The practices for the Upright MRI are private practices. This means that they cannot bill the statutory health insurers (SHI – [German: Gesetzliche Krankenversicherung / GKV]) directly for the costs of the examination. This is due to the fact that for direct billing with the SHI, a special billing authorization with the SHI must be available, which the practices, however, do not have. However, from a technical point of view, the Upright MRI fulfills the requirements specified by the SHI, so all quality criteria are met.
If a patient comes to us with a SHI, then we treat the patient as a self-payer. This means that he enters into a treatment contract with the private practice for Upright MRI (just like the private patients). The private practices for Upright MRI do not have a contract with the SHI, on the basis of which the SHI does not pay any money to the practices. However, the patient has a contract with the SHI, so they can claim reimbursement from the SHI under special conditions.
The following steps should be considered for reimbursement:
1) There must be a reason why the examination must be performed in the practice and not in another radiology practice. Reasons for this are often claustrophobia, that an examination of the patient because of e.g. severe shortness of breath, ankylosing spondylitis or pain etc., can only be performed in a sitting position, but not in a lying position. Or a spondylolisthesis, spinal canal stenosis, etc. is to be visualized, for which functional images are necessary. Due to the technical requirements, these can also only be performed in our practice in the Upright MRI. Otherwise, only a conventional myelography with significantly higher risks would be possible for further clarification. Many patients also state that they only have discomfort when standing or walking, but not when lying down. Therefore, an examination in the position in which the patient also has pain also makes sense.
2) The certificate for the reason for the examination must be issued by the referring physician. Corresponding forms can be downloaded further down on this page. However, it is important that the referring physician takes into account the special problems / complaints of the patient, otherwise there may be problems with the reimbursement of costs by the health insurance. A general reason is usually not sufficient for the SHI (such as: pain, anxiety…).
3) From the private practice for Upright MRI the patient receives a cost estimate for the respective examination and a certificate that the Upright MRI meets the quality requirements and complies with the radiological standards.
4) The patient then submits all certificates together to the SHI. The processing time takes about 1 to 2 weeks, this can be shortened if the patient contacts the health insurance company personally. Only when the patient receives a cost confirmation from the SHI should an appointment be made with us. Otherwise, patients are often not reimbursed by the SHI, and the costs of the performed examination must then be borne by the patient himself. However, if an examination must be performed immediately due to the clinic, then make an appointment directly with our practice. However, experience has shown that it is rather difficult for the SHI to cover the costs.
Here you can find the corresponding templates in an overview:
Open MRI for foreign patients
We generally cannot bill with insurance companies abroad. For an examination in the Upright MRI, you therefore conclude a treatment contract with us as a private patient. Following the examination, you will receive an invoice from us with the costs, which you pay directly after your MRI examination on site.