SwissDRG (Swiss Diagnosis Related Groups) is the new tariff system for acute somatical in-patient hospital treatments that regulates payments for such treatments under the statutory health insurance legislation (Krankenversicherungsgesetz (KVG)) across Switzerland on a case-based lump sum basis.

Each hospital stay is allotted to a case group and paid for on a lump sum basis on the basis of certain criteria such as main diagnosis, secondary diagnoses, treatments and further factors.

SwissDRG was brought in on January 1st. 2012. The set of regulations consists of a handbook over 700 pages long, the catalogue of lump sum payments for each case and various additional documents containing the rules and definitions for treatment billing under SwissDRG.

Using Sumex DRG Expert insurers can assess detailed treatment invoices simply and competently. All invoice versions are available in electronic form including the definition handbook, the catalogue of lump sum payments, the coding handbook, ICD and CHOP classification codes. Cross-references in the various sources are navigable and all information can be compared and searched.

Sumex DRG Expert provides the required specialist knowledge as a modern web solution with integrated decision support. In particular, it is possible to carry out in-depth analyses of the set of regulations and identify and automatically deflect critical DRGs in performance tests using intelligent rules. Sumex DRG Expert offers comprehensive coding functionality with which cases can be coded and varied simply.