Prequalification at PFI: Everything You Need to Know

Prequalification (PQ) is a process for medical aid providers who wish to demonstrate their eligibility to enter into supply contracts with statutory health insurance funds. 

But what exactly is prequalification, and how does the process work? 

In this article, you will find all the essential information about prequalification and how PFI can support you.

What is Prequalification?

According to Section 126 (1a) Sentence 2 of the German Social Code Book V (SGB V), service providers must undergo prequalification if they intend to enter into contracts with health insurance funds for the provision of medical aids under Section 127 (2) SGB V. Once the prequalification body has made a positive decision, service providers receive a certificate that must be recognised by all health insurance funds. This certification serves as proof that the provider meets the necessary requirements to become a contractual partner of the health insurance funds. The certificate is valid for a maximum of five years. During this period, at least two monitoring procedures must be conducted to verify continued compliance with the qualification criteria. 

To become a contractual partner of the health insurance funds under Section 127 SGB V, specific qualification criteria must be met. The GKV National Association issues recommendations under Section 126 (1) Sentence 3 SGB V, defining these criteria and the necessary evidence to ensure a uniform and transparent prequalification process.

How Does the Prequalification Process Work at PFI?

1. Information and Initial Contact

Before applying, it is advisable to review general information such as legal requirements and the qualification criteria set by the GKV National Association. Additionally, price and service overviews can provide further insight.

FAQs often offer a comprehensive overview of the process. However, if you have any additional questions, our experts are happy to assist you.

2. Application Submission

Once you decide to complete your prequalification with PFI’s certification body, fill out the application form and submit it via email to pq@pfi-germany.de or by post.

3. Processing and Review

Upon receipt, your application will be reviewed for completeness. For new customers, a framework agreement will be established before our experts request the necessary documents for prequalification. We will provide you with a checklist detailing the required documentation. Any missing or incomplete documents will be requested accordingly.

Je nach Versorgungsbereich und den betrieblichen Gegebenheiten kann es laut dem zugrunde liegenden Gesetz erforderlich sein, eine on-site inspection Depending on the service area and operational conditions, a site inspection may be required by law. This assessment ensures that the necessary spatial and material conditions are met. Service areas requiring an inspection are marked with "B)" on the application form.

4. Decision & Certification Notification

Once the prequalification process is successfully completed, PFI issues a certificate that is recognised by all statutory health insurance funds. The prequalification data is electronically transmitted to the GKV National Association, which makes it available to the health insurance funds.

5. Monitoring

During the five-year validity period of the certificate, at least two monitoring procedures must be conducted approximately every 20 months. These may take the form of either a document review (for service providers not requiring an on-site inspection) or a site visit (for those requiring an inspection).

The requirement for monitoring activities is legally anchored in Section 126 (1a) SGB V and mandated by DIN EN ISO/IEC 17065. 

You will be contacted by us in due time via email or telephone regarding the necessary monitoring procedures.

Why Choose PFI?

With our experts’ extensive industry knowledge and long-standing experience, we provide professional guidance throughout the entire prequalification process.

Do You Have Questions or Want to Get Started?

Contact us today—we will support you on your way to successful prequalification!

Our team is available to personally assist you and answer all your questions about PQ.

Prequalification

Prequalification

Sign up for our newsletter to stay up to date.

Did you enjoy our blog article? Then sign up for our newsletter today! Published quarterly, it provides exciting insights into all things PFI. Stay informed about the latest topics in research, development, and testing—always up to date! 

Verlinkung zum Seitenanfang

en_GBEnglish (UK)