Cash register approval
The insurance approved (more precisely: "socio-legal authorization") refers to the authorization of in Germany physician , psychological psychotherapist , dentist and a physiotherapist or occupational therapists and podiatrists , his achievements on the physicians 'association (KV) and dentists' associations (KZV) at the expense of to settle statutory health insurance . In Germany, registration with the cash register takes place through an administrative act .
In Austria, you are entitled to take part in the medical care of the social insured as a freelance doctor and to settle the fees set out in a fee schedule directly with the social insurance, based on an individual private contract between the doctor and the health insurance provider. Such doctors are called contract doctor or health insurance doctor . The number of contract doctors and their local distribution is determined by collective agreements, taking into account the number of beneficiaries, by mutual agreement between the Austrian Medical Association, the Federal Curia of Resident Doctors and the Main Association of Austrian Social Insurance Institutions. Interested doctors can apply for vacant contract doctor positions.
Germany
Admission
Doctors, psychotherapists and dentists are licensed by the licensing offices set up by the (dental) medical associations and the regional health insurance associations as well as the substitute funds for the district of each (dental) medical association or for parts of this district. The committees are made up of representatives of doctors, psychotherapists or dentists and the health insurance companies on an equal footing and are bound by the requirements of the respective approval ordinance. In the medical field, the requirements planning of the approval is also the basis. In the dental field, the admission restriction has been abolished.
For psychological psychotherapists , this insurance approval has existed since the Psychotherapists Act 1999 came into force . Approbation is a prerequisite for approval under social law, but not synonymous with this . The license to practice medicine is issued by the responsible state authorities in the respective federal state.
The physicians with statutory health insurance are also referred to as contract physicians, statutory health insurance physicians , or contract dentists or statutory health insurance dentists . The psychotherapists contract psychotherapist or health insurance fund psychotherapist.
Proof of insurance
The health insurance card or the electronic health card at the doctor, dentist or psychotherapist serves as proof of insurance for the patient . This settles the accounts with the health insurance companies via the KV or KZV. A distinction is made between services that are subject to application (e.g. psychotherapy , dentures ) and services not subject to application (e.g. treatment of a fracture ).
Economic framework
For the doctor or psychotherapist, the health insurance license in most cases represents the economic basis of his professional practice, because it entitles the treatment of the vast majority of the population who are members of a statutory health insurance . This contrasts with the fact that the system of statutory health care has a large number of bureaucratic regulations. As an alternative to the generally widespread principle of benefits in kind , reimbursement has also been available for those with compulsory insurance since January 2004 , although this is limited to the rates that the statutory health insurances would have to cover for benefits in kind. This limitation may result in additional costs to be borne by the legally insured person, which can be covered by private additional insurance if the cost reimbursement principle is selected.
Private treatments
If a practitioner does not have health insurance, he can only bill the patient for services under private law. Patients then usually cover their cost risk with private health insurance .
The fees for private medical or psychotherapeutic treatment, also in the context of so-called IGe services (individual health services), are based on the fee schedule for doctors (GOÄ), for psychotherapists according to the fee schedule for psychotherapists (GOP), for dentists according to the fee schedule for dentists (GOZ). Private health insurers usually reimburse up to three and a half times the fee rates specified in the GOÄ / GOZ, some private health insurances even beyond this.
Transferability
So far, doctors or psychotherapists have been allowed to sell or bequeath their statutory health insurance license. The background to this is the admission restriction in so-called oversupplied areas, for which no new admission is granted, but only a cash register admission can be purchased. The submission of a practice is now tied to conditions set by the respective statutory health insurance associations.
A health insurance license has not been sold to dentists since the health reform (GKV - Competition Strengthening Act) in § 103 SGB V, Paragraph 8, lifted the license restrictions on April 1, 2007.
See also
Individual evidence
- ↑ § 338 General Social Insurance Act (ASVG)
- ↑ Information on the website of the Austrian Social Insurance ( Memento from December 24, 2014 in the Internet Archive )
- ↑ Archived copy ( Memento from December 25, 2014 in the Internet Archive )
- ↑ Admission Ordinance Doctors (Doctors ZV)
- ↑ Admission Ordinance Dentists (Zahnärzte-ZV)
- ↑ Transitional and final provisions: Doctors' Admission Ordinance, Section XIII, Section 47 (2): "Sections 25 and 31 Paragraph 9 only apply to applications by psychotherapists that are submitted after December 31, 1998."
- ↑ § 103 SGB V
