The product

The ZABAS products are used to audit all medical claims billed in the out-patient sector. ZABAS GebüH audits non-medical practitioner bills according to the Non-Medical Practitioner Fee Ordinance (Gebührenordnung für Heilpraktiker - GebüH) while taking issued rulings and accompanying comments into consideration. During auditing, criteria such as age and sex of the patient are taken into consideration, while the quantity and combination of invoices are analysed. An employee is responsible for final release. A standard document template simplifies further release. A rule editor can be used to freely modify auditing criteria and routines. The product offers evaluation options and statistics functions.

Background

ZABAS GebüH supports complex processing all to do with the German medical fee schedule. As the product automatically covers a number of formal auditing routines, the employee is free to concentrate on the main case constellations. As an increasing number of doctors have corresponding billing aids which support the creation of high-priced invoices, ZABAS GebüH thus represents a vital instrument in order to control cost development.

Technology

ZABAS GebüH is modularly designed. The possible areas of use range from integration of the audit core into an automated auditing system through to use of the expert system as an end-to-end solution. ZABAS GebüH supports the recognition and scanning processes and was optimised for electronic data exchange.

Market

ZABAS GebüH was developed for use in private health insurance companies.