عناقيد
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From registration to discharge
Surprise bills often start with an assumption about cover. These steps apply to planned care under SGK, private insurance or TSS. In a genuine emergency, seek urgent help first; do not postpone necessary treatment while arranging financial approval.Before you go
- Identify the cover: SGK alone, private insurance or TSS used with active SGK entitlement.
- Check the hospital and relevant doctor or department are contracted for your exact plan. A private hospital does not necessarily accept your insurer. SGK arrangements also differ by provider and service.
- Bring your passport or residence document, foreign identity number if issued, policy details, insurance app/card where relevant, and previous prescriptions and reports.
1. Registration (kayıt)
Tell reception which insurer you use and that you want the visit billed through insurance. They may request identity and policy or SGK entitlement details. Before a planned consultation, ask whether it is covered, what you must pay and whether approval is needed.2. Consultation (muayene)
A consultation, examination and clinically indicated basic tests may be covered subject to your benefits. MRI, CT, additional tests and procedures may require separate approval or payment. Before agreeing to a costly non-urgent service, ask: “Is this covered, and has the required authorisation been obtained?”3. Authorisation (provizyon)
The provider checks eligibility or seeks insurer authorisation, particularly for surgery, admission, expensive imaging and certain treatments. An SGK eligibility check is not identical to a private insurer's service-specific approval.If approved, ask what amount and services are authorised and what conditions remain. Approval is not a promise that every extra will be paid. If declined for planned care, clarify why, contact the insurer, consider an eligible provider or understand the self-pay quote before proceeding. Do not cancel clinically urgent treatment solely because approval is unresolved.
4. Your share of the bill
Depending on the scheme, you may owe a fixed contribution, a percentage, a deductible or an allowed room/doctor supplement. Ask for the service, amount and reason in writing. Not every additional charge is lawful under SGK rules; some services are protected from additional fees.5. Admission or surgery
Check the agreed room category, any room upgrade, special materials, medicines or other items outside cover, and the scope of written authorisation. For elective care, settle these questions before the operation rather than relying on a verbal promise.6. Review the final bill
Request the itemised final statement and compare it with the approved services and payments already made. Query an unexplained self-pay item with the insurance or billing desk before settling the dispute.7. Leave with your records
Keep the discharge summary (epikriz), laboratory and imaging reports, invoices, receipts and prescriptions. These support follow-up with another doctor, a reimbursement claim or a billing complaint.Six common problems and their solutions
- Wrong network: verify the exact provider and department.
- Tests without required approval: ask about provizyon before non-urgent work.
- Unclear co-payment: request a written explanation.
- Relying on one informal assurance: confirm with the insurer and billing desk.
- Unexpected inpatient extras: ask about each item before agreeing.
- Missing records: collect the complete discharge and payment file.
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