How we measure: the method, published before the numbers

We publish the method before the numbers. That way you can check how a result was produced before it appears, and hold us to it.

What we measure

We will measure in normal practice operation, not on test cases. meda writes the documentation from the consultation, the doctor corrects it, and meda suggests the billing codes this documentation supports. For the measurement, every suggestion will be recorded with the decision that follows it, together with the sentence of the documentation it rests on.

So we don't measure what meda could find in theory, but what happens in the practice: which suggestions come up, which ones the doctor approves and which ones they don't.

The terms we count with

An approval rate is not a completeness rate. It says how often doctors approve our suggestions, not how much fee income a practice is missing overall. That's why we don't call it one.

What counts and what doesn't

• Only a billing code the documentation supports and the doctor approved counts as an approved suggestion.
• Rejected suggestions are in the result, not in a footnote.
• No projection to a full year, no hand-picked best cases, no euro totals built on assumptions.
• No number before the measurement is complete.

Why the rejection matters most

A suggestion the doctor rejects will be the most important data point we collect. It shows where a suggestion was wrong. This is exactly where the doctor decides whether the documentation supports the billing code. Because every billing code only goes into billing after approval, the measured result is only what doctors decided was correct. Nothing enters your PVS unless you approve it.

Why this matters for the KV's review

The regional association of statutory health insurance physicians (KV) checks doctors' billing for plausibility, above all the volume of services billed per day against the doctor's time.¹ For this, many EBM services carry a review time (Prüfzeit). If the time calculated from the review times exceeds twelve hours in the daily profile on at least three days in a quarter, or 780 hours in the quarterly profile, for a full-time licence, further checks follow.²

Billing in full what is documented also raises the time profile for services that carry a review time. Every approved billing code stays linked in meda to the documentation it came from.

What gets published

The method and the approval rates. When the results publish, they publish in full, including where they speak against us. Until then, this page is the promise you can hold us to.