G-DRG System for hospital reimbursement
The procedure to submit a supplemental fee (Zusatzentgeld = ZE) is part of the regular annual DRG-system update process; which aims at involving medical, scientific, and other competencies in the development of the G-DRG system.
As part of the self-administration process of the German Health Care System, the InEK updates the G-DRG system for Hospital reimbursement annually in a structured dialogue with qualified organizations as medical societies and associations. Applications should be preferably submitted by these organizations; but can also be submitted by hospitals or individuals.
German Reimbursement System
The process implies a formal request to InEK along the standard format; which is provided by the InEK data portal. It needs to support the requirement for a new method; and in a very detailed way, needs to describe the reimbursement gaps in comparison to the existing DRG-reimbursement for themethod.
The assessment of the need for a ZE / DRG proposal; and the creation of the proposal document, require a profound knowledge about the German reimbursement system in order to maximize the likelihood to be successfully integrated.
A successful ZE / DRG Proposal
At Kalms Consulting, we offer our experience in the process of the ZE / DRG submission in defining the appropriate strategy, liaising with manufacturers and medical societies, and producing the documentation based on our reimbursement analytics and communication with InEK.
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