DRG audit · Düsseldorf
Multiple stent surgeries
Three admissions for the same condition were billed separately. Our doctors found the DRG rules had been misapplied, and the hospital merged two of the invoices.
23%saved on the invoice
Germany
The German healthcare system is our speciality.
Germany offers some of the best medical care in the world, and one of the most complex systems to access and bill. It is our home market and what we know best. International insurers, TPAs and assistance companies rely on our Berlin team to get their members treated, priced and billed correctly here.
Why Germany is different
Excellent medicine, complicated billing
German hospitals and specialists are among the best in the world, which is why so many international patients come here. Billing in Germany follows a set of complex rules. Knowing them in detail is what keeps claims costs reasonable.
Private fee schedule (GOÄ)
Doctors bill private and foreign patients under their own fee schedule. Knowing what is justified, and what is not, is where much of our clients' savings come from.
DRG coding
Hospital stays are billed as diagnosis-related groups. A wrong main diagnosis, a split readmission or an extra day can move the price by thousands of euros.
Advance payments
Hospitals often refuse guarantees of payment from foreign insurers and ask patients for a deposit before admission. We have built relationships to get around that.
Separate doctor invoices
Chief-physician treatment and other elective services arrive as extra invoices, often from billing offices, weeks after discharge.
International rates
Some hospitals quote foreign patients higher prices than local ones. We make sure your members pay local rates.
German-only paperwork
Cost estimates, medical reports and invoices come in German. Our team reads, codes and challenges them in the original.
How we handle a German case
Cost control starts before the patient is admitted
In Germany, discounts are forbidden. Savings come from managing the case at every step.
- 1
Before admission
- We question medical necessity and length of stay.
- We point members to the right hospital and benchmark the estimate.
- We issue the guarantee of payment, so no deposit is needed.
- 2
During the stay
- We secure local rates, not international ones.
- German-speaking case managers talk to the ward and the doctors.
- Our medical team follows the treatment and plans discharge.
- 3
After discharge
- Our doctors audit every invoice.
- We re-code where the hospital got it wrong.
- We negotiate with the billing department until it is corrected.
Our German network
Direct billing in a country where it is rare
Most German hospitals do not bill insurers abroad directly. Over the years we have signed direct-billing agreements with hospitals and practices across the country.
Treatment without paying first
Members show their card at the hospital. We issue the guarantee of payment and settle with the provider.
German-speaking case managers
Our team books appointments, arranges admissions and talks to the hospital for the member.
Relationships – not just contracts
We know the international offices and billing departments by name. That is what gets a deposit waived or an invoice corrected quickly.
Recent German cases
What this looks like in practice
Four recent cases handled by our medical team in Germany.
Fee schedule audit · Frankfurt
Specialist consultation
A university hospital billed well above what the fee schedule allows. After our challenge it reissued the invoice.
87%saved on the invoice
Length of stay · Berlin
Planned ENT surgery
The estimate planned four nights. Our medical team and the treating doctor agreed one was enough, and the DRG billing was then corrected.
12%saved on the invoice
Provider sourcing · Bavaria
Cardiac rehabilitation
The suggested rehab clinic quoted well above customary rates. We found an in-network clinic of similar standing.
64%saved on the invoice
Want the full story behind these cases?
We are happy to walk you through the figures and how we would handle your German claims.
For providers
Are you a hospital, clinic or doctor?
Treat insured patients from abroad. We issue the guarantee of payment and settle your invoice directly.
