SZO Oberwallis:
Intelligence Brief

Spitalzentrum Oberwallis — Brig & Visp
68,441 episodes · 2.3M billing events · CHF 33.2M · 2023–2024

February 2026

The Hospital at a Glance

2
sites
Brig & Visp
498
cost centers
48,382
active materials
11,427
suppliers

70% outpatient / 30% inpatient — 47,587 ambulatory episodes · 20,839 stationary episodes

Two Sites, Two Economies

Brig
702K events · CHF 29.8M (90%)
13,336 cases

Oncology: CHF 26.1M from one cost center.
High-value, low-volume. Drug pricing dominates.
Visp
1,572K events · CHF 3.4M (10%)
55,105 cases

2.2× more rows at 1/9th the CHF.
High-volume ward consumables.

Brig = high-value oncology concentration · Visp = high-volume ward consumables

Nine Questions We Asked

  • REVO Materials used but not billed?
  • DUPL Same event billed twice?
  • PHAN Billing for non-existent cases?
  • STAL Catalogue out of date?
  • COMA Costs on the wrong desk?
  • COGA Controlled substances traceable?
  • XILE Materials crossing sites untracked?
  • GENO Overpaying for generics?
  • IOIM More going in than coming out?
9
hypotheses
25
probes
20 regular + 5 assessments
6
root-cause diagnoses

Revenue & Billing

Where money enters the system — and where it leaks out

Materials used but not billed

54,830
findings
CHF 17.3M
at risk
Confirmed
score 0.67
Usage events without matching billing. Under DRG inpatient rules, this is expected — materials are bundled into the case rate. But for ambulatory and high-cost items, it represents real revenue loss.

Duplicate and Phantom Billing

10,268
duplicate findings
1,068
orphan billing rows
CHF 33.3M
combined at risk
Both Confirmed
score 0.67 / 1.00

probe_duplicate_billing found 10,268 duplicates. probe_orphan_billing found 1,068 rows referencing non-existent cases. Same events often trigger both.

Why the Hypothesis Totals Don't Add Up

Each hypothesis aggregates multiple probes and assessments. A billing event flagged by 3 probes appears in 3 hypotheses.

Gross sum across all hypotheses: ~CHF 376M. Real exposure is a fraction of that.

The probes identify overlapping symptoms of the same underlying issues.
The diagnosis system untangles which root causes drive which findings.

The 86% Pattern

Zero-CHF
1,957,286 (86%)
< CHF 10
216,000
CHF 10–100
77,000
CHF 100–1K
15,000
CHF 1K–10K
7,114
CHF 10K+
230
Only 7,344 events (0.3%) carry CHF 26.1M — 79% of all billing.
This is DRG billing: ward consumables bundled into the case rate.

B-Onkologie: CHF 26.1M from One Cost Center

MaterialCHF
Keytruda (Pembrolizumab)4,350,000
Darzalex (Daratumumab)1,800,000
PRIVIGEN (Immunoglobulin)1,080,000
Opdivo (Nivolumab)879,000
Perjeta (Pertuzumab)668,000
Ogivri (Trastuzumab)595,000
Bavencio (Avelumab)557,000
Imbruvica (Ibrutinib)557,000

CC 17405 (B-Onkologie ambulant) accounts for 79% of total hospital billing.
Oncology drug pricing dominates financial risk.

Revenue Cluster: What We Know

Orphan Case Data Entry
PHANdata_quality · 85% confidence

Stale case IDs persist in the billing system after case merges or cancellations. Delayed master data sync between clinical and billing systems.
Investigation Pending
REVO Revenue leakage and DUPL duplicate billing have no root-cause diagnosis yet.

The billing workflow gap diagnosis exists but did not trigger for SZO. Further investigation needed.

Catalogue & Pricing

Is the material master keeping up with reality?

963 Stale Articles, CHF 3.1M at Risk

963
findings
CHF 3.1M
at risk
Confirmed
score 1.00
MaterialCHFSeverity
Opdivo (Nivolumab)879,000high
Pelgraz (Pegfilgrastim)394,000high
Zejula (Niraparib)237,000medium
Ibrance (Palbociclib)220,000high
Imnovid 4mg (Pomalidomide)206,000high
Imnovid 3mg (Pomalidomide)118,000high

Active billing against expired validity dates. Almost all oncology drugs.

The Price Gap

22,043
findings
CHF 30.4M
at risk
967K
units affected
Confirmed
score 1.00
Materials where internal pricing exceeds generic equivalents. Structural gap — procurement contracts not renegotiated.

Below-Cost Billing

Negative Margin
12,853 findings
CHF 4.2M at risk

Materials sold below purchase price. PRIVIGEN (top-3 oncology drug) shows negative margin.
Billing Below Internal Price
56,738 findings
CHF 16.8M at risk

Billing amount lower than the hospital's own internal price list.

Combined: tens of thousands of events where the hospital sells below cost.

The Foundation

EntityValid %Invalid RowsImpact
Cases100%0
Materials73.7%17,250Zero-price cascade
Billing Events95.7%∼98KOrphan material refs
Usage Events95.4%∼113KOrphan material refs
Movements90.2%∼87KInvalid locations
Suppliers100%0
Article-Suppliers2.8%∼166KMissing price/FK
17,250 zero-price materials cascade into 211K invalid billing + usage rows.
CHF 1.24M invisible to Gold-layer analytics.

Catalogue Cluster

Catalogue Maintenance Lag
STALprocess_failure · 85% confidence

Articles not reviewed or updated on schedule. Expired validity dates and missing standard prices accumulate over time.
Procurement Pricing Mismatch
GENOstructural · 85% confidence

Supplier agreements outdated for high-volume generics. Gap between procurement contracts and internal pricing not reconciled.

Structural & Operational

Cost centers, cross-site flows, and the I/O gap

Costs on the Wrong Desk

138,635
findings
CHF 66.7M
at risk
Confirmed
score 1.00
CC encoding: 5-digit billing (1xxxx=Brig, 2xxxx=Visp) vs 4-digit master data.
148 actual CC mismatches + 66,720 producteur mismatches.

Root cause: CC master data drift (data_quality, 85%) — CC assignments drifting after organisational restructuring.

Materials Crossing Sites Untracked

5,030
cross-site findings
CHF 393K
at risk
Confirmed
score 1.00
2.2% of billing crosses site boundaries. Financial tracking is opaque.

Root cause: Cross-site routing error (process_failure, 90% confidence — highest of all diagnoses).
Transfer orders not closed before billing.

The Hypothesis We Could Not Test

Not Observed
score 0.53
is_controlled_substance: 0% populated in OPALE export.
is_generic: 0% populated. MIGEL codes: 0% populated.

This hypothesis cannot be evaluated from current data.

Not disproven — untestable. Resolving this requires enriching the OPALE export or connecting to a reference database.

Two Supply Chains

Warehouse
TRANSFER
Ward Stock
Scanned
coeff ≈ 1.0
Pharmacy
Direct
Usage Only
no transfer
Ward Stock
Not Scanned
transfer-only

Overall I/O coefficient: 0.47 — but this is not a single number. It's three populations.

Three Populations

Transfer-only
1,323 (25%) · CHF 15.1M
Both-present
2,343 (43%) · CHF 9.5M xfer
Usage-only
1,727 (32%) · CHF 6.5M
Transfer-only
CHF 15.1M in warehouse moves with no patient attribution. Ward consumables.
Both-present
CHF 9.5M xfer vs CHF 7.7M usage. The analytically meaningful segment.
Usage-only
CHF 6.5M pharmacy dispensing. Oncology drugs, regulated items.

The Actionable Gap

Both-present materials, min 100 transfers

SegmentMaterials%CHF Delta
Under-recorded (< 0.80)73167.5%3,000,000
Balanced (0.80 – 1.20)27325.2%1,000,000
Over-recorded (> 1.20)797.3%615,000
Balanced segment proves accurate tracking is possible.
Total actionable delta: CHF 4.6M.

Root cause: Inventory process gap (process_failure, 85%) — disconnect between ward receipt and patient-level documentation.

The Full Picture

Verdicts, assessments, and what comes next

8 of 9 Confirmed

CodeHypothesisStatusFindingsScore
REVORevenue leakageConfirmed109,7400.67
DUPLDuplicate billingConfirmed77,0050.67
PHANPhantom casesConfirmed78,0731.00
STALStale catalogueConfirmed10,3971.00
COMACC misallocationConfirmed138,6351.00
XILECross-site leakageConfirmed138,4871.00
GENOOverpriced genericsConfirmed22,0431.00
IOIMI/O imbalanceConfirmed12,4001.00
COGAControlled substance gapNot observed8,4210.53

CHF values overlap — same events trigger multiple hypotheses.

Five Assessment Scorecards

Material Overall
722 high
1,922 medium
6,215 low
Material Compliance
49 high
881 medium
7,436 low
Billing Quality
15 high
2,302 medium
64,420 low
Material Health
181 high
2,061 medium
5,880 low
Case Financial Integrity
0 high
6,661 medium
48,249 low

Six Root Causes

#Root CauseCategoryConf.Hypothesis
1Cross-site routing errorprocess_failure90%XILE
2Catalogue maintenance lagprocess_failure85%STAL
3Procurement pricing mismatchstructural85%GENO
4Orphan case data entrydata_quality85%PHAN
5CC master data driftdata_quality85%COMA
6Inventory process gapprocess_failure85%IOIM
REVO Revenue leakage and DUPL duplicate billing have no diagnosis yet — root cause investigation pending.

Six Things in 90 Days

  1. 1 Quarterly catalogue review — 963 stale oncology articles with expired validity. Procurement + Pharmacy.
  2. 2 CC master data reconciliation — 5-digit vs 4-digit mapping against current org chart. Finance, 1 week.
  3. 3 Top-20 negative margin materials — Cross-reference against supplier contracts. Procurement.
  4. 4 Billing interface audit — Check for duplicate transmission and orphan case IDs. IT.
  5. 5 Cross-site transfer workflow — Verify transfer orders close before billing. Logistics.
  6. 6 Ward scanning pilot — 5 high-value materials with I/O < 0.5 on one ward. Nursing + IT.

What We Need From You

  • Controlled substance flags — is_controlled, is_generic, MIGEL codes. Enriched export or reference database.
  • Procedure data — 0 rows in current export. Required for implant traceability and DRG analysis.
  • Org chart — For cost center master data verification and restructuring timeline.
  • Supplier contract terms — For negative-margin audit and procurement renegotiation.
These gaps are data availability, not system limitations.
The analytics pipeline is ready — the fields exist, they just need to be populated.

From Data
to Decisions

25 probes · 9 hypotheses · 5 assessments · 6 diagnoses

Every finding is traceable. Every number is queryable.
Every root cause has a recommendation.

nuMetrix — February 2026

nuMetrix