Proctology in Munich since 2013
Dr. Bernhard Hofer and Florian Liebl, specialists in visceral surgery* and proctology** welcome you to our practice located in the center of downtown Munich.
So if you have received a recommendation to see a proctologist, you are in the right place at our practice in Brienner Straße 13 above Café Luitpold, which is also ideally accessible by public transport - the underground station is directly in front of our entrance.
We are there for you when complaints of the sensitive anal region limit your quality of life. Trust our empathy and experience. The most common diagnoses in our practice are coccygeal fistula (30%), haemorrhoids (20%), anal fissure (10%) and anal eczema (5%, all data as of 2020).
Together with an employed specialist, 2 medical assistants, 2 nursing assistants and a registered nurse, we treat around 5,000 patients per year with 10,000 doctor-patient contacts (male: female = 61 % : 39 %). You benefit from this experience through a routine and smoothly running treatment.
We are licensed to treat insured persons of all statutory and private health insurance companies and to perform outpatient surgery. For you, this means that the costs for services included in the catalog of the statutory health insurance are offered without co-payment. Only some special, innovative therapy procedures can only be offered as self-pay services, about which we will inform you in individual cases.
Dr. Hofer completed further training as a surgeon in Munich, Mainz and Starnberg and in the focus of visceral surgery in Dachau. With Prof. Dr. Hager in Kronach he deepened the focus on proctology with a final examination at the State Medical Association.
Florian Liebl acquired his qualification as a visceral surgeon at Klinikum rechts der Isar and Klinikum Bogenhausen Munich. As a student of Prof. Dr. Iesalnieks, he expands our spectrum with the Karydakis and LIFT surgeries for coccyx and anal fistula
Visceral surgery (from Latin viscera = viscera ): Surgery of the organs of the abdominal cavity, the thyroid gland, the abdominal wall and the soft tissues of the body surface.
** Proctology (from the ancient Greek proktós = anus, rump): study of diseases of the rectum. Since the 2004 further training regulations, this has been an official additional title, which requires structured further training and an examination before the state medical association.
Specialised in rectum and coccygeal fistula
After 20 years of working in clinics, I took the step to become self-employed in 2013 and fulfilled my dream of having my own practice. My motivation was and is to be able to offer the best possible treatment for coccygeal fistula and haemorrhoids. In doing so, we are never satisfied with what we have achieved, but are constantly looking for ways to improve.
For example, I transferred the surgical strategy for minimally invasive thyroid surgery to surgery of the coccyx fistula and took over video endoscopy from arthroscopic joint surgery. We found particularly fine instruments among our colleagues in ENT and dentistry. Constant study of the specialist literature provides the necessary input for new ideas.
Despite our enthusiasm for progress, we never lose sight of proven techniques. In the treatment of chronic anal fissure and anal fistula, no new method has yet come close to conventional excision in terms of success rate. But even during these operations, lasers and magnifying glasses ensure improved precision.
Our operations take place in the practice and in the Iatros Clinic (outpatient surgery centre). In matters of hygiene, we are advised and regularly audited by the hospital hygienists and hygiene specialists of the German Advisory Centre for Hygiene (BZH).
We always have an open ear for your questions and try to offer a suitable appointment even if your calendar is full. For patients who are not from the Munich area, we offer a post-treatment service via email or messenger (Threema) after treatment has taken place.
Specialists with experience
No matter which of our specialists you go to - you will get the best possible treatment. Our concept is uniform and is implemented by both doctors equally and from a single source. We have independently developed treatment options and can thus offer you specialist care in this field.
As of January 01, 2022, there are still 97 statutory health insurance funds in Germany. In principle, we can treat members of these health insurance funds at the expense of the health insurance fund if a valid insurance card is presented and the requested service is included in the catalog of services, the Einheitlicher Bewertungsmaßstab (EBM). The EBM system is based on flat rates per case and per service. For example, we currently receive a flat rate of €26.02 per quarter (as of 11/2022) for the treatment of a patient with statutory health insurance, €10.59 for a rectal endoscopy and €9.13 for a hemorrhoid sclerotherapy.
Whether or not a service is covered by the health insurance fund is not decided by the individual health insurance fund itself, but by the Joint Federal Committee (GBA). The basis for the decision is what is "medically necessary". Retinal surgery, for example, is medically necessary. However, laser treatment for extreme defective vision is considered a cosmetic procedure, since one could also wear glasses.
Treatments outside the benefits catalog can be approved in individual cases. However, the application for cost coverage must always be submitted before the treatment is carried out. Frequently, the health insurance company must involve the medical service of the health insurance companies (MDK) for assessment. In our field, most of these individual case applications are rejected.
If a treatment is not included in the benefits catalog, in some cases and with some insurance companies the treatment can be settled via integrated care (see below).
If this is also not possible in the given case, the patient can have the treatment performed as a self-payer. We can offer more favorable conditions for a patient with statutory insurance than for an uninsured self-payer from abroad, for example. Please ask us for an individual cost estimate. Payment by installments is possible upon request.
Integrated care (IGV) was introduced with the 2000 SHI health reform to promote the interlinking of the outpatient and inpatient sectors and further developed with the SHI Modernization Act. Within this framework, health insurance funds are allowed to conclude individual contracts with service providers that basically cover all medical issues, but can also cover individual diagnoses or special forms of treatment.
Participating contractual health insurers thus enable their insureds to access innovative forms of treatment without co-payment, among other things. The insured person(s) must confirm their participation in the respective contract by signing it.
In our specialty, there are care contracts for the minimally invasive surgery of coccygeal fistula (sinus pilonidalis) as well as laser surgery for anal fissure (anal fissure), anal fistula and hemorrhoids. Billing is done by independent management companies, we are contract partners of Micado Health Care (mainly company health insurances BKK) and IVM plus (among others IKK classic).
If your insurance company is not a contractual partner for a desired treatment, you would in principle have the option of changing health insurance companies. However, if you are otherwise satisfied with your insurance, you will not necessarily want to change health insurers because of an operation. After applying for a change, you have to wait 2 months before you are allowed to receive benefits from the new insurance company.
All standard services are billed according to the recognized principles of the official fee schedule for physicians (GOÄ) and adhere to the fee framework with a maximum increase rate of 3.5 depending on the difficulty and time required. Discussions sometimes arise with so-called analog digits, which are used for innovative therapy procedures that are not yet found in the 30-year-old GOÄ. For extraordinarily complex therapy procedures that cannot be adequately represented within the fee framework of the GOÄ, we will contact you regarding an individual fee agreement.
We have transferred the practical execution of the invoicing and dunning process to bfs+ health finance GmbH. We will therefore ask for your consent to forward the billing data to this company when you first visit our practice. If you do not agree to this, we can also complete your invoice immediately after the treatment and send it to you.
Basically, self-pay treatment is available for two groups of people: