Cost coverage

Reimbursement for privately insured persons

Dear patients,

Occupational therapy treatment is carried out on the basis of a medical prescription, specifying the remedy, the number of treatments, and the patient’s name and address.

Before therapy begins, a treatment contract (fee agreement) is concluded between the therapy practice and the private patient. In this contract, I commit to providing my defined therapeutic services, and the patient agrees to pay me the agreed price for the services rendered, regardless of reimbursement from private health insurance.

Private health insurance companies generally cover the costs of occupational therapy treatments, provided they are included in your insurance policy. You determine the exact amount of coverage at the start of your insurance policy.

Patients eligible for medical assistance receive reimbursement according to the applicable medical assistance regulations, which may vary by federal state. This may result in a partial reimbursement of the fee bill. If there are any differences that are not covered by the medical assistance office, you will have to cover them yourself. You may have supplemental insurance for such cases, which could help you with this.

Unfortunately, due to the diversity of insurance conditions, tariffs and subsidy regulations, I am unable to make a statement about the amount of reimbursement or the ability to reimburse.

I base my work on the fee schedule for therapists (GebüTh) and bill private patients, self-payers, and those entitled to benefits according to a signed fee agreement. The agreed fee agreement is valid regardless of whether and to what extent a claim for reimbursement exists against the cost carrier. The amounts set by the cost carriers do not affect the validity of this agreement.

For further information on pricing for private patients, please visit the website www.privatpreise.de .

In some cases, private health insurers attempt to reduce reimbursement premiums, often using reasons that are unjustified according to various court rulings. If you are faced with such a situation, we recommend that you file a written objection and assert your rights. If problems still arise, you can first contact an ombudsman, who will act as a free mediator between you and your private health insurer.

Further information on this option can be found at www.pkv-ombudsmann.de .

I always strive to help you as best as possible and am happy to answer any questions you may have.

Best regards,
Carolina Keller