Appointment service point
Appointment service centers in Germany serve to arrange appointments with resident specialists and psychotherapists in a timely manner if a referral is available . They are operated by the Association of Statutory Health Insurance Physicians . Your establishment on January 23, 2016 was enshrined in law by the Statutory Health Insurance Care Strengthening Act.
Mediation claim
The legal basis of the date of service point is § 75 para. 1a SGB V . Insofar as the statutory health insurance supply strengthening law has authorized the parties, Annex 28 to the federal contract for doctors specifies the legal basis.
All statutory insured patients who have been referred to a specialist are entitled to an appointment. No referral is required for appointment requests for ophthalmologists and gynecologists. A prerequisite for arranging an appointment for acute treatment with a psychotherapist is that a therapist must have recommended the treatment. The appointment service point must offer the caller a treatment appointment with a specialist within one week. The waiting time between the call to the appointment service point and the appointment to be arranged must not be more than four weeks. All routine and preventive examinations as well as minor illnesses are excluded from this 4-week period. If it is not possible to arrange an appointment within this period, the appointment service point must offer the insured person a treatment appointment in a hospital within one week.
The insured must be offered a specialist appointment within a reasonable distance. For doctors with general specialist care, the journey by public transport may take a maximum of 30 minutes longer than to the nearest specialist. For doctors with specialized and separate specialist care, a plus of 60 minutes is reasonable.
Implementation by the Association of Statutory Health Insurance Physicians
The appointment service points are operated by the 17 associations of statutory health insurance physicians. There are no uniform federal guidelines with regard to implementation, so that different procedures are used in the KV areas.
The most widespread method is the use of an electronically supported web application ("eTerminservice") that was programmed on behalf of the National Association of Statutory Health Insurance Physicians. Medical practices can use this portal - mostly on a voluntary basis - to set appointments which can then be assigned by the appointment service centers. To prove that they are entitled to a referral, the patients receive a special twelve-digit code with the referral from their general practitioner or specialist, which they must state when calling the appointment service point. There are currently 11 associations of statutory health insurance physicians using this portal.
The differences in implementation are shown in the following table.
| Association of Statutory Health Insurance Physicians | Available hours per week | Obligation to report by specialists | Appointment through | Use of the eTerminservice web portal |
|---|---|---|---|---|
| Baden-Württemberg | 36 hours | voluntary | Appointment service point | Yes |
| Bavaria | 37 hours | voluntary | Appointment service point | No |
| Berlin | 25 hours | voluntary | Appointment service point | Yes |
| Brandenburg | 10 hours | voluntary | Appointment service point | Yes |
| Bremen | 16 hours | voluntary | Appointment service point | Yes |
| Hamburg | 45 hours | 1–2 appointments per month must be reported for each specialist | Appointment service point | Yes |
| Hesse | 33 hours | voluntary | Appointment service point | Yes |
| Mecklenburg-Western Pomerania | 16 hours | voluntary | Appointment service point | No |
| Lower Saxony | 50 hours | Up to 24 appointments per quarter per specialist can be excluded from the fee limits. This is intended to encourage specialists to report appointments. | Appointment service point | Yes |
| North Rhine | 25 hours | voluntary | Appointment service point | Planned |
| Rhineland-Palatinate | 47 hours | voluntary | Appointment service point | Yes |
| Saarland | 15 hours | voluntary | Appointment service point | No |
| Saxony | 23 hours | voluntary | Appointment service point | No |
| Saxony-Anhalt | 17 hours | voluntary | Appointment service point | Yes |
| Schleswig-Holstein | 27 hours | Appointments service point assigns transfer cases according to a distribution algorithm | Appointments service point calls a specialist practice - appointments are made by the patient | No, but uses transfer code and transfer code verification |
| Thuringia | 15 hours | Two appointments per month must be reported per specialist | Appointment service point | Yes |
| Westphalia-Lippe | 25 hours | voluntary | Appointment service point | Yes |
Utilization
The National Association of Statutory Health Insurance Physicians has drawn an initial interim conclusion after 100 days. For exact utilization, she only has figures for the eleven KVs that use the eTerminservice web tool. If this data is extrapolated to the federal territory, the appointment service points arranged 31,500 specialist appointments in the first 100 days. This corresponds to around 525 appointment bookings per working day. Patient demand is rising steadily, but has so far fallen short of expectations. The most popular were appointments with internists and neurologists .
criticism
The establishment of the appointment service points is particularly rejected by the associations of statutory health insurance physicians. In their opinion, the waiting times in Germany are relatively short and the timely allocation of specialist appointments mostly works without the appointment service centers. The appointment service points are therefore unnecessary and costly bureaucracy.
The Federal Government's patient representative, Ingrid Fischbach , criticized the Association of Statutory Health Insurance Physicians for the fact that some of the appointment service points could not be reached for test calls during opening hours.
Web links
- Information from the National Association of Statutory Health Insurance Physicians on the appointment service points
- Overview of all telephone numbers of the appointment service points
Individual evidence
- ↑ a b c How do the statutory health insurance associations implement the appointment service centers in the federal states? Compilation by the German Foundation for Patient Protection. Retrieved May 13, 2016.
- ↑ a b - This is how every KV plans the new appointment service ( Memento of the original from May 12, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Doctors newspaper of January 21, 2016. Retrieved May 13, 2016.
- ↑ a b Presentation of the 100 day appointment service point website of the National Association of Statutory Health Insurance Physicians . Retrieved May 13, 2016.
- ↑ the KBV on appointment service points ( Memento of the original from May 12, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Website of the National Association of Statutory Health Insurance Physicians. Retrieved May 13, 2016.
- ↑ Patient Commissioner of the Federal Government: Seven appointment service points hardly reachable - no doctor can be found! January 3, 2018, accessed February 2, 2018 .
