In short and in plain language
In a video consultation you talk to your doctor's office by camera. With a fever on the sofa, setting this up for the first time is hard.
So test the tech while you are well. Check the camera, the sound and the volume. Try the office login and the app once.
This article also explains what to know about sick notes. It explains the digital prescription too. It does not replace advice from a doctor.
We help you set up your tablet or phone for this in your home.
Lying on the sofa with a fever is not the moment to find out where your tablet allows camera access or which password your health insurer’s app wants. Yet that is exactly what happens when a video consultation is needed for the first time on a day when concentrating is hard. The route to the doctor has changed for many needs: under the German Incapacity for Work Directive (Arbeitsunfähigkeits-Richtlinie), doctors may certify incapacity for work by video and, under narrow conditions, by phone, and prescriptions for prescription-only medicines arrive as e-prescriptions. This article starts before the cold season. It shows what should be set up on a tablet or smartphone and tried once while your voice is still healthy, which time limits apply to sick notes issued remotely, what employees must tell their employer and how long an e-prescription can be redeemed. It does not replace medical advice: whether a video consultation is suitable is decided by the practice.
Key takeaways
- If your practice knows you from earlier treatment, a first sick note by video can cover up to seven calendar days, otherwise up to three (section 4 paragraph 5 of the Incapacity for Work Directive).
- A sick note by phone is only possible if video is not, your symptoms are not severe and the practice knows you. It then covers up to five calendar days (section 4 paragraph 5a).
- An e-prescription can be redeemed for 28 days at the statutory insurer’s expense, then as a self-pay prescription up to three months after issue in total (gematik).
- The trial run happens while everyone is well: go through camera, microphone, volume, the practice access link, the insurer app and the health card once, not only when you have a fever.
- There is no entitlement to a sick note by video (section 4 paragraph 5 sentence 9). For life-threatening symptoms call 112; outside surgery hours call 116117.
Why preparing before the cold season matters
In autumn many households expect colds, coughs and fever again. Anyone who then needs a sick note or a prescription for a prescription-only medicine has more options today than the waiting room: the video consultation, in certain cases a phone call with the practice, and the e-prescription that reaches the pharmacy without paper. These options only work as well as the technology they run on. A camera blocked by another app, a muted microphone or a forgotten password for the health insurer’s app can cost you an appointment.
The solution is unspectacular: a trial run while everyone is well. On a quiet afternoon you can check whether the device lets the practice see and hear you, whether the sign-in details work and where the health card is kept. For families this means that anyone in work knows beforehand how the sick note reaches the employer. For older people it means that a repeat prescription for a regular medicine can be requested without setting off to the practice while ill. How video calls are set up on a tablet in general is described in the article setting up video calls with family on a tablet; much of it also helps with the video consultation.
Not every illness fits a video appointment, and that is not the aim either. For urgent symptoms outside surgery hours there is the on-call medical service. As examples of cases it treats, 116117.de lists among others a cold with a fever higher than 39 °C, severe sore throat or earache and acute back pain. According to the site, the service recommends whom you can turn to and, if needed, sends a doctor to your home.
An emergency is not a case for a video appointment
What you need for a video consultation
The National Association of Statutory Health Insurance Physicians (KBV) describes the requirements on the patient side briefly: internet access and a PC, tablet or smartphone with camera, microphone and speaker. There are also conditions that concern the procedure more than the technology. Before the first video consultation you give your consent, depending on the system via the video service or directly to the practice. Your real name must be recognisable to the practice; a nickname or the device name of the family tablet is not enough. And the conversation must take place in a room that offers privacy.
The technology itself is provided by a certified video service provider chosen by the practice. According to the requirements described by the KBV, it must encrypt the transmission end to end throughout. For you this means: which app or website to open is something you learn from your practice or the video service together with the appointment. Practice and patient both log in to the video service, and you wait in an online waiting room until the doctor admits you. After the conversation both sides log off.
For patients who are not known to the practice, the KBV describes an additional step: at the start of the video consultation they hold their electronic health card up to the camera so that the practice team can check their identity and take over the insurance data. In any case, section 4 paragraph 5 of the directive requires the practice to make sure it knows who it is talking to. Keep the card next to the device before the appointment starts, and make sure the camera is sharp enough for the print to be legible.
- A device with camera, microphone and speaker, charged or plugged in. A tablet on a stand stays steadier than a smartphone held in the hand.
- A stable internet connection in the room where you would sit or lie when ill, not just next to the router.
- Camera and microphone permission for the browser or app through which your practice offers video consultations.
- The access to the video consultation, saved somewhere you can find it even with a fever, together with the practice’s phone number.
- Your health insurer’s app with a working sign-in, because the GesundheitsID (health ID) for the e-prescription app runs through it.
- Your electronic health card within reach next to the device.
Picture
Your face should be lit from the front; a window behind you makes it dark. Holding the health card up to the camera needs a sharp, steady picture.
Sound
Headphones with a microphone separate your voice from the room. That helps when your voice is hoarse or children are playing in the background. Set the volume beforehand.
Connection
Video needs an even connection. If the picture drops out in the bedroom, the range of the Wi-Fi may be the cause. Our on-site Wi-Fi optimisation gives pointers.
If the internet fails completely on the day of the appointment, look for the cause before calling the practice: is it the device, the router or the line? How to narrow this down and which rights you have during longer outages is explained in the article internet outage: find the cause and know your rights. For the appointment itself: call the practice and ask for another way rather than letting the appointment lapse.
The trial run while your voice is healthy
A trial run does not replace the real appointment, but it takes the surprises out of it. Ask your practice whether the video service offers a technical test. Where there is none, a video call with a family member does the same job: it shows whether camera and microphone are allowed, whether the volume is sufficient and whether the connection holds in the room where you would sit when ill. The following steps can be done in one afternoon.
- Ask your GP practice whether it offers video consultations, how an appointment is made and which service it runs on.
- Open the access on the device you want to use when ill and allow camera and microphone when the device asks.
- Make a test call, either through the video service’s technical test or as a video call with a family member, and check picture, sound and volume.
- Hold the health card up to the camera and ask the other person whether name and number are legible.
- Sign in once to your health insurer’s app and to the e-prescription app and note where the sign-in details are kept.
- Keep the access and phone number of the practice as well as the numbers 116117 and 112 in a fixed place, on paper and on the device.
You receive the access to the video consultation from your practice or its video service. Treat messages that ask unprompted for sign-in details for your health insurer or for card details like any other scam attempt: do not reply, do not open any link and, if in doubt, check with the practice or the insurer on the number you already know. How to recognise such messages is described in the article spotting phishing, fake calls and scams.
Tip for relatives
Sick notes by video: seven or three days
The rules for sick notes are set out in the Incapacity for Work Directive of the Federal Joint Committee (G-BA), here in the version that entered into force on 21 February 2024. Under section 4 paragraph 5, the doctor may also certify incapacity for work in a video consultation if the illness does not rule this out. Beforehand the practice must inform you that the options for examination by video are limited. How long the first certificate may run depends on whether the practice knows you.
If you are personally known to the doctor, or to another doctor in the same group practice, from earlier treatment, the first sick note by video can cover up to seven calendar days (section 4 paragraph 5 sentence 5). If the practice does not know you from earlier treatment, it should not exceed up to three calendar days (section 4 paragraph 5 sentence 4). The KBV summarises this in the same way in its overview of video consultations. For families this means: the GP practice where you have already been treated has more scope when you are ill than a practice that sees you for the first time by video.
| Route | First sick note at most | Condition | Basis |
|---|---|---|---|
| Video, practice knows you | seven calendar days | illness does not rule out video | section 4 paragraph 5 sentence 5 of the directive |
| Video, practice does not know you | three calendar days | illness does not rule out video | section 4 paragraph 5 sentence 4 of the directive |
| Phone | five calendar days | video not possible, no severe symptoms, practice knows you | section 4 paragraph 5a of the directive |
| Extension by video | as assessed by the practice | earlier in-person examination for the same illness | section 4 paragraph 5 sentence 6 of the directive |
An extension faces an additional hurdle: continued incapacity for work should only be certified by video if incapacity for work due to the same illness was previously established after an in-person examination at the practice (section 4 paragraph 5 sentence 6). Anyone who received the first sick note by video will therefore usually have to visit the practice for the follow-up certificate. In addition, there is no entitlement to a sick note by video (section 4 paragraph 5 sentence 9). If the doctor does not consider a sufficiently reliable assessment by video possible, they refer you to an examination in person (section 4 paragraph 5 sentence 7).
Backdating a sick note is only possible by way of exception. Under section 5 paragraph 3 of the directive, backdating is only permitted after careful examination and as a rule only for up to three days. If someone does not attend an agreed appointment for a further video consultation, a backdated certificate may be refused (section 5 paragraph 3 sentence 3). A device that works on the day of the follow-up appointment is therefore more than a convenience.
Sick notes by phone: up to five days
Under narrower conditions the directive also allows a sick note after a phone call with the practice. Section 4 paragraph 5a names three requirements: a video consultation is not possible, the illness does not show severe symptoms, and the practice knows you from earlier treatment, because the phone rule expressly does not apply to insured persons unknown to the practice (section 4 paragraph 5a sentence 2). The first sick note should then not exceed up to five calendar days.
Where it is not possible to certify incapacity for work in a video consultation, it may, for insured persons with illnesses that do not show severe symptoms, also be certified in line with paragraph 5 after taking a history by telephone, on condition that the first certification of incapacity for work should not exceed a period of up to five calendar days.
For your preparation this sets an order. The directive names the phone only for the case that a video consultation is not possible. If you have set up and tested the video consultation, you have prepared the route the directive names first. A phone with good reception still belongs to the preparation, because questions and appointments can also come by phone. If reception in the house is weak, the article poor indoor signal: a guide to Wi-Fi calling helps.
A sick note is the result of a medical consultation, not its purpose. The KBV points out that practices may not offer appointments solely for issuing a certificate of incapacity for work. In the appointment, therefore, describe your symptoms: since when you have had them, whether you have measured a fever and what you have already taken. The decision on the sick note is made by the practice.
What employees must tell their employer
A sick note by video or phone does not change your obligations towards your employer. Under section 5 paragraph 1 of the Continued Remuneration Act (Entgeltfortzahlungsgesetz, EntgFG), you must report incapacity for work and its expected duration without delay. If it lasts more than three calendar days, a medical certificate is required by the following working day at the latest, and the employer may also ask for it earlier.
For people with statutory health insurance the route of this certificate has changed. Under section 5 paragraph 1a EntgFG they do not present a certificate to the employer, but have their incapacity for work certified by a doctor at the stated times and have a certificate handed to them. The data goes from the practice to the health insurer, and under section 109 of the Fourth Book of the Social Code (SGB IV) the insurer creates a notification for the employer to retrieve. The practice’s duty to hand you a certificate for your own records remains unaffected. Ask in the video appointment how this certificate will reach you.
Reporting sick remains your task
The e-prescription: three routes to the pharmacy
Since 1 January 2024 all doctors have been obliged to use the e-prescription for prescription-only medicines at the expense of statutory health insurance (gematik). The prescription is created and signed digitally and can be redeemed in three ways: with the electronic health card, by smartphone or with a printout. The gematik e-prescription portal expressly names the video consultation as a possible starting point. For patients unknown to the practice, however, the KBV states that prescribing should only happen by way of exception in medically justifiable individual cases.
Health card
At the pharmacy you insert the card into the card terminal and the pharmacy sees the prescription. This route needs no app and no sign-in, but it does need a trip to the pharmacy with the card.
E-prescription app
The gematik app shows prescriptions on the smartphone, lists pharmacies nearby and orders for reservation, courier delivery or shipping. Sign-in runs through the GesundheitsID.
Printout
You show the prescription code on the paper printout at the pharmacy. This route works without a smartphone, but the printout has to reach you.
For people staying at home while ill, the app is the route without a trip to the pharmacy, but also the one with the most requirements. Sign-in to the e-prescription app uses the GesundheitsID, which you use through the ePA app of your health insurer (gematik e-prescription portal). If you have already done this sign-in for the electronic patient record, you are a big step further; how that works is described in the article setting up the electronic patient record app. The app also shows pharmacies nearby and lets you choose whether to reserve, use a courier or order by post.
For older people on regular medication, the repeat prescription is a central point. According to the gematik e-prescription portal, you can request a repeat prescription from your practice within the same billing quarter and retrieve it in the app without visiting the practice. Whether and how your practice accepts such requests, by phone, form or message, you will find out there. Ask about it at your next regular visit, not when the pack is empty.
An e-prescription can be used only once
How long an e-prescription is valid
The time limits of the e-prescription correspond to those of the paper prescription, and gematik summarises them as follows: an e-prescription can be redeemed for 28 days at the expense of the statutory health insurer. After that it can be redeemed as a self-pay prescription until it expires, that is up to three months after issue in total. If you miss the period at the insurer’s expense, you pay for the medicine yourself afterwards.
| Point in time | What applies | Source |
|---|---|---|
| up to 28 days after issue | redeem at the statutory insurer’s expense | gematik |
| up to three months after issue | redeem as a self-pay prescription | gematik |
| 100 days after redemption | automatic deletion | gematik |
| ten days after validity ends, that is date of issue plus 92 calendar days | automatic deletion of unredeemed prescriptions | gematik |
For the day you are ill this means: a prescription issued after the video appointment does not have to be redeemed on the same day. The period of 28 days leaves time until you can go to the pharmacy yourself again or the delivery has arrived. Redeemed prescriptions are deleted automatically after 100 days, unredeemed ones ten days after validity ends, which gematik gives as the date of issue plus 92 calendar days. If you want a lasting overview of your medicines, you can use the medication list in the electronic patient record; our patient record help at home supports the setup.
Checklist for the day you are ill
When the day comes, a fixed order helps. The following list can be printed and placed next to the tablet. It assumes that the trial run has been done; where it has not, the day starts with a call to the practice.
- For life-threatening symptoms dial 112 immediately. Outside surgery hours, for urgent but not life-threatening symptoms, call 116117.
- Inform your employer: incapacity for work and expected duration, without delay (section 5 paragraph 1 EntgFG).
- Call the practice or book a video appointment the usual way.
- Charge the device, go to a quiet room with a good connection and have the health card ready.
- Briefly note your symptoms: since when, measured fever, medicines taken.
- Log in for the appointment via the practice’s access and wait in the online waiting room.
- After the conversation, clarify how the certificate for your records will reach you and whether an e-prescription was issued.
- Check the e-prescription in the app, choose a pharmacy and decide on reservation, courier or shipping, within 28 days.
How Technik daheim helps with the setup
Technik daheim sets up devices in your home, in the Hildesheim and Leine valley area. For the video consultation this means: we check camera, microphone and volume with you, set up the permissions, store your practice’s access so that you can find it again, and make a test call. The medical side, that is appointments, diagnosis, sick notes and prescriptions, stays with your practice.
Insurer app and ePA
Sign-in, GesundheitsID and the link to the e-prescription app belong together. How we accompany you is described on the page patient record help in your home.
Practise on tablet and smartphone
In the tablet courses and smartphone courses you practise video calls, permissions and app sign-ins at your own pace.
For seniors and families
Tech help for seniors and tech help for families set up devices the way they are used in the household.
You can book an appointment for the trial run through the contact form for an appointment in your home. If available, have your practice’s information on video consultations and the sign-in details for your insurer app ready. You enter passwords and PINs yourself; we show you where they go.
Sources and legal basis
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