital) photographic documentation of the treatment, to the transfer of data to third parties involved in the treatment, and to the anonymous use of the data for scientific purposes. In addition, the Clinic may write to the patient as part of a satisfaction survey.

(5) The processing of the data, including their disclosure, takes place in compliance with the statutory provisions, in particular the provisions on data protection, medical confidentiality and social confidentiality.

(6) Patients who opt for certain optional services of the Clinic that are provided by external third parties expressly consent to the

1. disclosure of the information required for the purpose of registration for the provision of nutrition and fitness programmes, in particular data from the patient file (name , date of birth, address, treatment data), to Oviva AG, Dortustraße 48, 14467 Potsdam;
2. disclosure of the information required in each case for the purpose of financing, in particular data from the patient file (name, date of birth, address), to medipay GmbH, sales financing, Am Turm 22, 53721 Siegburg (hereinafter medipay). In this respect, patients release the Clinic and their treating physician from the latter’s medical confidentiality under §203 StGB, insofar as this is necessary for billing, for asserting the claim and for obtaining a credit report.
3. disclosure of the information required for the purpose of taking out a follow-up cost insurance policy from the provider MedAssure, in particular data from the patient file (name, date of birth, address) and procedure-related data (surgeon, type and date of treatment), to Jahnke Hoyer & Cie. GmbH and its affiliated company JHC Service GmbH, each with its registered office at Konrad-Adenauer-Ufer 39, 50668 Cologne, insofar as this is necessary for the conclusion of the insurance contract with the patient and for the insurance cover to take effect.

After the statutory retention periods have expired, the data are destroyed in accordance with the provisions on data protection.

§ 13 ITEMS BROUGHT IN

(1) Only the necessary clothing and everyday items should be brought into the Clinic.

(2) Items left behind become the property of the Clinic if they are not collected within 12 weeks of being requested to do so.

(3) In the case of para. 2, the request expressly points out that the claim for surrender is waived, with the result that the items left behind become the property of the Clinic after the period has expired.

(4) Para. 2 does not apply to items from a deceased person’s estate or to money and valuables held in safekeeping by the administration. The storage, surrender and realisation of these items take place in compliance with the statutory provisions.

§ 14 LIMITATION OF LIABILITY

(1) The Clinic is liable in accordance with the statutory provisions. Liability presupposes that the patient fully complies with the instructions of the treating physicians and nursing staff.

(2) The Clinic is liable for the loss of or damage to belongings brought in that remain in the patient’s custody, or to the patient’s vehicles parked on the clinic grounds or in a car park provided by the Clinic, only in cases of intent and gross negligence. The Clinic accepts no liability for money and valuables that have not been deposited if they are lost, destroyed or otherwise reduced in value. For deposited money or valuables, e.g. jewellery or electronic devices, worth more than €500 (in words: five hundred euros), the Clinic excludes any liability.

§ 15 PLACE OF PAYMENT

Patients who are obliged to pay must discharge their debt at their own risk and expense in Dortmund, at the registered office of the Clinic’s operator.

§ 16 ENTRY INTO FORCE

These ABB come into force on 1 September 2023. At the same time, the earlier version of the ABB is repealed.

As at: 1 September 2023; version: 2.0