Suva saves 95 million francs in medical costs
Accidents involving Suva policyholders result in medical costs of CHF 3.5 million every day. Suva was able to save more than 95 million francs in 2019 through comprehensive invoice control. This also benefits the insured. Thanks to the savings, they pay less in premiums - that's the Suva model. Targeted prevention helps to prevent accidents and high costs.
A moment of inattention, a brief moment of distraction - an accident can happen quickly. In addition to a great deal of suffering and pain, high costs are also incurred. For example, the Suva every day around 3.5 million Swiss francs in medical costs for medical and therapeutic services. A fractured femur, for example, costs an average of 24,000 Swiss francs in medical expenses. Just as many Costs cause an average daily allowance. Thus, a fracture of the femur amounts to a total of 48,000 Swiss francs. But it can be even more expensive: If there are multiple fractures and other injuries, the total costs can even rise to over 1 million francs in individual cases. Costs that are borne by the insured, because the accident costs are covered by the premiums.
Fewer premiums for the insured
Thanks to active medical cost management, Suva keeps the cost increase under control without restricting benefits. The greatest savings are made possible by consistent and automated invoice control. Of the 2.4 million doctor and hospital bills checked last year, Suva corrected or rejected more than 320,000 bills. This represents nearly 13 percent of all invoices submitted. Most of the rejections involved duplicate invoices, incorrectly billed or uninsured services, and invoices for cases that had already been closed.
Suva uses the technical possibilities of digitization for invoice checking. "The automated invoice verification system recognizes, for example, on the basis of self-learned patterns, if a certain service occurs very rarely in the present case constellation and sorts out this invoice for detailed verification," explains Michael Widmer, team leader for medical costs at Suva. "Our medical cost specialists then check these invoices manually. They check whether the services received are based on the Accident are attributable, fit the diagnosis, and whether they meet the tariff."
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