Claim for reimbursement after a non-contracted doctor or therapist (Austria)
Published byDocMuse
This document is in German
The PDF you download is in German — that is the language it has to be filed in, so it is not translated. Everything on this page is here to tell you what it says.
The covering letter for sending paid fee notes from a Wahlarzt or Wahltherapeut — a doctor or therapist without a contract with the insurer — to Austria's statutory health insurers ÖGK, SVS or BVAEB: with insurance number, patient, treatment period, fee notes and IBAN, and for the psychotherapy subsidy too. The ÖGK refunds 80 % of its contract tariff, not of the bill (§ 131 ASVG, Austria's General Social Insurance Act), if the claim arrives within 42 months of treatment (§ 102 ASVG). Online through MeineSV or the insurer's app is free and usually simpler; this letter is for claims on paper. In German.
What you fill in
The details the document asks for.
- Insured
- Insured's address
- Statutory health insurer (ÖGK, SVS or BVAEB)
- Insurer's postal address (regional office or customer service)
- City
- Date
- Social insurance number (ten digits, on the e-card)
- What you are claiming: reimbursement, or the psychotherapy subsidy
- Person treated (you, or a co-insured dependant, with their insurance number)
- Treated by (non-contracted doctor or therapist, or hospital: name, speciality, address)
- Period of treatment
- Fee notes or invoices (one per line: date, number, amount)
- Total amount
- IBAN
- Notes
Preview
This document is produced for you. Your answers are typed into it and the finished PDF is yours to keep.
Common questions
- How much does Austria's ÖGK refund after a visit to a Wahlarzt?
- Not the fee note, but 80 % of what the ÖGK would have paid a contract partner for the same service (§ 131 ASVG). If the Wahlarzt charges more than the contract tariff, the difference stays with you. The SVS and the BVAEB refund under their own acts and statutes. For psychotherapy, where there is no overall contract, the insurer pays a subsidy per session instead of a refund, set by its statutes (§ 131b ASVG).
- By when must a Wahlarzt's fee note be submitted in Austria?
- Within 42 months of the treatment, or the claim is lost (§ 102 ASVG). This is a cut-off, not a limitation period: it cannot be suspended or interrupted. Since 1 July 2024, Wahlärzte who see at least 300 different patients a year must send paid fee notes to the insurer electronically themselves, with your consent. So ask the practice whether that has already happened; if it has, you do not need this letter.
- How is a Wahlarzt bill submitted to Austria's ÖGK, SVS or BVAEB, and what if too little comes back?
- Most simply online, through MeineSV with ID Austria or through your insurer's app: upload the fee note and the proof of payment. On paper, hand this letter in with the receipts or send it by post, and keep copies. If you disagree with the refund, expressly ask for a formal decision, a Bescheid (§ 367(1) ASVG); only that decision can be challenged, by a claim at the Labour and Social Court.
How you can sign this document
- Print it and sign by hand. The signature lines in the document are left blank on purpose — sign on them in ink.
- Sign it yourself with a qualified electronic signature. If you already hold a QES — Evrotrust, B-Trust, StampIT, ZealiD or any qualified provider on the EU Trusted List, on a card, a USB token, in a mobile app or in the cloud — our signing guide explains step by step how to sign this exact file without invalidating it. Step-by-step help, and a way to check it worked
DocMuse sells documents, not legal advice. Acceptance always depends on the recipient's rules and your local law.
Related documents
- Application for care allowance – Pflegegeld (Austria)
The application for care allowance (Pflegegeld), or for a higher level of it, to the PVA, SVS, BVAEB or AUVA under Austria's Federal Care Allowance Act (BPGG) — with insurance number, pension received, treating doctor, the help needed in your own words, a person you trust for the assessment, and IBAN. Care allowance is due from the first of the month after the application arrives (§ 9 BPGG): the day it arrives counts. The insurers provide their own form free of charge, but an application without it is valid too. In German, to print, sign and send promptly.
- Request to see the medical record and for a copy (Austria)
The letter to a doctor's practice (Ordination) or hospital in Austria asking to see your medical record (ärztliche Dokumentation, Krankengeschichte) and for a complete copy — findings, doctors' letters, imaging, surgery and nursing reports. Since 30 July 2026 the first copy is free under the Austrian Physicians Act (§ 51 Abs 1 ÄrzteG 1998); for hospitals the letter relies on the Hospitals Act (§ 10 KAKuG), the Land's hospital act and Art 15 GDPR, under which the first copy is free too. Deadline: one month (Art 12(3) GDPR). You choose a copy, or inspection and a copy, and e-mail, post or collection. In German.
- Request for a formal decision from a social insurer (Austria)
The letter by which you expressly ask Austria's ÖGK, SVS, BVAEB, PVA or AUVA for a formal decision (Bescheid) on a benefit it refused (§ 367(1) of the General Social Insurance Act, ASVG, applied to the SVS and BVAEB by § 194 GSVG, § 182 BSVG and § 129 B-KUVG). There is no appeal within the insurer: a refusal by letter or phone can be challenged only once it is a Bescheid, by a claim at the Labour and Social Court. With the benefit, the date of your application, how it was refused and your reasons — after a refused reimbursement or rehabilitation, for instance. In German.
- Application to determine insurance periods (Austria)
The application to the PVA, SVS or BVAEB to determine your insurance periods bindingly, by formal decision (Bescheid), under § 247 of Austria's General Social Insurance Act (ASVG), or § 117a GSVG for those insured with the SVS — the way to settle missing periods such as child-raising, military or civilian service or employment before claiming a pension, rather than relying on the non-binding account statement. With insurance number, date of birth, former surnames and the periods at issue; proof is enclosed. The decision can be challenged at the Labour and Social Court. In German.
- Claim for reimbursement to a private health insurer (Austria)
The letter for sending doctor's, therapy or hospital bills to your private health insurer in Austria for reimbursement — under a non-contracted-doctor or private-ward (Sonderklasse) tariff, for instance: with policy number, patient, treatment, invoices, the amount already refunded by the statutory insurer (ÖGK, SVS or BVAEB) and IBAN, with no diagnosis in the letter. If the insurer refuses, it asks for written reasons naming the policy clause relied on. Many insurers offer an app or customer portal for uploading invoices; your policy terms say which documents are needed. In German.
- Claim against a social insurer's decision (Austria)
The claim at Austria's Labour and Social Court (Arbeits- und Sozialgericht) against a decision (Bescheid) of the ÖGK, SVS, BVAEB, PVA or AUVA — on care allowance, a reimbursement or insurance periods, for instance: with claimant and defendant, the decision, the facts, the evidence and the relief sought. It must be filed within four weeks of service, or three months in pension and care-allowance matters (§ 67(2) ASGG); a claim filed in time sets the decision aside as far as claimed. No lawyer is needed at first instance and insured persons bear no risk of costs (§ 77 ASGG). In German, to print, sign and file by post or through JustizOnline.