Verweigerte Erstattung durch fehlende HTA-Konformität
Definition
Non-prescription or non-standard alternative treatments are excluded from SHI reimbursement, leading to unbilled or rejected claims if not properly documented.
Key Findings
- Financial Impact: 10-20% der Ansprüche unreimbursed, €500-2,000 pro verweigertem Fall
- Frequency: Bei OTC/Heilpraktiker-Leistungen ohne PKV-Vergütung
- Root Cause: Einschränkungen für OTC und nicht-standardisierte Therapien
Why This Matters
This pain point represents a significant opportunity for B2B solutions targeting Alternative Medicine.
Affected Stakeholders
Arzt/Heilpraktiker, Abrechnungsspezialist
Deep Analysis (Premium)
Financial Impact
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Current Workarounds
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Methodology & Sources
Data collected via OSINT from regulatory filings, industry audits, and verified case studies.
Related Business Risks
Verzögerte Abrechnung bei Heilpraktikern
GoBD-Verstoß bei manueller Abrechnung
BfArM-Prüfungsrisiken bei CAM-Produkten
Betrug durch unkontrollierte Barzahlungen
Kosten für ärztliches Attest und Führungszeugnis
Verlorene Rechnungen bei Paketabrechnung
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