Manage Care Rating

Explanation

The Care Rating is the calculation method used in the institution to obtain the official care level as intended by the federal health insurance law (KVG/LAMal). This level allows you to obtain reimbursements from health insurance companies.

The care level is used to select the correct invoicing rule and Service and price to bill for stationary care.

Create a Care Rating

Use Tell me and search for Care rating and select Care Rating List. Now you can create a new rating, give a Code and select the Calculation Type between RUG or BESA. This selection will change the columns on the bottom of the page as RUG is based on a Swiss-Index table of care codes by level, while BESA is based on a table of period of Time spent in Minutes. Create a version for this rating and then, fill-out the table below for each level available in the rating.

For example, create one Care Rating for CH-IDX-BE-570 and then one version per rating year.

The Status is used to define if the new rating is ready to use, means Certified or still under development.

tip

You have 2 columns for the care level. The Internal Care Level, for the system internal usage, like pricing and service detection, evaluation definition as well as for your internal usage. The second one Authority Care Level, the official one, for the authorities, i.e. level 12-RMC and level 12-SE2 can be one single level 12 or differentiated levels for the autorities. It's the official one that will be exported, printed.

Assign a Care Rating

Select the desired Care Rating Code on the institution card.