Motion Buffat (18.3513): KVG. Increase efficiency and reduce costs thanks to digitalization
Submitted text
The Federal Council is instructed to Technical requirements for electronic billing of services under the KVG to be specified as follows: After an appropriate transitional period, settlements under the KVG are to be only via an electronic application to the health insurance company with structured and standardized data. The Federal Council shall regulate any exceptions.
Justification
The KVG stipulates that the Health insurers review the bills of service providers. Every year, for example, around 120 million invoices, the form and quality of which can vary greatly, have to be stored and checked. The number of invoices is constantly increasing. In order to ensure modern, efficient, fast and at the same time careful control of the services charged to the compulsory health care insurances, it is of central importance to implement a system for digital recording and for structured and standardized data transmission between the service providers and the health insurers. The transmission of scanned documents is therefore not sufficient. Digital formats are much less error-prone and store structured and standardized data. Such formats are beneficial to healthcare providers because fewer errors mean fewer rejected invoices, fewer queries and fewer requested reports, and therefore faster payments. In addition, such data formats allow health insurers to use largely automated processes to verify invoices not only more quickly, but also more accurately. In this way, health insurers can fulfill their legally defined task even more efficiently. This has an impact on premiums and therefore also benefits premium and tax payers.
Statement of the Federal Council of 14.9.18
The Federal Council supports the motion’s concern that service providers should in future transmit invoices to health insurers electronically in a structured and standardized form. Digital billing is also already mentioned in Motion 17.4270 Brand “KVG. Transparency in the billing of services according to Tarmed”, which the Federal Council has requested be accepted. The motion 18.3664 Grossen Jürg “Digitalization also in the healthcare sector. All invoices should be sent electronically to health insurers”, calls for electronic invoice transmission from the service provider to the health insurer. However, the Federal Council points out that the Obligation to transmit invoices electronically may not be extended to insured persons.
The Federal Council is aware that such applications already exist between insurers and service providers in some areas and that efforts are underway in other areas to standardize electronic invoice transmission by means of a platform. It supports these efforts and would like to continue to leave the design of the instruments required for the transmission process to the parties concerned.