Fee agreement and patient information according to § 2 GOÄ
for a private medical video consultation
Therapist:
Dr. Jacqueline Metzner
Doctor with additional qualification in acupuncture and naturopathy
Private medical practice
Krummebergstr.13
88662 Überlingen
Phone: 0049 7551 9475688
info@dr-metzner.eu
1. Type of service
The medical service includes a detailed initial online medical history as part of a video consultation. This consultation serves as a medical consultation and diagnostic tool and is performed exclusively by the aforementioned physician. Treatment will be provided exclusively via remote treatment in accordance with Section 7, Paragraph 4 of the Model Professional Code of Conduct (MBO-Ä), provided this is medically justifiable.
2. Fees and billing basis
Billing is based on an individual written fee agreement in accordance with Section 2, Paragraph 1 of the German Fee Schedule for Medical Services (GOÄ). A fee exceeding the standard maximum rate is agreed upon because the service requires a significant amount of time and effort.
Service: Initial consultation via video consultation (duration approx. 60 minutes)
Fee: €183.60
Billing basis: German Medical Fee Schedule (GOÄ), analogous to section 30
Increase rate: 3.5 times the rate
VAT: The service is exempt from VAT according to Section 4 No. 14 UStG.
The fee must be paid in advance by credit card. A GOÄ-compliant invoice will be issued after the service has been rendered.
3. Reimbursement and self-payment information
Billing is carried out according to the GOÄ regulations. For privately insured patients, the invoice can generally be submitted to the insurance company. However, full reimbursement cannot be guaranteed in every case – especially in cases of similar assessments or higher incremental rates.
Patients without private health insurance (self-payers) may also use this service. In this case, the agreed fee must be paid in full. Reimbursement by statutory health insurance providers is not provided.
4. Data protection and confidentiality
The video consultation will be conducted via a certified, data protection-compliant platform in accordance with the GDPR. No recording will be made. Medical confidentiality will be fully maintained.
5. Cancellation policy / cancellation fee
If you are unable to keep an agreed appointment, please notify us in writing by email to [kontakt@deine-domain.de].
Cancellation or rebooking is possible free of charge up to 48 hours before the appointment.
In the event of cancellation less than 48 hours before the appointment or in the event of a no-show, we reserve the right to charge a cancellation fee equal to the agreed fee, provided that the appointment could not be rebooked (Section 615 of the German Civil Code).
6. Declaration of consent
This agreement is concluded digitally. A handwritten signature is not required. The current version, dated June 13, 2025, can be downloaded and saved for your records.