Information for specialists of complementary medicine (VVG)

For the recognition of service providers in the area of complementary medicine (e.g. as naturopaths, medical masseurs and osteopaths) under COMPLETA and SANA, we rely on the ErfahrungsMedizinische Register (EMR) in Basel and its Code of Ethics. This Code of Ethics encompasses the most important ethical values and standards that apply for therapists with EMR registration. In addition, we also consider registration with the Swiss Foundation for Complementary Medicine (ASCA) and adherence to their ethical standards for the reimbursement of selected methods from the supplementary insurance COMPLETA EXTRA. We also rely on our General and Additional Insurance Conditions for SANA and COMPLETA supplementary insurance.

Tariff 590 for the billing of complementary medicine benefits

Helsana, working together with various other health insurers and the relevant professional organisations for complementary medicine, has developed a standard tariff for complementary medicine benefits. You can download Tariff 590 from the SASIS website.

Please note:

• We consider the billing of complementary medicine benefits in accordance with Tariff 590 to be binding.
• Tariff 590 does not govern any prices and does not stipulate any compensation of benefits by the insurer.
• Tariff 590 may be adjusted annually (as a rule on 1 January). We therefore ask you to use the valid Tariff 590 in each case and regularly check the latest information.
• Some tariff items (e.g. tariff figure 1208 pharmacotherapy) are intended exclusively for naturopaths with a Swiss Federal Diploma. This information can be found in the tariff. If you do not have this diploma, please use other items that correspond to your qualification (e.g. 1085 phytotherapy).
• The tariff is divided into individual sections that correspond to the various complementary medicine professions. For example, section 5 refers to naturopaths with a Swiss Federal Diploma. For this reason, individual tariff items also appear in duplicate in the overview.
• Services and complementary medicine treatments that are not included in the tariff can be shown on your invoices with the corresponding free text via Tariff 999.
• Please also provide the details and corresponding tariff item numbers for remedies/drugs and laboratory services. Tariff item numbers are available for this purpose, e.g. 1310 for complementary medicines.

Standard invoice form

As with Tariff 590, billing using practice software with a 2D matrix code, offering enhanced protection against counterfeiting, is considered to be binding by us. There are more than 80 providers with a practical solution available who fulfil the current requirements. You can find a list of these software providers here.

Under SANA, COMPLETA and COMPLETA EXTRA supplementary insurance, Helsana reimburses the costs for complementary medicine, provided the treatment is medically necessary and effective, expedient and cost-effective, and is provided by a service provider recognised by us.

If the treatment takes longer or is unclear, our complementary medicine specialists contact our customers. The further course of action will be discussed on the phone or a report/questionnaire will enable the review of further payment of costs.

By filling out our questionnaire in detail, you allow us to quickly review the co-payment of medical costs and we can provide our joint customers with reliable information regarding the next steps.

Please complete the questionnaire in full and send it, by mail only, to the following address:

Helsana Supplementary Insurances Ltd
Customer Service
Leistungskostenmanagement
P.O. Box
9008 St. Gallen