The Apothekenrechenzentrum is the settlement house between a pharmacy and the statutory payers, because individual pharmacies do not invoice individual Krankenkassen. The claims of a settlement period are delivered to the settlement house, which sorts them by payer, checks them for the formal errors that would otherwise cause a rejection, submits them and pays the pharmacy. Naming the function matters more than naming the companies, because every pharmacy uses one and the mechanism is the same whichever contract a pharmacy has.
Three things happen at the settlement house:
- Aggregation comes first, since prescriptions, the Packungsfixum earned on them and claims for a pharmazeutische Dienstleistung submitted on a Sonderbeleg all arrive as one stream and leave sorted by payer.
- The formal check is narrow, because the settlement house looks at whether a claim is complete and internally consistent rather than at whether the service was pharmaceutically sound.
- The money is the third part, since the settlement house pays the pharmacy on a predictable cycle rather than leaving it waiting on each payer.
Deductions are applied at the settlement house too, including the Kassenabschlag, though any increase to that Abschlag comes from a separate law rather than from the ApoVWG.
Just as important is what the settlement house does not handle:
- It does not decide whether a service is claimable.
- It does not set the price of any pharmacy service.
- It does not carry the pharmacy's own documentation duties.
- It does not resolve a Retaxation on the pharmacy's behalf, though it passes the correspondence through and usually supports it.
Above all it has no role in self pay revenue, because where the customer pays for a service directly the pharmacy issues its own invoice in its own name, collects the money itself and books it itself. That is ordinary Privatliquidation, and nothing about the transaction is submitted anywhere.
For a pharmacy planning a paid diagnostics offer this is the clearest way to see the difference between the two revenue lines. One line is settled through an external house on a fixed cycle, with fees set outside the pharmacy. The other is invoiced, collected and reconciled in house, so the pharmacy carries the payment risk and the VAT question as well. That question depends on what exactly was performed, so it belongs with the pharmacy Steuerberater before the first invoice is written.
This glossary entry is general information about German pharmacy law and practice. It is not legal advice. For binding guidance on your own pharmacy, contact your Landesapothekerkammer.
