Overview of Reimbursement by health insurers (focus on mandatory health insurance)Principles:WZW criteria (effectiveness, appropriateness, and economic efficiency) Tariff autonomyRelevant tariffs and their tariff organisationsSwissDRGST ReheTarmed/TardocNursing care (it isn’t a tariff, but also relevant)Binding lists, outside the area of competence of the tariff organisationsAnnex 1 KLV - undisputed medical servicesAnnex 1a KLV - medical services that are generally to be performed on an outpatient basisAnnex 2 KLV - medical devices for self-application and as a part of nursing careAnnex 3 KLV - laboratory analyses
Overview of Reimbursement by health insurers (focus on mandatory health insurance)
Principles:
- WZW criteria (effectiveness, appropriateness, and economic efficiency)
- Tariff autonomy
Relevant tariffs and their tariff organisations
- SwissDRG
- ST Rehe
- Tarmed/Tardoc
- Nursing care (it isn’t a tariff, but also relevant)
Binding lists, outside the area of competence of the tariff organisations
- Annex 1 KLV - undisputed medical services
- Annex 1a KLV - medical services that are generally to be performed on an outpatient basis
- Annex 2 KLV - medical devices for self-application and as a part of nursing care
- Annex 3 KLV - laboratory analyses