EBM-Abrechnungs-Kürzungen und Ablehnungen
Definition
Private outpatient laboratories bill via EBM to statutory health insurance funds. Massive reimbursement cuts from January 1, 2025, threaten existence without successful appeals, amplifying denial management risks.
Key Findings
- Financial Impact: Up to 70% cut per reimbursement item; industry turnover €5.5B exposed to mass reductions
- Frequency: Ongoing, intensified by 2025 EBM reform
- Root Cause: Evaluation committee decisions without medical or cost basis; poor denial management fails to recover losses
Why This Matters
This pain point represents a significant opportunity for B2B solutions targeting Medical and Diagnostic Laboratories.
Affected Stakeholders
Laboratory managers, Billing specialists, Laboratory physicians
Deep Analysis (Premium)
Financial Impact
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Current Workarounds
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Methodology & Sources
Data collected via OSINT from regulatory filings, industry audits, and verified case studies.
Related Business Risks
Verzögerte EBM-Forderungs-Einziehung
GoBD-Verstöße bei Ablehnungsarchivierung
Verpasste Erstattungen bei Eligibility-Fehlern
IVDR-Verstöße in Diagnostiklabors
Verzögerte Abrechnung durch ePA-Integration
Kapazitätsverlust durch manuelle Prüfungen
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