Information for health promotion (VVG) specialists

We divide our health promotion offering into the following areas:

• Fitness
• Back and full-body training
• Pregnancy
• Nutrition, relaxation and exercise courses and other services provided by Helsana cooperation partners
• Sport promotion

Our recognised service providers in the area of health promotion include, in particular, gyms and course providers certified by a quality label/certification body recognised by us, as well as all gyms in hospitals and doctors’, chiropractic and physiotherapy practices. Depending on the area, we also define specific providers that are eligible for recognition.

Please note:
This list is not exhaustive, as the prerequisites for recognition and payment of costs under our supplementary insurance products are defined differently for each area. You can find all the information on this in our list: 

Important:
The published conditions of recognition apply until further notice and are subject to change by Helsana. There is no entitlement to recognition as a service provider or for specific offerings/courses. 

The General Insurance Conditions and Additional Insurance Conditions for SANA, COMPLETA, COMPLETA PLUS and COMPLETA EXTRA apply – we are happy to answer any questions or provide further clarification.

Tariff 595

Helsana, working together with other health insurers and the relevant quality labels/certification bodies for health promotion, has developed a standard tariff for outpatient health promotion services. You can download Tariff 595 from the SASIS AG website.

Please note:

• The statement of outpatient health promotion services in accordance with Tariff 595 is currently only required for electronic statements (eTG).
• Tariff 595 does not govern any prices and does not stipulate any compensation of benefits by the insurer.
• Tariff 595 may be adjusted annually (as a rule on 1 January). We therefore ask you to use the valid Tariff 595 and regularly check the latest information.
• Further information can be found in the Tariff 595 FAQs. The document is currently still being prepared and will be made available at a later date.

Software providers:
We do not currently have a list. As soon as one is available, it will be published here.

Invoicing with electronic third-party guarantor system (eTG)

Your benefits: this additional service enables you to offer your customers fast, digital processing.

Instead of subscription confirmations that were previously filled out by hand, automated, digital transmission with the electronic third-party guarantor system (eTG) offers an efficient alternative. The switch takes place in a few simple steps:

• Customer and subscription data is entered into the software (invoicing program).
• The tariff items are listed directly with Tariff 595.
• The eTG invoice is then sent to the health insurance company via the MediData network.
• The health insurance company checks the invoice and reimburses its customers for the benefits directly (taking into account the supplementary insurance requirements).
• Your customers pay the subscription invoices as usual and only sign the declaration of consent for the electronic transmission of the proof for reimbursement (eTG) when signing the contract.

Please note:

• Declaration of consent: this is an agreement between the gym and the customer – please get in contact with your label/certifier.
• The transmission takes place via MediData and the dispatch of electronic proofs for reimbursement via the MediData network requires a participant contract. The application and registration process can be completed directly with MediData (www.medidata.ch).

Further information is available here:

• Connecting eTG for gyms with Fitness Guide (SFGV) certification. The document is currently still being prepared and will be made available at a later date.
• Not certified with Fitness Guide? Please contact your certifier.

You can find questions and answers about invoicing, etc. in the Tariff 595 FAQs. The document is currently still being prepared and will be made available at a later date.

Helsana thanks you for switching to eTG.

MediData:
You can find the contact details on its website.

PAR number or GLN number:
Contact your certification body.

Helsana Insurance Company Ltd:
General questions on the recognition criteria and Tariff 59:
gesundheitsfoerderung@helsana.ch

Questions about payment of costs or benefit statements:
Contact and advice – Helsana