Instructions

You pay first. Then the money comes back.

This is the biggest practical difference from the public system — and the point where almost everyone stumbles once in the first year.

The process

Four steps, no more than that.

01 Attend the appointment At a doctor's practice you pay nothing in the consulting room. The invoice arrives by post a few days to a few weeks later. It is different with alternative practitioners, physiotherapy and smaller practices — there you often pay on the spot. Keep the receipt.

02 Submit the invoice Through your insurer's app, by email to the claims department or by post. The app is the fastest. If you are my client, send it to me — I check the billing before it goes any further, and that costs you nothing extra.

03 The insurer checks it It is checked against your tariff, against the medical fee schedule (Gebührenordnung für Ärzte) and against the diagnosis. If everything fits together, it moves quickly. If an unusual multiplier stands out, a query follows — to you or directly to the practice.

04 Reimbursement to your account For an unremarkable invoice, often within a few days. If the insurer has to query it with the doctor, it takes correspondingly longer. Make sure you pay the invoice yourself on time — the practice's payment deadline runs independently of the reimbursement.

Eine Arztrechnung wird mit dem Smartphone abfotografiert — **Two minutes of effort**Photograph the invoice, upload it, done. The rest happens at the insurer.

Take care

Three pitfalls that cost money.

Therapies without a prescription

Most tariffs reimburse physiotherapy, occupational therapy and speech therapy only with a doctor's prescription. Without one the payment is reduced or refused altogether. See the doctor first, then start the treatment.

Overlooking the GP-first rule

Some cheaper tariffs require you to see a GP before a specialist. Skip that and the specialist's invoice is only partly reimbursed. Check this once in your contract — it is rarely on page one.

Expensive treatment without prior approval

For dental prosthetics, larger operations and psychotherapy a treatment and cost plan (Heil- und Kostenplan) in advance is worth having. The insurer then confirms in writing what it will cover. After that there are no more surprises.

What belongs in the paperwork

The practice's original invoice
Your insurance number
The bank details held on file by the insurer
A prescription or referral, if your tariff requires one
Pharmacy receipts as a separate submission, not together with the doctor's invoice

Keeping the premium refund in mind

Many tariffs pay you back premiums at the end of the year if you have submitted no invoices — depending on the contract, one to six monthly premiums. For small amounts it can therefore be worth paying yourself and taking the refund. Work it through once for your own tariff before you submit an invoice for eighty euros.

Watch out for one particularity: many tariffs leave preventive check-ups out of account, so they do not cost you the refund. What exactly applies in your case is set out in your tariff terms — and I am happy to look it up for you.

When it takes a long time

If the reimbursement drags on beyond a week, the invoice is usually under review. A short call to the claims department normally clears up where it is stuck. If the payment is reduced after all, the insurer has to give reasons — and those reasons can be examined.

An invoice you do not understand?

Send it to me. Checking invoices is part of the ongoing support for my clients and costs nothing extra.

Have an invoice checked