For fair premiums: Suva saves 124 million francs in medical costs
Im letzten Jahr zahlte die Suva 1,26 Milliarden Franken für medizinische und therapeutische Leistungen und überprüfte 2,7 Millionen Arzt- und Spitalrechnungen. 75 Prozent der Rechnungen wurden automatisch verarbeitet. 12,5 Prozent der Rechnungen wiesen Fehler oder Ungenauigkeiten auf und wurden zurückgewiesen. Dadurch konnten 124 Millionen Franken an Heilkosten eingespart werden. Dieser Betrag kommt den Suva-Versicherten in Form von tieferen Prämien zugute.
Healthcare costs are rising steadily. This also applies to medical costs, i.e. the costs of medical and therapeutic treatment for accident victims. In 2024, Suva paid out CHF 1.26 billion in medical costs. That's around CHF 3.5 million per day.
Thanks to active medical cost management, Suva has costs under control and protects its insured persons from unjustified costs without restricting the quality of benefits. This applies to medical care as well as therapies and rehabilitation following an accident. The most important measure for this is consistent invoice control.
"When checking invoices, we check whether the legal provisions have been complied with," explains Michael Widmer, team leader for medical costs at Suva. "There are tariff provisions that regulate exactly which service may cost how much. We also check whether the costs charged correspond to the services provided and whether the treatment is related to the accident at all."
2.7 million invoices checked - 12.5 percent rejected
Suva received and checked 2.7 million doctors' and hospital invoices last year. 337,000 invoices (12.5 percent) contained errors or inaccuracies and were rejected. "The vast majority of all doctors, hospitals and therapists bill correctly," emphasizes Michael Widmer. "Most of the rejections involve duplicate invoices, incorrectly billed or uninsured services, invoices for cases that have already been closed and, in some cases, invoices for services that were not provided at all."
Thanks to the comprehensive audit, savings of CHF 124 million were made, CHF 19 million more than in the previous year. This saving benefits all Suva policyholders, as Suva is not profit-oriented and passes on savings and surpluses to its policyholders in the form of lower premiums. Without the invoice control, premiums for Suva-insured companies would be around 3 percent higher on average.
75 percent of invoices processed automatically
Man and machine work hand in hand when checking invoices. The medical expense invoices that arrive at Suva are automatically checked by the system. If everything is in order, the invoice is released for payment. If the system detects errors or irregularities, the invoice is forwarded to the medical cost specialists. They use their expertise to check whether the invoice is correct and will be paid or whether it needs to be sent back to the biller for correction. The proportion of invoices processed automatically is 75%, and automation is constantly being optimized.
Partnership-based cooperation for efficiency, quality and fair costs
Suva relies on partnership-based cooperation with doctors, hospitals and therapists when managing medical costs and offers various support services. These include online services for simple and secure electronic data and information exchange, uniform invoice forms and standards as well as advice on tariff application. "Suva's medical cost management is a quality instrument based on partnership that ensures efficiency, quality and fair costs - everyone benefits from this," emphasizes Michael Widmer.
The current "Costs under control" campaign, which will be available on suva.ch and Suva's online channels until October 19, 2025, also draws attention to the partnership-based cooperation for effective medical cost management.
Source: Suva
