Fehlerhafte OPS-Codierung in Verhaltenstherapie-Abrechnungen
Definition
Annual OPS updates require exact coding for procedures including behavioral health; errors in claims submission result in reimbursement denials or audit penalties under GoBD/DATEV standards.
Key Findings
- Financial Impact: €5,000+ per Betriebsprüfung violation; 2-5% revenue loss from rejected claims
- Frequency: Annual OPS updates (e.g., 185 changes in 2025)
- Root Cause: Manual handling of OPS/ICD codes for behavioral therapies; integration friction with DATEV
Why This Matters
This pain point represents a significant opportunity for B2B solutions targeting Mental Health Care.
Affected Stakeholders
Abrechnungsabteilungen, Ärzte mit Privatpraxen, Kliniken
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
Verhandlungsverzögerungen bei DiGA-Preisen
Verzögerte Abrechnung von DiGA-Leistungen
DSGVO-Bußgelder bei Verletzung der Schweigepflicht in der Suchttherapie
Zeitknappheit bei Patientenkontakten durch Koordinationsaufgaben
Bürokratische Overhead-Kosten für Schweigepflicht-Compliance
Kostspielige Behandlungs-Readmission durch Koordinationsdefizite
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