The service provider and health insurer agree on the XML standard, tariff and provider.
Once these points have been defined, the service provider can start sending bills, commitments to provide cover and needs or care assessments digitally via the XML interface. These will be received in digital form by the health insurer. Rejections can also be sent and received through this channel.
In Switzerland, the standards and guidelines required for the exchange of digital data are defined by the Forum Datenaustausch organisation. The Forum’s membership is made up of associations representing the service providers and health insurers. The standards result in agile processes and contain requirements for commitments to provide cover, needs assessments, bills for services and reminders. When data is being transmitted, data security and confidential handling is guaranteed by ISO-27001 and VDSZ-intermediary certification.
Data protection, data security and logging requirements are complied with at all times in order to protect clients. Therefore, encryption is used – as in online banking.
Confidential personal data is transported via the selected intermediary. It must be protected against unauthorised access. Data transport via the intermediary is designed to meet particularly stringent security and privacy requirements. Data is exchanged over the internet; documents are encrypted using SSL technology – in a similar way to online banking applications, for example.
To make sure digital benefit statements, commitments to provide cover and needs assessments can be verified correctly, services must be invoiced using a recognised tariff structure. The Forum Datenaustausch organisation provides a complete, up-to-date list of the tariff types. The tariffs listed there enjoy industry backing.
You create the request for a commitment to provide cover / the needs (or care) assessment in your sector-specific application. The requests will be encrypted and sent by your software partner to the insurer and / or the cantonal authorities. Requests can be identified and traced in the sector-specific application at any time.
Once they've been processed by the insurer, you'll receive a message directly in your sector-specific application. The next step(s) in your process can be automatically triggered.
No. You enter both standards in the same software module in parallel with the respective analogue data.
No. The Forum standard allows you to use the same systems that you're currently using for digital billing. You don't need any new systems or any new support know-how, and you won't have any additional operating expenses.
The standard is provided by Forum Datenaustausch free of charge. Costs may be charged by the application manufacturers and by the intermediaries for their services. Please contact your software partner directly for more information.
- Hospital VVG & OKP
- Nursing home
- Others are currently being developed
Please send around five test bills to our test GLN 2099988870314.
- Select test mode to send these test bills.
- Please inform us promptly that you are sending the test documents. That way, we can confirm that we have received the bills and check them.
If you would like to test the digital commitment to provide cover or the digital needs assessment, please contact us directly.