Alternative basic insurance models
In addition to the standard model, alternative models of basic insurance are also offered. The relevant information in this regard is provided below:
Family Doctor models: When taking out Family Doctor Insurance, insured persons agree that the coordinating doctor may receive access to the data necessary for this insurance model concerning diagnosis, treatment and billing in connection with the provision of medical care. This form of insurance also requires an exchange of data between the coordinating doctor, CSS, and any third parties involved.
The data in question concerns the diagnosis, treatment and billing of the insured persons. This data will be made available in particular to specialists, hospitals and other persons and institutions involved in organising or providing medical services for the purpose of performing the contract or if a change of coordinating doctor occurs.
Telmed models: When taking out a Telmed model, insured persons agree that CSS may process their personal data in order to determine the premium, process claims and perform statistical analyses.
CSS may pass on data to authorised third parties (in particular co-insurers or reinsurers) to the extent required and permitted by law. In addition, to the extent permitted by law, CSS may acquire data from service providers, other insurers and authorities as necessary to clarify the entitlement to benefits.
Within the framework of this insurance model, CSS delivers data pertaining to the insured person necessary for the performance of the contract to the telemedicine centre, in particular the insured person’s number, surname, first name, date of birth, gender, address, benefit statements and details of the insurance cover.
The telemedicine centre provides CSS with the data it requires to check the entitlement to benefits, in particular details of telephone calls (time of call) and the recommendations given. Health data pertaining to the insured person is only disclosed to the Medical Advisory Service of CSS.
Multimed: When taking out Multimed insurance, insured persons agree that CSS may process their personal data in order to determine the premium, process claims and perform statistical analyses of Multimed. Where necessary and permitted by law, CSS may disclose data to authorised third parties (e.g. service providers, other insurers, and authorities) and/or obtain data from these third parties to the same extent.
The information that is needed for treatment is available to all parties involved in the treatment in question (service providers and/or coordination partners) and may be exchanged between them or processed for the purposes of quality assurance and to ensure the best possible treatment. The data in question specifically concerns the diagnosis, treatment and billing of the insured person.
HMO model / group practice insurance (HMO): When taking out Health Maintenance Organisation Insurance (HMO model), insured persons agree that the coordinating doctor may receive access to the data necessary for this insurance model concerning diagnosis, treatment and billing in connection with the provision of medical care. This form of insurance also requires an exchange of data between the coordinating doctor, CSS, and any third parties involved.
The data in question concerns the diagnosis, treatment and billing of the insured persons. This data will be made available in particular to specialists, hospitals and other persons and institutions involved in organising or providing medical services for the purpose of performing the contract or if a change of coordinating doctor occurs.