Vereinfachung des Abrechnungsverfahrens in der privaten Krankenversicherung

Für Privatpatienten soll das Abrechnungsverfahren mit ihrem Krankenversicherer vereinfacht werden; jedenfalls bei der AXA Krankenversicherung. Diese schloss sich mit dem Softwarekonzern CompuGroup Medical zusammen. Für Mitglieder der AXA M?glichkeit, bedeutet dies, dass sie über das Portal „Meine Gesundheit“ ihre Rechnungen einsehen und direkt an die Versicherung schicken können. Alles online, ganz wie es im modernen Zeitalter üblich ist. Das Einscannen der Rechnungen ist nicht notwendig. Grund ist, dass Ärzte, welche ebenfalls die Software von CompuGroup Medical (CMG) nutzen, die Rechnungen nicht mehr an die Patienten senden, sondern direkt in das Portal hochladen. Die Patienten rufen im Portal die Rechnungen ab und senden sie direkt an ihre Krankenversicherung. Derzeit wird geprüft, inwieweit Apotheken in dieses neue Verfahren einbezogen werden können.


Damit das Verfahren ins Laufen kommt, haben der Softwarekonzern CGM und die AXA das Portal „Meine Gesundheit“ ins Leben gerufen. Die Mitglieder der AXA haben den alleinigen Zugriff auf ihre Daten und entscheiden selbst, ob sie die Rechnung mit ihrem Anbieter abrechnen wollen oder diese selbst bezahlen. Ob das einzelne Mitglied das Portal nutzen will, bleibt ihm überlassen. Diejenigen, die sich für die Nutzung des Portals entscheiden, können dies kostenlos nutzen und ihrem heimischen „Papierkrieg“ ein Ende bereiten.
Die beiden Unternehmen zeigen mit der Einrichtung des Portals eine Reaktion auf die Ergebnisse der Marktforschung, die zeigten, dass privat Krankenversicherte eine Vereinfachung des Rechnungsmanagements wünschen.

Axa und CGM

Neben dieser Abrechnungs-Vereinfachung haben AXA und CGM vor, auf dem Portal weitere Services anzubieten. Vorstellbar ist für beide Unternehmen eine Arztsuche und Terminvereinbarung direkt online über das Portal.


Die Nutzerfreundlichkeit sowie die Funktionalität soll Zaproszenia in den kommenden Monaten die Testphase zeigen, an der ausgewählte Kunden und Ärzten teilnehmen. Für alle bei der AXA Krankenversicherte, die über eine Vollversicherung verfügen, steht das Portal etwa ab Mitte des Jahres zur Verfügung. Erst dann wollen AXA und CGM prüfen, ob sie weitere Leistungserbringer in das Verfahren einbinden. Weiterhin soll geprüft werden, ob sich auch andere private Krankenversicherer für das Online-Portal interessieren und sich einbringen wollen. Mitglieder der HUK Coburg und der PAX-Familienfürsorge brauchen seit Mitte 2015 Kosten für teure Medikamente nicht mehr aus der privaten Tasche auslegen. Die Versicherer haben mit dem Apotheker-Verband entsprechende Verträge abgeschlossen und rechnen direkt mit den Apotheken ab. Auch die Allianz und die Debeka haben mit dem Apotheker-Verband Verträge in ähnlicher Form abgeschlossen und entlasten so ihre Mitglieder. Eine Direktabrechnung mit bestimmten Apotheken bieten andere Krankenversicherer wie beispielsweise die Bayerische Beamtenkrankenkasse oder die Barmenia ihren Mitgliedern an.

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