Since the introduction of §33a and §134 SGB V, the prescription and billing of digital health applications (DiGA) has been firmly anchored in statutory health insurance. The legal framework requires providers not only to integrate the technology into the healthcare system, but also to comply with complex processes when billing health insurance companies.

These requirements present DiGA manufacturers with the following challenges, among others:

• High technical effort: The billing processes are technically demanding, especially when it comes to connecting to the health insurance companies’ IT systems and complying with prescribed standards.
• Fragmented health insurance landscape: The health insurance companies have different requirements and procedures, which makes the DiGA billing process confusing and complex.
• Technical and payment-related processes: Many DiGA manufacturers do not have an established network or the necessary resources to quickly and efficiently resolve technical and billing issues related to DiGA billing.
• Utilization of liquidity potential: Many DiGA manufacturers do not fully utilize their liquidity potential when invoicing DiGA, which can lead to financial bottlenecks.
• Financial controlling: Working with health insurance companies often leads to high DSO (Days Sales Outstanding), ADD (Average Days Delinquent) and ART (Accounts Receivable Turnover), which can have a negative impact on financial performance in the context of DiGA billing.
• Unclear payments: The large number of transactions and lack of traceability make smooth accounting difficult in the DiGA billing process.

The VeriDiGA API

To overcome these billing challenges, CONVEMA takes over the prescription code validation and billing of digital health services with the health insurance companies.

CONVEMA uses the VeriDiGA API to ensure code validation and compliant billing of DiGA to currently 93 health insurance companies.

VeriDiGA offers various functionalities that are specifically tailored to the needs of DiGA manufacturers and the efficient billing of DiGA:

• Dashboards: An intuitive and clear presentation of all relevant billing data. The dashboards enable DiGA manufacturers to monitor their DiGA billing in real time, identify bottlenecks and sales trends at an early stage and make informed business decisions using predictive models.
• Payment overview: A clear and concise presentation of all incoming payments supports efficient accounting and improves transparency in DiGA billing.
• Invoice clarification: CONVEMA takes over the clarification of outstanding invoices for DiGA manufacturers as part of the billing process. Thanks to personal contacts with health insurance companies, CONVEMA achieves fast and transparent solutions to billing-related issues.
• Customer support portal: A central portal provides support teams with direct access to check activation codes and assist policyholders in activating DiGA applications.

In addition to the functions of the VeriDiGA portal, CONVEMA offers individual advice on market access opportunities, current developments in the healthcare sector and solutions for specific billing issues through regular exchanges with experts.

The VeriDiGA solution simplifies and optimizes the entire DiGA prescription code verification and billing process for manufacturers, allowing them to focus more on their core business.

Billing with statutory health insurance companies presents many DiGA manufacturers with technical and organizational challenges. With BAYOOMED’s DiGA services – including invoicing and code validation services – these processes can be designed efficiently and transparently. Our service takes over central invoice processing tasks and ensures that billing data is submitted reliably, payments are processed in a traceable manner and revenues can be realized more quickly.

If you would like to find out more about our invoicing service or other DiGA services, please contact us. We will advise you without obligation on the right solutions for your project.

You can find more information here.