Ambulatory Territory Price setup
Explanation
Ambulatory management, also known as SPITEX in Switzerland, use 3 main services that are covered by insurances, known as A B and C for
- Basic care (A)
- Examination and treatment (B)
- Clarification, consultation, coordination (C)
Each Swiss Canton has its own pricing and calculation method. Actually E-Care manages 4 different calculation types.
Field description
Below, the explanation for each field:
Territory Price fields
> Territory code : select which canton (region) this pricing belongs to
> From Date : the start date for this pricing
> Apply from age of : only for concerned canton: from which age (of the beneficiary) should the calculation be effective
> CBR A MAX : max amount for Service A (CBR = Care Benefits Regulation)
> CBR B MAX : max amount for Service B
> CBR C MAX : max amount for Service C
> CBR A Insurance : insurance amount for Service A
> CBR B Insurance : Insurance amount for Service B
> CBR C Insurance : insurance amount for Service C
> CBR A Authority : Authority amount for Service A
> CBR B Authority : Authority amount for Service B
> CBR C Authority : Authority amount for Service C
> Calculation Type : How the amount are calculated
Use following Calculation type for canton
> 1 :
> 2 : AG, BE, LU, NW, OW, SG, SH, SO, UR, ZG (GL South)
> 3 : TO BE CONFIRMED:BL, BS, GR, SZ, ZH, (GL North)
> 4 :
> undefined : ..
> undefined : ..
> PCt Total Insurance: for concerned canton: the percent to calculate the insurance part
> Patient max Amount: for concerned canton: the daily max amount for the beneficiary
> Duration min.: for concerned canton: duration in minutes from which the canton is billed
tip
For canton BERN: CBR Authority are calculated as the difference between CBR MAX and CBR Insurance
For Canton BERN: use Calculation Type = 2 (20% from Confederation max amount defined by CBR, with max amount for beneficiary)
