Self-employed nursing: billing and bookkeeping in Switzerland

Nursing independently requires a licence from the canton in which you work. It calls for a recognised nursing diploma and supervised professional experience — as a rule two years full time, correspondingly longer at a smaller workload.

The licence applies per canton. Work across cantonal borders and you need several. The cantonal health department is responsible; your professional association's local branch knows the details on the ground.

The ZSR number from the register of payee codes identifies you to health insurers as a provider authorised to bill. The register is run by santéservices (formerly SASIS AG).

Two steps come before the application: cantonal approval to bill mandatory health insurance, and joining the administrative agreement through your professional association. You don't have to apply for a GLN — it is generated automatically with your approval.

Plan generously and start with the licence. The ZSR number sits at the end of that chain, not at its beginning.

Under tiers payant you bill the health insurer directly. Under tiers garant you invoice your client, who claims the amount back from their insurer. Which model applies isn't a matter of preference but of the agreement and the insurer — and it determines who your debtor is.

Technically, your service records become a billing file in the Swiss General Invoice XML standard, which reaches the insurer via an intermediary. Since July 2024 you bill assessment, advice and coordination as well as basic care directly, without a medical prescription: more independence, and more invoices passing through your hands.

Alongside KVG, depending on the case, come UVG, IVG and MVG (the Swiss accident, disability and military insurance laws). And next to all of that sit patient cost-sharing under Art. 25a KVG and services outside the tariff that you invoice yourself.

Submitting the invoice doesn't finish the work, it starts it. Which insurer has paid, which hasn't, since when is something overdue, what is left at the end of the year? Without ongoing reconciliation between invoice and incoming payment, an unpaid invoice stays invisible for months.

Two thresholds are worth knowing early. Above CHF 100,000 of taxable turnover you become liable for VAT — tariffed care doesn't count towards it, consulting and training do. Above CHF 500,000 in turnover, double-entry bookkeeping becomes mandatory.

Your accountant stays for the year-end, taxes and the questions where experience counts. For data entry they are no longer needed: photographing a receipt takes five seconds.

CuraSovo reads the billing file you submit to the insurer anyway and creates the entries in your bexio accounting from it — with the contact, the revenue account and a link back to the document in your care system. bexio reconciles incoming payments against the bank, so you can see live what is open and what is overdue.

CuraSovo creates neither the invoice nor the QR payment slip — that stays with your care system. CuraSovo takes care of the complete, reconciled bookkeeping behind it.