Total compensation

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The term total remuneration comes from the Social Security Code V ( SGB ​​V ) and is defined in § 85:

(1) In accordance with the general contracts , the health insurance company pays the respective Kassenärztliche Vereinigung (KV) total remuneration for the entire contract medical care of the members residing in the district of the Kassenärztliche Vereinigung, including the family members who are also insured.

(2) The amount of the total remuneration is agreed in the overall contract. The total remuneration is the volume of expenditure for the entirety of the contract medical services to be remunerated; it can be calculated as a fixed amount or on the basis of the evaluation standard according to individual services, according to a head lump sum, according to a case lump sum or according to a system that results from the combination of these or other types of calculation.

Section 85 also applies to the statutory health insurance associations (KZV).

The distribution of the total remuneration between the contract physicians and contract psychotherapists took place until 2011 in the fee distribution agreement (HVV). Since then, it has been decided in the form of a fee distribution scale (HVM) as a statutory right of the individual KV or KZV by their representative assemblies in consultation with the health insurance companies. The total upper remuneration limit determines the budget of the respective KV or KZV, which must not be exceeded. The fee distribution standard (HVM) ensures that an impending excess is buffered through fee reductions for the medical, psychotherapeutic or dental services provided.

See also

Basic wage bill

Web links

Individual evidence

  1. ↑ Wording of the law § 85 SGB V