Get G0851

The G0851 form is essential for requesting reimbursement for participation in rehabilitation sports or functional training groups. This guide will provide you with clear and step-by-step instructions for filling out the G0851 online.

Follow the steps to successfully complete the G0851 form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your insurance number and any identifier (if known) at the top of the form.
3. Provide the name and address of the rehabilitation sports group or functional training group.
4. Fill out your personal details, including your name, date of birth, street address, postal code, and city.
5. On the specified dates, list your attendance at the exercise events, detailing the type of rehabilitation sports or functional training you participated in.
6. Sign the form where indicated; a signature on page three is sufficient if regional agreements allow.
7. Complete the confirmation section to affirm your participation on the listed dates.
8. Ensure that the rehabilitation group confirms your attendance, including their name, location, and stamp.
9. Fill in the reimbursement calculation, using the agreed payment rates and the number of sessions attended.
10. Provide the necessary banking information, including your bank identifier code and IBAN for the reimbursement to be processed.
11. Attach the medical prescription for reimbursement (Kostenzusage G0850) and ensure all sections are completed accurately.
12. Review all details carefully before saving your changes, then download, print, or share the completed form as required.

Complete your G0851 form online for a smoother reimbursement process.