Copy of the invoice

What is a copy of the invoice?

A copy of the invoice is a copy of a bill for medical services whose original goes not to you but directly to your health insurer. You receive it for information and checking. It is not a request for payment, even though it looks like a bill, often marked “copy” or “copy of the invoice for the patient”.

The background is the two billing systems of basic health insurance. Under the tiers garant system, the medical practice sends you the bill; you pay it and then submit it to your health insurer, which reimburses its share. Under the tiers payant system, the bill goes directly to the health insurer, which pays the service provider. That is exactly when you receive the copy of the invoice. For inpatient treatment, the health insurer always owes its share directly; in other areas, the system depends on what health insurers and service providers have agreed.

The copy of the invoice belongs to basic health insurance under the Federal Health Insurance Act (KVG). For benefits under supplementary insurance, the health insurer’s contract conditions apply, which often provide for similar procedures. Under the Health Insurance Ordinance (KVV), the service provider must in any case issue separate bills for basic health insurance benefits and other services.

How it works

Under tiers payant, the process has three steps:

1. Bill to the health insurer. After treatment, the practice, hospital or pharmacy sends the bill electronically to your health insurer.
2. Copy to you. At the same time, you must receive a copy, without having to ask for it. The copy can also be sent electronically, for example via a customer portal. The health insurer and the service provider may agree that the health insurer sends you the copy.
3. Statement of benefits. The health insurer checks the bill, pays it and sends you a statement of benefits. It shows how much was counted towards your deductible and how much retention fee you owe. The health insurer reclaims this part from you.

The bill must be set out in a way that you can follow. It contains the date of each treatment, the services provided in as much detail as the tariff requires, the diagnoses and procedures required for the tariff, your health insurance card number and your AHV number (OASI number). The type, duration and content of the treatment must be presented in an understandable way.

Medical information is sensitive. You can ask the service provider to disclose medical information only to the health insurer’s medical adviser and not to the claims staff.

Legal basis

Art. 42 KVG governs billing. Under para. 1, you owe the remuneration to the service provider unless otherwise agreed (tiers garant). Under para. 2, the health insurer and the service provider can agree that the health insurer owes the remuneration (tiers payant); for inpatient treatment, it owes its share in any case. Art. 42 para. 3 KVG requires a detailed and understandable bill and states that under tiers payant the service provider must, without being asked, send the insured person a copy of the bill sent to the health insurer. The health insurer may take this over if agreed, and the copy may be sent electronically.

Art. 42 para. 3ter KVG prescribes electronic transmission to the debtor and gives you the right to receive the bill on paper free of charge on request. Under Art. 42 para. 5 KVG, the service provider must, at your request, disclose medical information only to the health insurer’s medical adviser. Art. 59 KVV sets out the content of the bill, including the obligation to issue separate bills (para. 2) and to make them comprehensible (para. 4).

Example: physiotherapy with a high deductible

Sara is 29 years old and has chosen the CHF 2,500 deductible. In March 2026, she attends nine physiotherapy sessions prescribed by a doctor. The practice bills under tiers payant. Suppose the bill comes to CHF 480.

What this means for you

Do not file copies of invoices without reading them. Compare the date, number of treatments and services with what you actually received. The service provider will explain any unclear items; the law requires an understandable bill.

Keep the copy until the health insurer’s statement of benefits arrives, and compare the two. If the amounts do not match or a copy is missing, ask. If no copy of the invoice arrives even though the health insurer has settled a service, you may request it from the service provider or the health insurer.

Bills addressed to you (tiers garant) are not copies. You pay them and submit them to your health insurer with the reimbursement claim form. How your health insurer processes bills and through which channels you can reach it is set out in the health insurer profiles. You can save the results of our tools in your account. If you get nowhere with your health insurer, the Office of the health insurance ombudsperson helps free of charge.

Common mistakes

• Paying the copy. The copy of the invoice is not a request for payment. If you pay it anyway, you pay twice as soon as the health insurer sends its reimbursement claim.
• Submitting the copy to the health insurer. The health insurer already has the original. Documents submitted twice only lead to queries.
• Not reporting errors. You help pay for wrongly billed services through the deductible and retention fee. Report errors to the service provider first, then to the health insurer.
• Doing without paper even though you need it. The paper version is free of charge on request. No one may charge you a fee for it.

We explain how we handle documents and data under How we calculate.