{"id":3512,"date":"2021-06-09T13:29:11","date_gmt":"2021-06-09T11:29:11","guid":{"rendered":"https:\/\/sananet.com\/?page_id=3512"},"modified":"2026-02-11T09:33:03","modified_gmt":"2026-02-11T08:33:03","slug":"reimbursement-in-the-ambulatory-sector","status":"publish","type":"page","link":"https:\/\/sananet.com\/en\/medical-device-consulting\/sales-marketing\/reimbursement-for-medical-technology\/reimbursement-in-the-ambulatory-sector\/","title":{"rendered":"Reimbursement in the ambulatory sector"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-k1lx1yci-a1d7f2166056346c0cbaca20a0cff57f\">\n.avia-section.av-k1lx1yci-a1d7f2166056346c0cbaca20a0cff57f{\nbackground-color:#f2f2f2;\nbackground-image:unset;\n}\n<\/style>\n<div id='av_section_1'  class='avia-section av-k1lx1yci-a1d7f2166056346c0cbaca20a0cff57f main_color avia-section-no-padding avia-no-shadow  avia-builder-el-0  el_before_av_one_third  avia-builder-el-first  head-top 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wp-image-689 size-full\" src=\"https:\/\/sananet.com\/wp-content\/uploads\/2019\/10\/sananet-textquadrat-1-70px.png\" alt=\"\" width=\"70\" height=\"62\" \/><br \/>\nReimbursement in the Ambulatory Sector<\/h1>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-k3zunulp-4-132099f3f962278ac577ec7ca533075a\">\n#top .hr.hr-invisible.av-k3zunulp-4-132099f3f962278ac577ec7ca533075a{\nmargin-top:-40px;\nheight:1px;\n}\n<\/style>\n<div  class='hr av-k3zunulp-4-132099f3f962278ac577ec7ca533075a hr-invisible  avia-builder-el-4  el_after_av_textblock  avia-builder-el-last  av-desktop-hide av-medium-hide'><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><\/p><\/div>\n<\/div><\/div><\/main><!-- close content main element --><\/div><\/div><div id='after_section_1'  class='main_color av_default_container_wrap container_wrap sidebar_right'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-3512'><div class='entry-content-wrapper clearfix'>\n<div class='flex_column_table av-e0dys-f8ea593a1a05f7e8de983227ac9c191b sc-av_one_third av-equal-height-column-flextable'>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-e0dys-f8ea593a1a05f7e8de983227ac9c191b\">\n.flex_column.av-e0dys-f8ea593a1a05f7e8de983227ac9c191b{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\nbackground-color:#ffffff;\n}\n<\/style>\n<div  class='flex_column av-e0dys-f8ea593a1a05f7e8de983227ac9c191b av_one_third  avia-builder-el-5  el_after_av_section  el_before_av_two_third  avia-builder-el-first  first flex_column_table_cell av-equal-height-column av-align-top av-zero-column-padding  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kp6qub7o-cea04dadd9b35af9138020a4af14c27a\">\n.avia-image-container.av-kp6qub7o-cea04dadd9b35af9138020a4af14c27a img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-kp6qub7o-cea04dadd9b35af9138020a4af14c27a .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  class='avia-image-container av-kp6qub7o-cea04dadd9b35af9138020a4af14c27a av-styling- avia-align-center  avia-builder-el-6  avia-builder-el-no-sibling '   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" fetchpriority=\"high\" class='wp-image-5748 avia-img-lazy-loading-not-5748 avia_image ' src=\"https:\/\/sananet.com\/wp-content\/uploads\/2023\/07\/doctor-5634790_1280-300x300.jpg\" alt='Reimbursement in the ambulatory sector' title='Outpatient treatment'  height=\"300\" width=\"300\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/sananet.com\/wp-content\/uploads\/2023\/07\/doctor-5634790_1280-300x300.jpg 300w, https:\/\/sananet.com\/wp-content\/uploads\/2023\/07\/doctor-5634790_1280-80x80.jpg 80w, https:\/\/sananet.com\/wp-content\/uploads\/2023\/07\/doctor-5634790_1280-768x768.jpg 768w, https:\/\/sananet.com\/wp-content\/uploads\/2023\/07\/doctor-5634790_1280-36x36.jpg 36w, https:\/\/sananet.com\/wp-content\/uploads\/2023\/07\/doctor-5634790_1280-180x180.jpg 180w, https:\/\/sananet.com\/wp-content\/uploads\/2023\/07\/doctor-5634790_1280-705x705.jpg 705w, https:\/\/sananet.com\/wp-content\/uploads\/2023\/07\/doctor-5634790_1280.jpg 853w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/div><\/div><\/div><\/div><div class='av-flex-placeholder'><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-b0yok-90d40f3b73cc11a95decc5e105021a85\">\n.flex_column.av-b0yok-90d40f3b73cc11a95decc5e105021a85{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-b0yok-90d40f3b73cc11a95decc5e105021a85 av_two_third  avia-builder-el-7  el_after_av_one_third  el_before_av_postcontent  avia-builder-el-last  flex_column_table_cell av-equal-height-column av-align-top av-animated-generic bottom-to-top av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-2ly294-472de90a3388c36ed43ff559fba6f094\">\n#top .av-special-heading.av-2ly294-472de90a3388c36ed43ff559fba6f094{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-2ly294-472de90a3388c36ed43ff559fba6f094 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-2ly294-472de90a3388c36ed43ff559fba6f094 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-2ly294-472de90a3388c36ed43ff559fba6f094 av-special-heading-h3 blockquote modern-quote  avia-builder-el-8  el_before_av_textblock  avia-builder-el-first  av-linked-heading'><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Advice on Reimbursement in the Outpatient Sector<\/h3><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-k1lxo6db-c98a1412ea97222bfd2847dd75705d35 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>sananet Unternehmensberatung supports medical technology companies with advice on Reimbursement in the ambulatory sector.<\/p>\n<p>When introducing innovative medical products to the market, the fundamental influence of procedures and medical products on the costs and revenue of a medical practice should be considered in addition to reimbursement.<br \/>\nThe sananet management consultancy will be glad to help you with your questions about reimbursement in the outpatient segment.<\/p>\n<\/div><\/section><br \/>\n<div  class='avia-button-wrap av-k3zvra8x-2744c8d9cd6451ce08b0a06b6d6c6394-wrap avia-button-left  avia-builder-el-10  el_after_av_textblock  el_before_av_hr  contactbutton'>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-k3zvra8x-2744c8d9cd6451ce08b0a06b6d6c6394\">\n#top #wrap_all .avia-button.av-k3zvra8x-2744c8d9cd6451ce08b0a06b6d6c6394{\nbackground-color:#fdc62b;\nborder-color:#fdc62b;\ncolor:#474747;\ntransition:all 0.4s ease-in-out;\n}\n#top #wrap_all .avia-button.av-k3zvra8x-2744c8d9cd6451ce08b0a06b6d6c6394 .avia-svg-icon svg:first-child{\nfill:#474747;\nstroke:#474747;\n}\n<\/style>\n<a href='#contact'  class='avia-button av-k3zvra8x-2744c8d9cd6451ce08b0a06b6d6c6394 av-link-btn avia-icon_select-yes-left-icon avia-size-medium avia-position-left'   aria-label=\"Contact us now!\"><span class='avia_button_icon avia_button_icon_left avia-iconfont avia-font-entypo-fontello' data-av_icon='\ue832' data-av_iconfont='entypo-fontello' ><\/span><span class='avia_iconbox_title' >Contact us now!<\/span><\/a><\/div><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-k3zunulp-2-2149d14a8776fcd56f18bb573c162243\">\n#top .hr.hr-invisible.av-k3zunulp-2-2149d14a8776fcd56f18bb573c162243{\nheight:10px;\n}\n<\/style>\n<div  class='hr av-k3zunulp-2-2149d14a8776fcd56f18bb573c162243 hr-invisible  avia-builder-el-11  el_after_av_button  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-k1lxo6db-1-783808351f4035ea19220a4307d6a378 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h5><strong>Reimbursement in the outpatient area on the basis of EBM or GO\u00c4<\/strong><\/h5>\n<p>In the outpatient sector (outpatient in doctors&#8217; offices or less than 24 hours in hospital), medical services are billed on the basis of the Einheitlicher Bewertungsma\u00dfstab (EBM) or the Geb\u00fchrenordnung f\u00fcr \u00c4rzte (GO\u00c4).<\/p>\n<p>The EBM regulates the billing of services provided by contract physicians to patients with statutory health insurance. The GO\u00c4, on the other hand, is used to calculate the costs of services provided by private physicians to private patients or self-pay patients.<\/p>\n<p>Billing is not done directly with the health insurance companies, but via the Association of Statutory Health Insurance Physicians (KV).<\/p>\n<h5><strong>Consultation on the market introduction of medical devices with and without reimbursement of costs<\/strong><\/h5>\n<p>In principle, procedures are reimbursed in the EBM or GO\u00c4 system rather than directly their product, although it is the detail that matters here. Here sananet can first analyze for life science and medical technology companies whether reimbursement is possible in principle.<\/p>\n<p>Medical products that are not reimbursed here have a difficult time entering the market. This does not mean, however, that market success is not possible without reimbursement. sananet&#8217;s expertise lies in finding long-term ways to achieve reimbursement and, in the short term, to enable market entry and initial sales through benefit arguments or alternative paths.<\/p>\n<h5><strong>Consulting alternative ways of reimbursement<\/strong><\/h5>\n<p>The adjustment period of the EBM catalog for a specific digit is about 5 years, but varies depending on the evidence. Thus, obtaining a new billing digit would be more of a long-term plan. However, if the medical procedure and its medical product are not initially reimbursed, then there are alternative ways that can still make a successful sale possible.<\/p>\n<p>The sananet consulting firm specializes in reimbursement and will guide you through these alternative paths to successfully market your medical product.<\/p>\n<p>Some examples of alternative routes to reimbursement for medical products are:<\/p>\n<p>&#8211; Selective contracts can supplement collectively bargained care. They offer the opportunity to test new optimized concepts of patient care.<br \/>\n&#8211; Some procedures that are neither listed in the EBM nor covered by individual contracts between health care providers and payers can be used by patients, but must be paid for out of their own pockets. These services are referred to as &#8220;individual health care management&#8221; (IGeL).<br \/>\n&#8211; In addition, there is the so-called &#8220;individual case request&#8221;, where patients can apply for exceptional cost coverage by the health insurance company in their individual case.<\/p>\n<h5><strong>Advice on DiGA<\/strong><\/h5>\n<p>A relatively new avenue for software and digital medical devices may be DiGA, the digital health application.<br \/>\nWith the fast-track process for adding DiGA to the BfArM directory, there is an unusually fast path to reimbursement. Within three months, the BfArM reviews the manufacturer&#8217;s claims on safety, performance, data protection, medical quality and interoperability of DiGA, among other things, as well as scientific evidence of its positive care effect.<br \/>\nContact sananet to find out whether your medical software or digital medical device is eligible for DiGA and what the best way to apply is.<\/p>\n<\/div><\/section><\/p><\/div><\/div><!--close column table wrapper. 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