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CSS Insurance

How do I read the benefit statement?

The benefit statement gives you an overview and information in detail about the processed bill.

The overview (page 1)

The first page gives you an overview of the bills that have been processed for each insured person.
All amounts are shown in Swiss francs (CHF).

leistungsabrechnung_d_1

A

All bills are numbered to allow you to find them quickly in the detailed overview (next page).

B

Amount billed by the service provider (doctor, hospital, pharmacist, laboratory, physiotherapist, etc.).

C

Amount in your favour per bill

E

At the end, you will find the total “Amount in your favour” / “Amount in our favour”, i.e. the amount due to you or due to us for the benefit statement as a whole.

D

Amount in our favour per bill

The details (following page)

leistungsabrechnung_d_2

Your co-payment is made up of:

F

your chosen deductible

G

and the retention fee

orange

Summary of the billing data (service provider, treatment date, billing amount)

gelb

Information showing under which insurance products the benefits are paid. In this example: under Profit Family Doctor Insurance (KVG)

blau

Information regarding the co-payments in question

gruengrau

Total amount in your favour/in our favour: Carried over

Each bill from a service provider that has been processed is shown individually

rueckerstattung

“Refund to client”:
You submitted the bill to us.

“Direct payment”:
The service provider (doctor, hospital, laboratory, physiotherapist, etc.) submitted the bill to us directly.

This overview shows the co-payments you have made for the calendar year. All co-payments to date, including the latest, have been taken into account.