Reimbursement

The practice holds no contract with the public insurance funds – it is a private practice, a Wahlarztordination. You pay the fee yourself and then submit the invoice to your insurance fund. Eighty per cent of the public tariff is reimbursed.

How submitting the invoice works

1. After the appointment you receive an invoice. It contains everything the fund needs: your details, the diagnosis, the services provided, the date and confirmation of payment.
2. You submit that invoice to your insurance fund – with most funds online through their service portal, by post, or in person at a service point.
3. The reimbursement is transferred to your account, usually within a few weeks.

There is a deadline: as a rule you have 42 months from the day of treatment. It is still worth submitting invoices promptly, because otherwise they tend to be left lying around.

What 80 per cent actually means

This figure is frequently misunderstood. What is reimbursed is 80 per cent of what the same service would have cost at a contracted practice – not 80 per cent of the fee you paid here. The public tariff is considerably lower than a private fee, and the difference stays with you.

It is better to know that beforehand than afterwards. If you want to know the exact reimbursement for a particular service, ask your fund – they can name the tariff for the item in question.

All of this describes the Austrian public insurance system. If you hold private or foreign insurance instead, you can submit the invoice to your insurer as well – what you are reimbursed then depends on your individual cover, not on the Austrian tariff. Asking your insurer in advance is the reliable way to find out what it covers.

Which funds accept the invoices

The invoices of this practice are accepted by, among others, the following bodies:

• Österreichische Gesundheitskasse (ÖGK)
• Sozialversicherungsanstalt der Selbständigen (SVS)
• Versicherungsanstalt öffentlich Bediensteter, Eisenbahnen und Bergbau (BVAEB)
• the health welfare institutions of the provinces and cities, such as KFA Wien
• private health insurers, within the terms of the individual policy

Supplementary insurance

Depending on the contract, private supplementary insurance covers part or all of the remainder. The usual sequence is that the public fund reimburses first and the supplementary insurer then covers the difference – for which it generally needs the fund’s statement in addition to the invoice. What your contract provides is set out in your policy; if in doubt, a phone call to the insurer before the appointment helps.

Why a private practice

The difference you notice is time. A consultation lasts 25 minutes, and every examination carried out on the spot is included. With a coil insertion that is exactly the point: the procedure itself takes a few minutes, but how it is experienced is decided by the preparation and by whether anyone is working against the clock.

The fees of this practice are set out in full on the page Fees – with no small print and no items that appear for the first time on the invoice.