Information for care homes & hospital organisations

Helsana's healthcare controllers are qualified healthcare experts with tertiary-level education. Their role is to act as professional contact partners for the service providers.

Claim

Helsana's healthcare controlling is a professional and efficient operation. It is based on binding internal procedures that are uniform throughout Switzerland.

The vast majority of documents received by Helsana (prescriptions and invoices) have been completed correctly, and they can be processed efficiently.

Internal document checking procedures are identical for all service providers, regardless of languages, regions and systems for clarifying needs. Helsana's healthcare controlling operates with various instruments to clarify needs and generate documentation.

Helsana carries out healthcare controlling throughout Switzerland, in three of the national languages. The healthcare controllers are given training on the systems used by the service providers.

The Health Insurance Act (KVG) leaves the choice of instrument up to the service providers. Helsana healthcare controlling accepts documents from all classification systems used in Switzerland. Certain cantonal tariff agreements include special regulations regarding the procedures for healthcare controlling by insurers. Helsana complies with the rules laid down in the agreements.