Hastaneai

This platform brings deduction and disallowance appeals, regulatory research, and recovery workflows into one place for private hospitals and healthcare providers contracted with SGK, Turkey’s Social Security Institution. It is designed for medical accounting teams, billing departments, and healthcare professionals who need to assess deductions, identify the relevant regulatory basis, and prepare appeals within a limited response period.

Users can enter a deduction reason, procedure details, or upload a MEDULA tracking PDF. The system identifies relevant SUT provisions, circulars, contract clauses, and penalty grounds, then generates a reasoned appeal letter with source references. It also supports preliminary risk screening, medical justification, recovery estimation, and further document preparation if an appeal is rejected.

Key Features

Appeal Preparation

Generate a reasoned appeal letter based on the deduction or disallowance.

The system uses the entered deduction reason and relevant case information to prepare a ready-to-use document, with the applicable regulatory basis and source references included.

This helps standardize appeal preparation rather than leaving the quality and structure of each submission entirely to the individual preparing it.

MEDULA PDF Processing

Process Period Sampling Tracking Detail reports from MEDULA and extract the information needed for review.

The system can automatically identify fields such as:

• Specialty
• Medical report (epicrisis)
• Rejected procedure
• Deduction reason

This reduces the need to manually search through MEDULA reports before beginning the appeal process.

Regulatory Research

Find the regulatory provisions relevant to a deduction from one workspace.

The platform provides access to relevant materials including:

• SUT
• Annex lists
• OHY
• Circulars
• Relevant provisions

Source references accompany the regulatory information so teams can understand the basis used for an appeal.

Medical Justification

Incorporate medical justification into the deduction review and appeal workflow.

This allows teams to combine the regulatory basis with the clinical reasoning needed to support a disputed procedure or claim.

Risk Screening

Identify issues that can be overlooked during deduction and appeal reviews.

The system can flag areas such as:

• Additional charges
• Contractual penalties
• Other potential risk items

This provides a preliminary screening step before the organization proceeds with recovery or appeal actions.

Court Document Support

If an appeal is rejected, the platform can also assist with preparing a statement of claim for litigation.

This extends the workflow beyond the initial administrative appeal and gives healthcare organizations a structured way to continue working with the underlying deduction case.

Recovery Estimate

The workflow can generate an estimate of potential recovery after the deduction has been reviewed.

This helps teams assess the financial significance of disputed deductions alongside the regulatory and medical analysis.

End-To-End Deduction Workflow

The platform brings the main stages of a deduction review into one dashboard:

Enter deduction → preliminary assessment → research SUT and FİUE → review regulatory basis → add medical justification → assess risks → generate appeal → estimate recovery

If the appeal is rejected, the workflow can continue into preparation for litigation.

This approach reduces the need to move between separate spreadsheets, regulatory documents, and manually prepared letters.

Source-Referenced Appeals

Each appeal letter is prepared using relevant source references and consistent language.

This helps create a more standardized process where the reasoning and regulatory basis are visible, rather than having the quality of an appeal depend entirely on the experience or working style of the person preparing it.

Built For SGK-Contracted Healthcare Organizations

Private Hospitals

Use a centralized workflow for reviewing deductions, researching applicable SUT provisions, preparing appeals, and estimating potential recovery.

Medical Centers

Manage deduction cases and regulatory research without relying on scattered spreadsheets and manually assembled documents.

Medical Accounting Teams

Reduce repetitive work around deduction analysis, regulatory research, documentation, and appeal preparation.

Billing Departments

Review rejected procedures, deduction reasons, and relevant contractual or regulatory provisions from one workspace.

Healthcare Professionals

Add medical justification to the regulatory and financial assessment of disputed procedures.

Common Use Cases

Challenging A Deduction

Enter the deduction reason and relevant procedure information to identify the regulatory basis and generate an appeal letter.

Processing MEDULA Reports

Upload a Period Sampling Tracking Detail report and extract the specialty, epicrisis, rejected procedure, and deduction reason automatically.

Researching SUT Provisions

Find relevant SUT, annex lists, OHY, circulars, and other provisions with source references.

Screening Contractual Risks

Review a deduction for overlooked additional charges or contractual penalties before proceeding.

Preparing For Litigation

Continue from a rejected appeal toward preparation of a statement of claim.

Estimating Recovery

Assess the potential financial recovery associated with disputed deductions after completing the preliminary review.

Centralized Medical Accounting Workflow

Deduction management can involve short appeal periods, complex regulatory provisions, MEDULA reports, medical justification, contractual requirements, and financial calculations. Managing these through separate Excel files and manually written documents can make it difficult to consistently identify the right provision in time.

This platform brings those activities together into a single workflow, from initial deduction entry and preliminary assessment through regulatory research, medical justification, appeal generation, and recovery estimation.

KVKK-Focused Data Handling

KVKK compliance is a key consideration for the platform's healthcare use cases.

Its data and AI servers operate in Turkey, with the goal of ensuring that patient data does not leave the country. This approach is particularly relevant to healthcare organizations where simply removing identifying information may not be considered sufficient for their data-handling requirements.

Why It Matters

SGK deduction appeals require teams to work quickly while dealing with regulatory provisions, contract terms, MEDULA records, medical details, and financial consequences. Finding the correct provision within a limited appeal period can become difficult when information is distributed across multiple sources.

By combining MEDULA PDF processing, regulatory research, risk screening, medical justification, source-referenced appeal generation, and recovery estimates, the platform creates a more consistent workflow for deduction management.

The result is a centralized system designed around the actual medical accounting and SGK deduction processes of private healthcare organizations in Turkey.

Bring SGK Deduction Management Into One Workflow

Review deductions, process MEDULA reports, identify relevant SUT and contractual provisions, add medical justification, screen for risks, and generate source-referenced appeal documents from one dashboard. Built for private hospitals, medical centers, accounting teams, and billing departments, the platform provides a structured path from deduction assessment to appeal and potential litigation support.