My Payment Provision Got Rejected after A Diagnosis on the 1st Of Dec

I have a complementary Mapfre Healthcare insurance policy originating from the company I work for. A gastroenterological finding was detected in an ultrasound I took on December 1, 2022, and I was asked to be seen by a gastroenterology doctor for control. Since the public hospitals were full, I immediately applied to Ataşehir Medicana Hospital and was able to be examined on 1 December that day. My doctor requested I have another ultrasound and endoscopy for control purposes. I got out of the inspection and the provision approval processes were started immediately. My examination and ultrasound approvals were obtained. The ladies at the gastroenterology counter said that they would send the provisional approval for endoscopy to Mapfre Insurance 1-2 days before the procedure. They sent it for approval on the 6th for the endoscopy, which was on the 8th. For 2 days, they asked E-Nabız documents to send them a pdf of all my diseases that only me and my doctor can access. These are extremely personal documents by the way. In each of my e-mail messages, I received a call from Ataşehir Medicana informing me that Mapfre Insurance did not receive my evaluation documents. Unfortunately, as a result of sending a lot of files several times, my request for provision always awaited approval until the endoscopy day on December 8th. Thanks to me and the hospital workers at the counter, we had calls with Mapfre insurance many times and talked about the fact that the endoscopy date would have to be postponed and the effects of this on my routine and health life. My endoscopy has been postponed to the 9th of Dec hoping that Mapfre will accept the payment. Even on the date of my appointment, which was at 9.30, my provision approval process was not given. Finally, when my endoscopy appointment passed, they sent the provision rejection response to my hospital. After my two appointments called due to their incompetence in answering back in time. The reason for rejection was told to me that I had an examination from the same department 2 years ago. Even though the diagnosis is different, they reject my payment provision on the basis of this. From my side, it was a complete frustration. I have sent them emails to explain the situation and send them the documents that show my diagnosis is quite different and they HAVE TO cover it as a part of my health care policy. Eventually, I didn't get a response back yet.

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