Overview

OAAT’s TarfiMatcher software handles the application of outpatient medical tariffs (TARDOC and outpatient flat rates). Service entry, provision of catalogs with description texts and code search and invoicing are not part of the software. TarifMatcher focuses on the correct tariff application.

The components

The TarifMatcher software consists of the following components:

Grouper

The grouper component can read in a classification system of outpatient flat rates and then apply it to an outpatient treatment (with LKAAT codes). The result is an assigned outpatient flat rate. The grouper is also used to decide whether an outpatient treatment is billed per flat rate or per individual service. The grouper requires the respective valid catalogs for LKAAT and the outpatient flat rates (patient classification system file).

For more details, see Grouper.

Mapper

Outpatient treatments that have been determined by the grouper for billing with TARDOC (and other individual service tariffs) are then prepared for billing in the mapper. The services that were recorded via LKAAT are mapped to TARDOC. All TARDOC rules that can be decided in the context of a session are applied. A note is created for TARDOC rules that require further information / consideration. The mapper requires the respective valid catalogs for LKAAT and TARDOC.

Implemented rules on the level of an LKAAT service are:

Code is valid
Code is not a trigger position
Code is not a duplicate in the context of the session and side.

Implemented TARDOC rules are:

Side is required
Master is present in slave services (Haupt- und Zuschlagsleistungen)
Cumulation rules, all types
Number limitations (Mengenlimitationen) that are decidable within the context of a session
Age limitations
Sex limitations

Unimplemented TARDOC rules are:

Percentage services (Prozentleistungen)
All rules regarding the service provider (Leistungserbringer): Dignität, Sparten, ..
All rules that need information from previous treatments: number limitations in the context of a patient’s history, ..
All rules that need information not present in the LKAAT catalog

For more details, see Mapper.

Casemaster

The Casemaster takes data from a patient or case file with already defined sessions as input and applies the definition of outpatient treatments in accordance with Appendix B of the tariff structure agreement. The use of Casemaster is voluntary, provided that the definition of outpatient treatment is already implemented in the service provider’s case management.

For more details, see Casemaster.

Software Package

The OAAT tarifmatcher package contains the following files:

tarifmatcher-{VERSION}.zip
  ├── LICENSE-3RD-PARTY.txt
  ├── README.md
  ├── tarifmatcher-{VERSION}-standalone.jar
  ├── tarifmatcher-{VERSION}-javadoc.jar
  ├── tarifmatcher-{VERSION}.jar
  └── tarifmatcher-{VERSION}.pom

LICENSE-3RD-PARTY.txt – A file containing the open source software licenses of all third-party software that is packaged as part of this TarifMatcher distribution.
README.md – A short readme file with a link to this documentation
CHANGELOG.md – A file containing the changes made to the software in all published versions since version 0.5.0.
tarifmatcher-{VERSION}-standalone.jar – An executable JAR containing all referenced Java classes that are necessary to run the software (including 3rd-party dependencies). Use this artifact if you want to use the Batchgrouper as an executable or if you do not include additional dependencies yourself.
tarifmatcher-{VERSION}.jar – JAR without dependencies. Includes only the tarifmatcher classes. Use this artifact if you want to use the software as a library and if you want to resolve the dependencies yourself.
tarifmatcher-{VERSION}-javadoc.jar – Contains the Javadoc files for the TarifMatcher software. Use this artifact if you need more detailed and up-to-date information about the classes and methods of the software.
tarifmatcher-{VERSION}.pom – Maven POM file stating the 3rd-party dependencies that are required by the TarifMatcher software.

Tariff files

Tariff files are distributed separately from the TarifMatcher software and versioned independently and according to the tariff version(s). All files are provided in a ZIP archive and contain the following files:

Patient classification system for “ambulante Pauschalen”

The grouper component groups patient cases according to specific versions of the “ambulante Pauschalen” (e.g. version 1.1 to be introduced in 2026). The grouper logic for the assignment of a group (Pauschale) is bundled for each version as a patient classification system. A patient classification system is bundled in a single JSON file and contains all logic, groups and code tables specific to this system.

The classification systems are provided on (TBD) and are versioned differently than the TarifMatcher software (Java components). Hence the publication schedule of the TarifMatcher software is independent of the schedule for the publication for new versions of the tariffs.

Filenames: system_ambP_XX_lkaat.json for the grouper and system_ambP_XX_cap_assignment.json for the Casemaster (XX is the version number)

Catalog for “ambulante Pauschalen”

Each patient classification system / version of the “ambulante Pauschalen” comes with its catalog with tax points for each class / group (Pauschale) that is assigned by the grouper. The catalogs are CSV files, included in the ZIP archive of a tariff version. The grouper component can be used to associate tax points with the resulting group.

Filename: catalog_ambP_XX.csv (XX is the version number, e.g. “1.1b”)

Catalog for LKAAT

The LKAAT catalogs is provided as a JSON file that contains the LKAAT codes and their mapping to TARDOC codes. The LKAAT catalogs are included in the ZIP archive of a tariff version. The mapper component can be used to map LKAAT services to TARDOC tariff positions.

Filename: lkaat_YY.json (YY is the version number, e.g. “1.0b”)

Catalog for TARDOC

The TARDOC catalog is provided as a JSON file that contains the TARDOC tariff positions, TARDOC rules and tax points. The TARDOC catalogs are included in the ZIP archive of a tariff version. The mapper component can be used to map LKAAT services to TARDOC tariff positions.

Filename: tardoc_ZZ_de.json (ZZ is the version number, e.g. “TARDOC_1.4b”, ‘de’ is the language code and can be one of ‘de’, ‘fr’, ‘it’)