- Bases for recognition by Helsana as a service provider in the area of complementary medicine
- Questionnaire to clarify benefits
Bases for recognition by Helsana as a service provider in the area of complementary medicine
For the recognition of service providers in the area of complementary medicine (e.g. as naturopaths, medical masseurs and osteopaths), we fundamentally 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. We also rely on our General (PDF, 70KB) and Additional Insurance Conditions for SANA (PDF, 43KB) and COMPLETA (PDF, 87KB) supplementary insurance. In addition to these bases, the following should especially be taken into consideration for recognition (this list is not exhaustive and does not grant any entitlement to recognition):
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.
- 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.
Our invoice template (PDF, 121KB) provides you with an overview of billing in accordance with Tariff 590.
Standard invoice form
A standard invoice form is available for billing your services in accordance with Tariff 590. This allows you to perform transparent billing. As further advantages of the standard invoice form, our joint customers receive their reimbursement faster, you can use the same invoice form for all billing, and we all have all relevant billing information.
Like Tariff 590, billing using the standard invoice form, with the 2D matrix code offering enhanced protection against counterfeiting, is considered by us to be binding. We recommend that you use practice software (PDF, 238KB) that correctly displays all fields and includes the current versions of the form and Tariff 590.
If you issue very few invoices each month, you can download a simplified invoice form, free of charge, from the secure area of any of the common registers. As we use the EMR for registrations, we recommend that you download the form from myEMR. Please note that the form does not contain any additional functionalities and is not compatible with all operating systems, notably macOS. This PDF invoice form can only be used until 31 December 2021 at the latest. After this it will no longer be available and must be replaced with practice software.
If you have questions relating to invoicing, please send an e-mail to: email@example.com
Questionnaire to clarify benefits
Under SANA and COMPLETA supplementary insurance, Helsana reimburses an unlimited 75% of 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 is discussed on the phone or a report/questionnaire allows the cost approval to be reviewed.
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 (PDF, 545KB) in full and send it, by mail only, to the following address:
Helsana Supplementary Insurances Ltd
Complementary Medicine Specialist
9008 St. Gallen