Prevent Rejected Claims Through Automatic HeilM-RL Compliance Checks
Every rejected prescription is unpaid work. Whether it's a missed deadline, a missing signature or an incorrect diagnosis group – form errors happen, but each one can cost hundreds of pounds per case. TheraNext checks every prescription automatically against the German Therapeutic Aids Directive, flags issues before they reach the payer, and only releases a billing run when everything is genuinely watertight.
Rejected claims cost more than just time
A single rejected prescription often means a clawback demand, rework and, in the worst case, correcting the treatment record. Across a year, these losses add up quickly to four or even five figures in a mid-sized practice. This is not a theoretical risk – it affects every practice that bills without automated compliance checks.
- ✓Unbilled therapist hours spent reworking rejected cases
- ✓Cash-flow shortfalls from delayed reimbursement or total write-off
- ✓Credibility damage with payers when form errors recur
The HeilM-RL traffic-light system: real-time compliance
TheraNext keeps the current Heilmittel-Richtlinie – including all diagnosis codes, therapeutic assignments and quantity limits – continuously up to date. The built-in traffic-light system evaluates every prescription as you work: green means billable, amber signals something to clarify, red blocks the submission with a precise explanation. Therapists and admin staff see at a glance what needs attention, before the payer is ever involved.
- ✓Current HeilM-RL diagnosis codes and therapeutic assignments built into the prescription screen
- ✓Colour-coded traffic-light warnings that need no specialist knowledge to interpret
- ✓Specific error guidance instead of opaque error codes
Deadline tracking: no prescription expires unnoticed
Treatment windows, prescription validity and the ten-day initiation deadline are all critical time constraints. TheraNext monitors them automatically and sends reminders to the right person in good time – not after the deadline has already passed. Blanket prescriptions with extended planning responsibility are tracked separately with their own rule set.
Preflight check before billing: verify first, submit second
Before any billing batch goes to the payer via direct §302 submission, TheraNext runs an automatic preflight check. The system verifies that all mandatory fields are complete, the diagnosis group assignment is correct, and the batch is formally ready to submit. Only a fully green preflight unlocks submission – no manual counting, no guesswork.
- ✓Completeness check for all mandatory §302 SGB V fields
- ✓Diagnosis group cross-check against current therapeutic assignments
- ✓Submission only unlocked when every item passes
Direct billing without a billing centre – full control, lower costs
TheraNext supports direct §302 self-billing with no third-party billing centre required. Billing in-house means every prescription, every payer response and every correction stays in one place – with no commission payable. Combined with built-in compliance checks, it is the most efficient way to keep rejection rates permanently low.
Frequently asked questions
What is the HeilM-RL traffic-light system and how does it work?
The traffic-light system in TheraNext checks every prescription automatically against the current Heilmittel-Richtlinie requirements. Green means the prescription is formally correct and billable. Amber signals something that needs clarifying. Red blocks submission and shows precisely what is missing or incorrect.
Are blanket prescriptions (Blankoverordnung) supported?
Yes. TheraNext handles blanket prescriptions – which carry extended therapist planning responsibility – separately, including specific deadline monitoring and adapted compliance rules in line with the current HeilM-RL.
Can I submit claims directly without a billing centre?
Yes. TheraNext supports full §302 self-billing: direct electronic data transmission to the payer, with no billing centre intermediary and no commission.
What happens if a preflight check fails?
TheraNext shows exactly which mandatory field is missing or which requirement is not met. The submission remains locked until every issue is resolved, so no incomplete billing batch can be sent accidentally.
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