Genehmigungspflicht
Genehmigungspflicht means that patient rides to outpatient treatment must be approved by the health insurer in advance (§ 60 SGB V); rides to inpatient treatment need no approval, and for the disability markers aG, Bl or H and care grades 3 to 5 the approval is deemed granted.
Rides to outpatient treatment can only be prescribed in exceptional cases: a treatment scheme with a high frequency over a longer period, as a rule dialysis, radiotherapy and chemotherapy (§ 8 and Annex 2 of the Krankentransport-Richtlinie).
With care grade 3 the approval is deemed granted only if mobility is permanently impaired; rides to pre- or post-inpatient treatment and to outpatient surgery need no approval (§ 7 of the directive).
The insurer sets the duration and scope of the approval, such as the means of transport and outbound and return legs (§ 9 of the directive).
ALSO CALLED
- Vorabgenehmigung
- Kassengenehmigung