Outpatientization – evaluating opportunities and risks
Check for context factors and specification of GOP digits to be billed (EBM)
Functions of the AOP Analysis
The AOP analysis checks for the presence of procedures according to the AOP catalogue as well as hard and soft context factors on the basis of the § 21 data records. Justification texts are output for cases that were admitted as inpatients for medical or social reasons to ensure the success of the treatment. If AOP measures are available, GOP numbers incl. surcharges and supplements are shown, which can be billed in the case of outpatient service provision. This information is supplemented by the presentation of costs and revenues incurred by outpatient service provision in the inpatient setting.
These, like all other tools at “My Hospital”, are still usable free of charge until December 31, 2023.
- Occurrence of AOP services
- Output per department
Evaluation of the GOP (EBM)
- Automatic query between AOP and GOP
- Evaluation of associated surcharges and add-ons
Double context check
- Hard context factors from ICD-10 and OPS
- Soft context factors from other medical and social reasons
Calculation of costs and revenues
- What is the DRG revenue vs. the AOP revenue?
- How much does an AOP case cost that is performed in the hospital?
General platform functions
- Historical display of data since 2010 (trend graphs)
- Numerous filter parameters tailored to specific areas
- Display of results in various graphs
- Link to all platform areas
- Export function of result lists
- Analyzes of millions of data records in seconds
- Video tutorials
- Support by experts from the Reimbursement Institute
Specifically, these sources were used:
- BfArM – Official Classification of Diagnoses (ICD-10)
- BfArM – Official Classification for Operations and Procedures (OPS)
- DKG – Context factors