Call for Applications: Open Innovation Challenge (Switzerland)

Challenge

• Switzerland’s upcoming transition from the legacy TARMED tariff system to TARDOC and outpatient flat rates (ambulante Pauschalen) will fundamentally reshape how outpatient medical services are documented, coded and reimbursed as of 1 January 2026. This change is more than administrative — it demands a transformation in how healthcare providers document and code patient interactions.
• TARDOC and outpatient flat rates introduce new layers of billing logic: the billing outcome for a case depends not only on what was done, but also on when it was done, which insurance type was involved, and which organ system the case relates to. If the codes are incomplete or the case is not grouped correctly, it may not qualify for flat-rate reimbursement or even be ultimately rejected. The logic is strict, and errors can lead to underbilling, compliance risks or delays in reimbursement.
• After care is delivered to a patient, hospital IT systems assemble billing-relevant information into a structured format. At KSBL and many other Swiss hospitals, this is done using ALIS, a standardized data interface that packages key service and diagnostic information. The ALIS format does not include full clinical documentation; instead, it captures essential metadata such as performed services, timestamps and department codes. This dataset eventually lands on the desk of the coding team, which assign billing codes retrospectively.
• This is where AI can make a tangible impact. The right solutions can act as a validation layer between ALIS data export and coding – analyzing structured data to reduce manual work, increase coding accuracy, and enable hospitals to navigate the new TARDOC and outpatient flat rate environment by, for example:
  • Detecting whether required ICD-10 codes are missing or inconsistent.
  • Suggesting plausible code completions or corrections.
  • Flagging uncertainty or highlighting documentation that requires human review.
  • Generating a confidence score for each coding decision to help prioritize effort.
• Crucially, AI can do this before the case reaches final billing — catching issues while they are still easy to correct.
• By building usable AI tools that support coders within the new reimbursement process, participants will contribute not only to smoother hospital operations, but to a more transparent and efficient Swiss healthcare system overall. The solutions co-created within the framework of this Challenge can become the foundation for broader adoption across the country as these new reimbursement models take hold.
• Challenge participants will receive a detailed overview of KSBL’s reimbursement workflows, user journeys, and IT system requirements.

What Innovation Booster support is available? 

• Fuel your innovation
  • Up to CHF20,000 non-dilutive funding per project to develop or adapt solutions.
• Unlock top-tier resources
  • Including support and clinical expertise from the Kantonspital Basel Land, to validate your idea.
• Accelerate your growth
  • Coaching, workshops and mentorship to boost your idea.

Eligibility Criteria

• Anyone can apply for the Open innovation call and participate in Challenge events aimed foster collaboration and knowledge exchange, creating a shared understanding of the problems being addressed and generating innovative solutions.
• To be eligible for the Innovation Booster “Idea to MVP” stage support and funding, teams must have at least one research partner and one implementation partner. Research partners can be university research institutes, non-commercial research centers, departmental research institutions or federal research institutes. Implementation partners can be SMEs, larger companies, start-ups, non-profit organizations or others with the potential to contribute to the innovation process.​ The definition of implementation partners is flexible and depends on the nature of the idea being explored.
• Innovation boosters aim to promote the economical and societal development of Switzerland, and the ideas must directly contribute to this goal. While international partners can be included in innovation teams, the primary benefit should be for the Swiss economy and society.
• The following conditions apply:
  • IBs must award and release the innovation team funding to a Swiss beneficiary.
  • A Swiss implementation partner is required in every innovation team and value creation must be in Switzerland.

For more information, visit DayOne.