How do I become an AC technician

Billing for long-term care insurance benefits

The following types of long-term care insurance benefits include the data exchange procedure in accordance with Section 105 SGB XI:

  • Care in kind according to §36 SGB XI
  • day care
  • night care
  • Short-term care §41 SGB XI
  • Full inpatient care §43 SGB XI
  • Care aids
  • Replacement care
  • Subsidy according to § 43 Abs. 3 SGB XI
  • Advisory service according to Section 37 (3) SGB XI
  • Relief benefits according to § 45b SGB XI
  • Advice voucher according to § 7b SGB XI
  • Residential group surcharge according to § 38a SGB XI
  • Nursing courses according to § 45 SGB XI
  • Remuneration surcharge according to § 43b SGB XI (remuneration surcharge for additional support and activation)

Data acceptance and verification

Send the data records with the invoice content to the service provider T-Systems commissioned by TK.

T-Systems
Fasanenweg 5
70771 Leinfelden-Echterdingen

IK number: 109989162
Email: [email protected]

The TK-Pflegekasse must be identified as the recipient of the user data with decryption authorization (IK number: 181575519)be entered.

If you have any questions about the configuration, please contact your software manufacturer.

At TK, the data go through a pre-checking software that checks the data for syntax errors. In the event of an error message, you will receive an email with a description of the error.

Please send the original receipts and performance records to the following address:

Techniker Krankenkasse
20902 Hamburg

Trial procedure

In order to be able to participate in the procedure, every service provider and billing service provider must go through a test procedure.

The aim of the test phase is that after successful implementation, proof is available for every service provider and billing service provider that they deliver syntactically and semantically correct files that can be processed by TK without technical errors. Insured person-related technical examinations are not carried out in the trial phase.

Registration for testing procedures

You then have the option of registering with TK online with your care facility. To do this, you need the institution ID of the participating institutions.

If you have any questions about the required information, please do not hesitate to contact us.

Every service provider and billing service provider who has registered for the trial procedure will receive a letter of confirmation after the check has been carried out. In addition to general information on the further course of the test procedure, this contains a summary of the data transmitted by the service provider and billing service provider as well as the start date for the test procedure.

How can I register my care facility for the test procedure for data exchange according to §105 SGB XI?

Simply use our online form to register:

Test procedure for data exchange of care services

FAQ on the data exchange procedure according to § 105 SGB XI

Which data are required for the data exchange procedure according to §105 SGB XI?

The institution identifier (IK) of the physical recipient and the logical recipient is required for the transmission of the data.

Physical recipient: 109989162
Logical receiver: 181575519

Which documents are to be sent to TK in paper form?

phase

documents

Trial procedure

Paper invoices, performance records, accompanying notes

Real process

Proof of achievement, accompanying slip

Please send the documents to:

Techniker Krankenkasse
20902 Hamburg

Are original documents Proof of achievement and Paper bills

Does my software support the data exchange procedure according to §105 SGB XI?

You can find out directly from your software provider whether your software supports the data exchange procedure according to Section 105 SGB XI.

For more information, see Software Creator - Statutory Health Insurance Data Exchange.

What if an error occurs?

At TK, the data run through pre-checking software that checks the data for syntax errors. In the event of an error message, you will receive an email with a description of the error.

Why are the billing code and the tariff code (AC / TK) required?

In the case of electronic data transmission, it is necessary that you, as the service provider, transmit the details of the contract according to which you are billing. The billing code and the tariff code (AC / TK) are required for this. The contractually agreed services and prices are linked to this 7-digit key.

The 1st and 2nd position denotes the Billing code.

Example:Outpatient care provider:
35 - free non-profit providers (social station)
36 - private commercial providers
37 - public provider
39 - other care service

The 3rd to 7th position denotes that Tariff indicator. Here is the 3rd and 4th digit for the Tariff area (e.g. 05 for Hamburg) and the 5th to 7th digit denotes the individual tariff with the contract number.

With every change of contract or the conclusion of a new remuneration agreement, the contract number in the tariff indicator changes. The tariff area usually remains unchanged.

The information can be found in your current compensation agreement.

How are the item numbers formed?

The fee item numbers in long-term care insurance generally consist of 8 digits (exception: benefits to help with housekeeping and time allowances). The individual positions are assigned as follows:

The 1st and 2nd position is the Activity type:
Example: 01 for care benefits in kind according to §36 SGB XI

With the3rd and 4th digit will the Type of remuneration specified:
Example: 01 for performance complex remuneration

The 5th position includes the Qualification of the provider:
Example: 1 for a nurse

With the 6th, 7th and 8th digits is the appropriate Service number to submit.

In the case of complex service remuneration, the 3-digit item number is transmitted as the service number. In the case of time compensation, the service includes a single-digit time unit (e.g. 4 = per hour) and a single-digit time type (e.g. 1 = accompaniment to the doctor's visit). So two positions are transferred with a time allowance.

You can find the item numbers in the current remuneration agreement.