Outpatient Reimbursement

 

Regulations for outpatient billing in hospitals

Interface between aG-DRG and AOP, EBM & Hybrid-DRG

AOP catalog
EBM catalog
Hybrid-DRG catalog

Functions of the “AOP, EBM and Hybrid-DRG catalog” areas

The “AOP catalog”, “EBM catalog” and “Hybrid-DRG catalog” areas are based on the officially published AOP catalogs and establish the link to the outpatient remuneration system via the uniform valuation standard (EBM). Furthermore, the Hybrid-DRG catalog, which will be valid from 2024, has been included in the “Catalogs” menu item.

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AOP catalog

  • Insight into the AOP catalog incl. context factors
  • Direct connection to the EBM catalog
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Hybrid-DRG catalog

  • Revenues from Hybrid-DRG
  • Nursing revenue valuation ratio
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EBM catalog

  • Billing information and reimbursement
  • Connection to related GOP Codes
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Link to § 21 data sets

  • Analysis of hospital-specific outpatientization
  • Risks and opportunities for hospital planning

Are you already familiar with the new Context Grouper?

Inpatient admission or outpatient surgery? Check the case for possible context factors BEFORE admission. If the case has no context factors, the billable EBM (GOPs) will be displayed!

 

Learn more about the Context Grouper

General platform functions

  • Historical display of data since 2006 (trend graphs)
  • Numerous filter parameters tailored to specific areas
  • Display of results in various graphs
  • Link to all platform areas
  • incl. export function in all areas
  • Available in German and English
  • Integrated video learning platform for all areas
  • Support from experts at the Reimbursement Institute

Source

The information presented here is based on information from the official regulations of the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) in cooperation with the German Hospital Federation e.V. (DKG). Information from the Federal Ministry of Health (BMG) and the Institute for the Hospital Remuneration System (InEK) was also used.

In detail, these sources were used:

  • BMG and InEK – Hybrid-DRG catalog
  • DKG and GKV – AOP catalog
  • KBV – EBM catalog