Verzögerte Abrechnung von DiGA-Leistungen
Definition
Claims for behavioral health services using DiGA involve physician prescription or patient request to statutory health insurance (GKV), with verification delays before activation codes are issued, causing time-to-cash drag via high Accounts Receivable days.
Key Findings
- Financial Impact: 20-40 hours/month manual verification per provider; 15% of DiGAs via direct request amplifying delays
- Frequency: Per claim, especially 15% direct patient requests
- Root Cause: Manual verification by health insurers post-prescription; lack of automation in claims coding (OPS 2025 updates)
Why This Matters
This pain point represents a significant opportunity for B2B solutions targeting Mental Health Care.
Affected Stakeholders
Ärzte, Psychotherapeuten, Mental Health Practices, GKV-Kassen
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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
Fehlerhafte OPS-Codierung in Verhaltenstherapie-Abrechnungen
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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