Verweigerte Erstattungen durch ungenaue Notwendigkeitsnachweise
Definition
SHI reimburses only approved therapies with proven necessity; failures in documentation lead to systematic revenue leakage amid tightened 2025 HTA rules.
Key Findings
- Financial Impact: €100-150 pro abgelehnter Sitzung; 10-20 Stunden/Monat Rebilling
- Frequency: Bei jeder Abrechnungsrunde
- Root Cause: Fehlende digitale Nachverfolgung von Besuchsgrenzen
Why This Matters
This pain point represents a significant opportunity for B2B solutions targeting Physical, Occupational and Speech Therapists.
Affected Stakeholders
Physio-/Ergo-/Logo-Therapeuten, Praxisverwalter
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
Bußgelder bei Überschreitung der Besuchsobergrenzen und fehlender medizinischer Notwendigkeitsprüfung
Kapazitätsverluste durch manuelle Obergrenzen-Überwachung
Diebstahl von Physiotherapiegeräten und Zubehör
GoBD-Verstöße bei Inventurunterlagen
Ausrüstungsstillstand durch fehlende Inventarverfügbarkeit
Qualitätsmängel bei Outcome-Messung unter KHVVG
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