reimbursement.INFO – We make the difference!
– Your hospital analysis system –
for hospitals, manufacturers, professional associations & consultants!
The online platform reimbursement.INFO not only provides data. We have created a system in which you can view and analyze ALL relevant information on inpatient services and billing as well as on the reimbursement of inpatient and outpatient services without having to leave the platform.
Our team of experts provides personal support for all content-related questions. As authors of the now standard reference books “Das aG-DRG System” and “Das aG-DRG Kompendium“, we have in-depth knowledge that goes far beyond the world of data. We would like to take this opportunity to thank you for selling > 3,000 books!
Find out more about the special features of the individual areas (tools) by clicking on the desired box.
General Features
All inclusive solution
During your one-year license term, you receive unrestricted full access to all existing tools, newly added data, further developments and updates – without additional costs!
It is not possible to outsource individual tools, as all tools are linked together like clockwork.
Your benefit:
- No invoices during the year – security in your budget planning!
- Excellent 360° analysis experience – be guided and inspired by the interactive tool link!
- No maintenance of complex roles and rights systems – neither for you nor for us. This saves valuable time and costs!
Video platform
We have produced short and informative videos for all areas that illustrate the functions of the platform in the various areas. The video platform can be accessed after registration and can be accessed by clicking on the video icons in the individual tools.
Transparent
We always clearly show the sources of the data displayed and provide a comprehensive description of the content shown. This means that you always know the characteristics of the individual data so that you can make a clear interpretation. As we operate a scientifically oriented database, we do not use any extrapolation calculations that you cannot understand.
Help Center
As the publisher of the Book aG-DRG Compendium, which is now used as a standard work in many colleges and universities, we have integrated this comprehensive work into the platform. You can therefore clarify terms that you are not familiar with or for which you require detailed information at any time. More than 150 individual articles from aG-DRG to additional fees are available to you. Select a search term in the Help Center or enter the search term in the global search. In the Help Center, you will also find our blog posts and news, which provide you with regular updates and publications.
Multilingual
The platform can be used in English and German. Select the desired language when registering or change it in the “Personal data” section.
Teamplayer
If you wish, you can work together with your colleagues in one organization and share filter forms and areas. This means that you never run the risk of a colleague using different filter parameters for an analysis, resulting in different results! It is also possible to create an additional organization per user, e.g. for sensitive and confidential projects or analyses.
Filter and memory function
All filters can be individually named and saved. This means that you and your colleagues can use the individual name to carry out consistent analyses even after a longer break. The filter parameters are not only diverse, they also have a wide range of operator fields. You determine whether the desired filter parameter should restrict your search results by adding the rule. For example, ‘all with’, ‘without’, ‘between x and y’, ‘<=’ or ‘>=’and much more, should limit your search results.
A small side effect: The name you choose also appears in the legend names of the displayed graphics, which are available for download. This saves you the time-consuming task of creating graphics in Excel.
Global search
The global search shows you results based on your input, which is fed from all tools/content on the platform. The search hits are provided with an abbreviation that directly shows you the range of search hits. The search can be used via terms or codes, whereby special characters do not need to be entered. The results can be narrowed down further using shortcuts (e.g. hypo ops) or by using various filter parameters.
Grouper, Tools und Calculators
DRG & SG-Grouper
This InEK-certified grouper has a free input mask that can be used either with the ‘with the’ or ‘without the’ service group version. The input fields required for the calculation change depending on the selection. All entries can be saved and shared within the team if desired.
Context-Grouper
This grouper, developed by the experts at the Reimbursement Institute, shows whether a procedure is related to the outpatient area according to AOP or hybrid DRG. A colour-coded display provides an immediate overview of whether the case requires additional information or whether inpatient admission is possible without any issues.
AOP Analysis
This tool requires a §21 data set to be imported in order to output the results. Initially, all cases of your imported data that contain one or more defined AOP-OPS codes are checked. Various filter parameters are available to narrow down the results list. For example, cases can be filtered out that represent further surgical, interventional or special diagnostic measures that require the special resources and facilities of a hospital.
The cases determined in this way are displayed for each clinic department. This data is also checked for the presence of contextual factors. This provides a quick overview of your potential for outpatient treatment in each specialist department. In a further step, we check your cases for “soft context factors” and issue individual MBEGs for these. This tool can also be used for prospective use. Thanks to the direct link to the EBM catalog, we also calculate the possible revenue via billing in accordance with §115b SGB V and provide you with the GOP numbers used for your billing. The costs arising from the provision of an outpatient service in an inpatient setting are also calculated. A direct link to the Case Explorer provides an insight into the individual cases.
Hybrid-DRG Analysis
The Hybrid-DRG Analysis requires a §21 data set to be imported in order to output the results. All cases in your imported data that contain one or more defined hybrid OPS codes are checked. Various filter parameters are available to narrow down the results list. For example, cases can be filtered out that represent further surgical, interventional or special diagnostic measures that require the special resources and facilities of a hospital.
The cases determined in this way are displayed for each clinic department. This data is also checked for the presence of contextual factors. This provides a quick overview of your possible outpatient potential per department. A direct link to the Case Explorer provides an insight into the individual cases.
Market Analysis
The Market Analysis data is fed from the quality reports since 2006. If desired, the entered service data from ICD and OPS can be displayed over the course of the year or for a freely selectable period. This trend display can be carried out down to hospital level. For this presentation, the data is compiled for you on an annual basis. The comparison filters are a special feature of the Market Analysis. Compare areas or clinics with each other or even clinics in an area. Comparisons can be made in a variety of ways. Share distributions can be displayed visually and thus impressively using a convenient drill-down function. The Market Analysis data provides a comprehensive picture of the services provided by german clinics, right down to department level, including contact details and much more. A direct link to the Geo Analysis enables the desired results to be displayed visually on the map of Germany. The addition of saved filters from the Clinic Guide enables linked search queries based on structural conditions with the performance data.
Clinic Guide
The Clinic Guide enables a comprehensive search for all structural features of German clinics. Various filter options allow a quick overview of the clinic departments, staffing and equipment, inpatient and outpatient case volumes, types of provider and much more. The list is highly variable and can be narrowed down to specific regions and areas. The clinics / specialist departments extracted in this way can be saved and used for searching in the market analysis. A direct link to the geoanalysis enables the desired results to be displayed visually on the map of Germany.
Another important element of the Clinic Guide is the status assignments, including comments, which we maintain on an ongoing basis. For example, conspicuous reports, closed clinics or cumulative reports can be identified and thus help with a targeted evaluation of your analysis results.
Geoanalysis
The geoanalysis can be used to display structural features, performance data of German hospitals, economic key figures and to display service groups on the map of Germany. The results can be displayed as a pin, as a bubble with size division and/or as a heat map. The display options can be used to customize the output via heatmap and bubble.
Areas
Under the “My” menu item, you can create your own areas and name them individually. These can be supply areas for rural hospital planning or sales areas. The territories can be created quickly using a convenient input via zip code, city, district, KV region or federal states (incl. exclusion procedure). An import function is also available for creating territories if many territories or a large number of zip codes need to be created. After creation, the area and the hospitals included in it are visualized on a map of Germany.
Potential-Calculator
Based on the parameters you enter, such as sales price, restrictions in the target group, desired market potential, targeted sales quantities in units, the potential turnover in € and sales figures per clinic and specialist department are displayed. Optionally, the results can be further restricted to your specially created sales area, zip codes, federal states, districts or cities. We also provide you with an automatic factor to support the calculation of unit numbers. For example, you can use “every 3 days” or “twice a day” to determine the potential quantities fully automatically based on the actual data.
EBM-Grouper
This grouper, developed by the experts at the Reimbursement Institute, precisely translates all operation and procedure codes into the outpatient billing system according to EBM (Einheitlicher Bewertungsmaßstab). An extensive and intuitive input mask requests all relevant information and displays all billable GOPs as a result.
Service Group Analysis (KHTG)
The Service Group Analysis (KHTG) requires a §21 data set to be imported in order to output the results. The grouping is carried out by a InEK-certified SG-Grouper directly during the upload of the case data. After a few minutes, the results are available for you to view and download. If desired, the calculation basis can be switched back to the previously valid NWR model, so that a comparison with previous planning can be made. A wide range of filter options are available for further analysis, e.g. based on a DRG or department. A direct link to the Case Explorer provides insights into individual cases.
more about Service Group Analysis
Service Group Editor
The area of service groups is just as scientifically based as the rest of the database. This means that every single required condition was checked against the contents of the quality report using an extensive translation table. This results in an absolutely valid basis for assigning clinics to the status ‘meets the conditions’ or ‘does not meet the conditions’. Some conditions cannot be verified automatically and are marked accordingly. For example, a cooperation may be required that is not described in the quality report.
The Service Group Editor was developed because of this and due to the fact that the quality reports are only available retrospectively and also contain inaccuracies. This editor makes it possible to check the conditions again for each hospital in Germany and to adjust them if necessary. Every effective adjustment immediately shows the changes in the status in the service group matrix. In addition to the visual representation in the matrix, the impact analysis can also be viewed in tabular form and exported. All edits can be saved for your own evaluations.
Case Explorer
This tool forms the core of the §21 data set. It contains all individual case data with the individual information for direct viewing. All tools for which an upload of internal hospital data is required are directly linked to the Case Explorer. This means you can view the individual cases directly from the respective analyses or export the identified cases with all detailed information.
The Case Explorer also allows you to extract your desired case data outside of the analysis tools. All filterable information originates from the §21 data set itself and is structured according to standard parameters such as specialist departments or locations, economic key figures, inpatient services, patient characteristics, etc. and can be further narrowed down using additional operator fields (see also “Filter”).
Case Simulator (coming soon)
This tool allows you to remove, replace or add certain characteristics from your §21 data record. In the first step, you determine whether the entire data record or only parts of it should be used for the simulation. Then you determine the simulation parameters, such as OPS, VWD, ventilation hours, etc., and start the re-grouping with our InEK-certified grouper. A clearly structured before/after view shows you the changes in CMI and revenues within a few seconds, plus the service group.more about Case Explorer
Patient Analysis
The Patient Analysis data is based on DRG statistics and shows the coding frequencies for OPS and ICD in relation to gender, age and length of stay over the course of the year. A special feature of the Patient Analysis are the comparison filters. Compare genders or years with each other if you wish. Comparisons can be made in a variety of ways. The comparison of single or multiple coding per case is also interesting. This makes it easy to measure how often a procedure is used during a stay. As in the Market Analysis, the presentation of the years in the trend can also be customized here. A convenient drill-down function allows proportion distributions to be displayed visually and thus impressively.
G-DRG Analysis
The G-DRG analysis data is based on DRG statistics and shows the billing frequencies of DRGs per district over the course of the year based on the patients’ place of residence. This allows catchment areas to be compared with the hospital’s own billing data and market shares to be determined. In addition to the number of cases per DRG, CMI and length of stay are also displayed. A special feature of the G-DRG analysis are the comparison filters. If desired, you can compare DRGs, MDCs or regions with each other. Comparisons are possible in many different ways. As in the Market Analysis, the presentation of the years in the trend can also be customized here. A convenient drill-down function can be used to display district or case flat rate distributions visually and thus impressively. A direct link to the Geoanalysis enables the desired results to be displayed visually on the map of Germany.
Reimbursement-Calculator
The Reimbursement-Calculator determines the associated DRG and, if available, linked additional fees or NUB templates in a matter of seconds based on indications according to ICD-10 (in HD or ND) and at the level of the operation and procedure keys (OPS). If the selected codes are linked to the AOP or Hybrid DRG catalogue, these are also determined and displayed with a € amount. Furthermore, individual cost modules can be selected from the cost centre and cost type matrix in order to limit the calculation to this area of the DRG.
G-DRG Matrix-Calculator
The G-DRG Matrix-Calculator displays the total revenues according to the InEK cost element and cost centre matrix based on one or more G-DRGs entered. The total revenues vary based on the number of cases and CMI individually specified by the user. It is also possible to enter your own average length of stay (ALOS). In addition to the pure calculation of revenues, which extends to the individual modules of the InEK cost matrix, a benchmark is also carried out for the calculation basis.
Public rules and data
Catalogs – outpatient reimbursement
The catalogs of outpatient reimbursement include the AOP and Hybrid-DRG regulations. They are directly linked to the tools for evaluating the §21 data. The relationship between the catalogs is also shown, thus making it possible for the first time to understand the conditions of the codes in relation to each other.
For all hospitals that have entered a §21 data set into the platform, further internal information is available in the ‘My Hospital’ box at every hierarchy level of the catalog. All catalogs have a direct link to the groupers.
NUB Exchange
The NUB Exchange has been an established tool for posting and finding NUB requests annually since 2015. A convenient search function enables all verified service providers to find NUB templates from the fields of medical technology and pharmaceuticals in a targeted, free and interdisciplinary manner. This facilitates the process, so that we can look forward to more than 3,500 users from the hospital sector and more than 52,000 accesses (as of 2023). An information sheet and a retrieval analysis (see also under coding aids) are also available for this area at hospital level. In addition, the status assignment, the current InEK number, the number of submitting clinics and other information are linked as soon as they are made available. The associated NUB history shows all NUB requests ever submitted to InEK directly in the template called up or via various filter parameters, together with the specified key figures and status assignment. In this way, a relevant or non-relevant template can be identified.
Note: NUB templates that have been in NUB status 2 for years or have been assigned to an additional charge or DRG are not offered!
Proposal procedure
You are planning a proposal for OPS, ICD, DRG for an additional fee? Our database contains all proposals ever submitted (since 2006) to the InEK or BfArM (formerly DIMDI). Use the keyword search to check who has already sent proposals to the responsible institutions, when and on which topic. You can also view and download the original proposal in the OPS and ICD proposals section.
G-DRG Report-Browser
The data in the G-DRG Report-Browser is based on the §21 data from the calculation hospitals. Furthermore, a differentiation by main department or affiliated department is possible. Various filters for partitions, MDC or base DRG expand the results shown. Searches can be made from OPS to DRG, ICD (in HD or ND) to DRG and vice versa. A very valuable and unique feature of this analysis is the display of the relevance of the codes in the selected constellation. Was the code relevant for the assignment to the displayed flat rate per case, and if so, how? A coloured icon shows whether the OPS or ICD code plays a role in the assignment to this DRG. This can be done via a global function, a redirection or by direct relevance to the assignment to the displayed flat rate per case.
The G-DRG Report-Browser is available to all registered users free of charge!
Catalogs - inpatient reimbursement
The catalogs of inpatient reimbursement include the OPS, ICD, DRG and ZE sets of rules. They form the core of the platform, as they are directly linked to all tools for evaluating routine data and to the tools for evaluating §21 data. This bundled presentation not only allows a quick grasp of all legally binding coding instructions, but also shows the structural transitions and textual changes (see also ‘transitions/migrations) for all code levels over the past few years. In addition, each code and level is accompanied by specific information on the market, reimbursement and patient clientele.
The relationship between the catalogs is also shown, enabling users to understand the relationships between the codes for the first time. For all hospitals that have entered a §21 data record on the platform, further internal information is available in the ‘My Hospital’ box at every hierarchy level of the catalogs. All catalogs are directly linked to the grouper.
NUB History
The NUB history shows the status, the consecutive number and the number of requesting hospitals over the course of the year for all procedures ever requested. Regardless of whether a template is available in the NUB Exchange. If a template has been entered, it is automatically linked to the associated history. This means that relevant templates can be quickly distinguished from irrelevant ones.
We make this tool available to all registered and verified service providers free of charge!
Coding aids
Coding aids can be created on the platform for internal or public use (can only be viewed by verified service providers).
For hospitals: By creating a coding aid, valuable information can be shared within the team. Publication and the associated access by other hospitals is optional. Created coding aids can also be used as synonyms. For example, to use the Context Grouper, the EBM Grouper or the DRG & SG-Grouper with colloquial terms, far removed from the terms for procedures or indications from the BfArM classification data.
For manufacturers: Avoid the time-consuming and usually expensive creation of a coding guide. If you do not want to do without such a brochure, you can combine it in PDF format with your coding guide. We also provide you with an information sheet with a direct URL to your coding guide, which you can hand out to interested service providers. In addition to efficient distribution, your advantage is in particular the retrieval analysis, which shows you the retrievals at any time by naming the hospital (without personal details). Created coding aids can also be used as synonym terms. For example, to use the market analysis with product names, far removed from the designation for procedures or indications from the BfArM classification data.
Code transfers / Migrations
Transfers from the OPS / ICD classifications and additional fees are particularly helpful when analyzing over a longer period of time. The catalogs are updated annually and include new admissions / deletions or transfers. Don’t be surprised about drops in the time series. Find the reason directly on the platform. For our hospital users, this tool can be used for the annual update training for the DRG system. Which codes have been added for the coming data year, are no longer available or have been changed structurally or in the text? The DRG migration overview allows you to see which case migrations have been made in the course of the annual updates.