Billing check at the end of the quarter (EBM)
At the end of the quarter, we check your family doctor bill for completeness and correct EBM numbers: missing services, inconsistent combinations and typical stumbling blocks with your KV. The collaboration is based on fixed prices - we will mention specific amounts in the discussion.
- Comparison of documentation and billed figures
- Correct setting of EBM numbers typical for general practitioners
- Prioritized to-do list for MFA and doctors
- Fixed prices – without hidden additional charges
GOÄ and private liquidation
For the private sector, we support the correct selection and justification of GOÄ digits - including factor and analogue evaluation, where they are technically viable.
- Examination of selected private cases
- Notes on increasing factors and justification
- Avoiding typical objections from insurers
Fee notice & objection
We compare your fee assessment with your billing and explain any reductions clearly. If an objection has a realistic prospect of success, we work with you to formulate the professional grounds for it.
- Comparison of notice vs. submitted statement
- Assessment: accept, ask or contradict
- [Placeholder: example case studies after approval]
Help with recourse claims from the examination body or health insurance companies
Performance audits and recourses in accordance with Section 106 SGB V are carried out by the joint audit bodies of KV and the health insurance companies; Inquiries can also come from health insurance companies. We support you with analysis, deadlines and the preparation of a statement – together with you; Legal advice remains with lawyers.
- Early warning of risky patterns
- Checklists for documentation and regulations
- Support with procedures of the examination body or health insurance companies
- Own page: Help with recourse claims
To the recourse page
Controlling for MVZ and group practices
Several doctors, employed staff, several focal points: We make it clear where fees are generated, where they are lost and whether personnel costs and billing fit together.
- Overviews per service provider
- Comparison with patterns common in specialist groups (if the database is available)
- Regular monitoring on request
Training for your practice team
Rules and regulations change faster than everyday practice. We train MFA and doctors on a practice-specific basis - on your cases, not on abstract slides.
- Short training courses on EBM focal points
- Coding and documentation in everyday life
- Refresher before the end of the quarter
