Analogbewertung
English translation: analog billing
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| 21:16 Feb 15, 2017 |
| German to English translations [PRO] Medical - Insurance | |||||||
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|  Selected response from: Michael Martin, MA United States Local time: 14:17 | ||||||
Grading comment
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| Summary of answers provided | ||||
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| 3 +1 | fee set based on comparable medical services |
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| 3 | valuation by analogy |
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| 3 | analog billing |
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| Discussion entries: 1 | |
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Answers
1 hr confidence: 
valuation by analogy Explanation: It relies on reasoning by analogy Reference: http://www.cfapubs.org/doi/pdf/10.2469/dig.v39.n2.33 https://www.leagle.com/decision/2003294120ktc174_1284/BANK%20ONE%20CORP.%20v.%20COMMISSIONER |
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2 hrs confidence: peer agreement (net): +1
peer agreement (net): +1fee set based on comparable medical services Explanation: Analogbewertung Eigene Berechnung neuer oder andersartiger Leistungen, die nicht im Verzeichnis der Gebührenordnung für Ärzte (GOÄ) aufgelistet sind entsprechend gleichwertiger Leistungen durch den Arzt. https://portal.dimdi.de/de/hta/hta_berichte/hta280_bericht_d... "fehlerhafte Analogbewertung" means that the fee was incorrectly set, i.e. it did not match /reflect comparable medical services of the GOÄ -->fee set based on comparable services listed in the GOÄ (Physicians’ medical fee schedule) |
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1 day 58 mins confidence:
analog billing Explanation: See below under "3 Special billing terms" "If there is no explicit code for a test and/or analyte in the GOÄ, analog billing is applied. Under Section 6(2) GOÄ and the General Provisions No. 8 of Section M, independ-ent medical services not listed in the fee schedule may be settled using a service of the fee schedule that is equiva-lent to the service in question in terms of type, cost and time expended. For services under sections MII to MIV, the fee schedule item chosen for the purpose of analog billing for a service not listed in the schedule must be identified by prefixing it with the letter “A”. In case of doubt, the GOÄ commentary18 will be consulted.However, such analog billing is not binding for private health insurers; reimbursement problems may arise with private insurers even in the event of correct billing. Insur-ers frequently reimburse a lower amount, saying that a different analog code, for a lower-priced service, should have been used in their view." https://www.researchgate.net/publication/279217536_A_systema... |
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