How does RAB bill with my insurance?

The billing path for a house call

Unlike a statutory system with insurance card and direct billing, private medicine in Germany follows a classical three-step path: first, we treat you and document the services. Second, a few days later you receive a GOÄ-compliant invoice — with us via the Privatärztliche Verrechnungsstelle Berlin-Brandenburg, an established and officially recognised clearing house that has handled private billing for doctors for decades. Third, you submit this invoice to your private insurance (PKV), Beihilfe (for civil servants) or international insurance with the case number and receive the contractually agreed reimbursement. In this construct you are the contractual partner of your insurance — we are not directly connected to your insurance.

Why this is the case: private doctors in Germany have no direct contract with private insurers. The insurer reimburses what your personal tariff stipulates — for a standard full tariff usually 100 % of GOÄ-compliant services, for tariffs with deductible proportionately, for Beihilfe according to the Beihilfe rate (50 to 80 % depending on family status and rank) plus residual tariff. The upside is transparency: you see a detailed invoice, can check every position and know exactly what you are paying for. The downside is short-term pre-financing — the invoice is usually due within two weeks of receipt, the insurance reimbursement typically arrives 2 to 6 weeks after submission. For larger invoices you can ask your insurer to remit reimbursement directly to your account.

For statutorily insured patients: a private service is not reimbursed by the statutory fund. If you book a private house call as a GKV member, you pay yourself — we cannot grant a statutory discount because we are not a statutory contract doctor. For travellers with international health insurance the invoice is typically fully reimbursable in acute cases — the clearing house can issue an English version or a detailed breakdown for the insurer on request. For hotel guests and business travellers this is an established path.

Example: PKV-insured patient in Berlin

A PKV-insured patient in Schöneberg has a Sunday house call with antibiotic prescription for strep tonsillitis. Final invoice: 285 euros including weekend surcharge. Eight days after the visit she receives the invoice from the Verrechnungsstelle by email. She scans it with the app of her PKV (standard full tariff, 100 % reimbursement); the case is checked automatically; after 12 days 285 euros are on her account. She had transferred the invoice on receipt — i.e. three weeks before reimbursement, a typical pre-financing window.

Step by step: from visit to reimbursement

• We treat and document GOÄ positions on site.
• Invoice arrives 3 – 14 days later from the Privatärztliche Verrechnungsstelle Berlin-Brandenburg (PVS).
• Invoice contains: each GOÄ item with factor, travel fee, time surcharges, total amount.
• You submit the invoice to your PKV / Beihilfe / international insurer — usually via app, post or email.
• Reimbursement typically arrives 2 – 6 weeks after submission on your account.
• Invoice is due within 2 weeks of receipt — bank details are on the invoice.
• Travel insurance: the clearing house can issue an English version or a tailored breakdown.
• Statutorily insured patients pay the private service themselves — no statutory discount.