Case Flow — 10-Step Process

Three channels: international WhatsApp line (coordinator answers directly, 24/7 message receipt, instant response in business hours), international email (24-hour reply guaranteed), website tele-consult form (auto-confirmation email + coordinator call within 24h).

Information to share in first contact: full name, age, country, chief complaint (one sentence), current diagnosis (if any), treatment history (if any), preferred contact channel (WhatsApp / email / video call), language preference.

The coordinator's first reply includes: triage category (urgent oncology / elective surgery / second opinion / information request), next-step calendar, list of documents to share, any flag requiring immediate action (e.g. medical emergency → referral to emergency care in your home country).

Privacy: from the moment your message is received it is processed under KVKK (Turkey) and GDPR (EU patients). No identity or health data is shared with third parties without your consent. WhatsApp is end-to-end encrypted; a PHI-compliant mail server is used for email.

Expected timing: at most 24 hours from first contact to coordinator response. Usually 2-6 hours; out-of-hours / weekend messages are answered in the first hours of the next business day.

Format: 30-minute video call (Zoom, Google Meet or WhatsApp Video). Surgeon attends, with interpreter if needed. Language at your choice: TR, EN, DE, AR, RU, FR, IT, ES.

Pre-call prep: identity copy, current medical report, imaging reports, current medication list shared with coordinator beforehand. Surgeon reviews the file before the call.

Topics covered: detailed history of complaint, comorbidities (cardiac, pulmonary, diabetes, blood thinners), prior surgical/anaesthesia history, important family history, lifestyle (smoking, alcohol), your expectations.

Surgeon assessment: can the case be managed via tele-consult or is a physical exam needed, are extra tests required, which surgical options are worth discussing, alternative treatment paths (including non-surgical options).

End-of-call deliverable: verbal preliminary plan (the written plan comes in step 4), list of missing documents, which tests can be done in your home country, which tests we recommend doing in Istanbul.

The fee for this call is as listed on the tele-consult page; it may be credited against the total bill if surgery is undertaken (ask the coordinator).

Imaging transfer methods: DICOM CD/USB via courier, cloud link (PHI-compliant portal), hospital-to-hospital DICOM bridge (with affiliated centres), photo/PDF report (scanned original beforehand).

Accepted formats: contrast neck MRI, paranasal sinus CT (HRCT), chest CT, PET-CT (for oncology cases), audiogram (ear cases), nasal endoscopy video/photo (for rhinoplasty plan), pre-op photos.

Pathology slides: original glass slides preferred (accepted via courier) — our pathologist prepares a second-opinion report. Report alone may also be sufficient (depending on the case).

Missing tests: which tests are appropriate to do at home and which in Istanbul? The plan is finalised at the step 2 consultation. Expensive tests (PET-CT, contrast MRI) done in Istanbul are supported with insurance-reimbursement documentation.

Additional test orders: routine pre-anaesthesia bloods, ECG, echocardiogram (if needed), pulmonary function test (if smoking history / lung disease). It is clarified which are done at home and which in Istanbul.

Multi-specialist review: complex cases (e.g. head & neck cancer) go to the tumor board — the separate multidisciplinary tumor council process is initiated. A written English decision report is prepared.

Written plan content: diagnosis, recommended primary surgical option, alternatives, expected outcomes, hospital-stay duration, estimated Istanbul-stay duration, additional specialists on the team (anaesthesia, reconstructive plastic surgery, etc.).

Risk-expectation balance: case-specific complication rates (adjusted for smoking, age, comorbidities), expected functional outcome, expected cosmetic outcome (where applicable), which outcomes cannot be guaranteed.

Price framework (ADR-003 compliant): no concrete figure is published on the web pages; the personalised written proposal is unique to your case and varies with these factors — surgery duration and complexity, implant/prosthesis used, hospital-stay duration, ICU requirement, additional procedures (neck dissection, reconstruction), pathology and imaging packages.

A transparent list of price-affecting factors is written out; a detailed line-item breakdown is shared on request. Insurance-reimbursement documentation (CPT codes, ICD-10 diagnosis codes, detailed operative report) is prepared when requested.

Payment plan: an upfront deposit (typically 20-30%) confirms the surgical date; the remainder is due at hospital admission. Bank transfer (SWIFT), credit card (3D Secure) and cash are accepted. Crypto is not. Invoices are issued in English.

Cancellation/change policy: surgical date can be changed at no extra cost 14+ days in advance. Between 7-14 days: deductions equal to non-refundable reservations (hotel, OR). Under 7 days: details specified in the step 4 written plan.

Informed consent: signed before surgery. A Turkish + your-language copy is prepared. You may withdraw at any point after signing — only the costs incurred up to that moment are calculated.

Visa support: medical invitation letter prepared (Turkish + English + your language if needed). For consulate application a passport scan, biometric photo and copy of the proposal are sufficient. Visa processing takes 1-3 weeks depending on country.

Flight: the coordinator suggests which airport to land at (Istanbul Airport IST or Sabiha Gökçen SAW) based on the hospital location. You book the flight yourself (we have an affiliated travel agency offering discounted bundles on request).

Companion: one companion stays in the hospital room free of charge per patient. The family-companion guide page details the policy. A separate invitation letter is prepared for the companion visa.

Accommodation: if an extended stay outside the hospital room is needed, partner hotels are available (medical tariff 15-20% lower). Apart-hotel options for families/companions. Payments direct to the hotel or via our coordinator.

Insurance documentation: documents needed for insurance reimbursement (pre-authorisation, itemised cost list, CPT/ICD-10 codes) can be requested. Physician reports are translated into insurance language for the pre-approval process.

Travel insurance: medical travel insurance can be purchased in your home country or via an affiliated insurer in Turkey. Recommended to cover additional hospital costs from complications and undeniable post-surgical risks.

Luggage: briefing on which documents to bring, which medications can be brought, a clothing list (for post-op comfort), and Turkey entry rules (alcohol, tobacco, medication limits).

Welcome: a dedicated international patient coordinator meets you at the airport — name placard, language-speaking, phone number shared in advance. Welcome transfer is a standard part of the surgical package.

Hotel or hospital check-in: usually you are advised to arrive 1-2 days before surgery. The check-in day is for acclimatisation and recovering from jet lag.

Face-to-face consultation: a 45-60 minute clinic evaluation by the surgeon. Physical exam (endoscopy if needed), confirmation of the plan discussed during tele-consult, final photos (for rhinoplasty cases), evidence-matching.

Anaesthesia evaluation: a preoperative review by the anaesthesiologist — cardiac/pulmonary status, allergies, previous anaesthesia history, ASA risk class (1-5). Extra tests (echocardiogram, pulmonary function test) ordered if needed.

Additional tests (if not completed in your home country): routine bloods, ECG, chest x-ray, imaging if needed. Results available in 4-24 hours.

Surgical date confirmation or change: after all assessments, the surgical date is finalised. Postponement (e.g. active upper respiratory infection delays rhinoplasty 2-3 weeks) or — rarely — cancellation possible if serious new findings emerge.

Final consent: the final informed-consent document is signed. Time is allowed for questions. The companion is invited to attend.

Hospital admission: morning of the surgery day (typically 06:00-07:00) or the prior evening (for complex cases). With your companion. Registration, room placement, final fasting check.

Pre-op preparation: final physical exam, IV access, prophylactic antibiotic (if needed), DVT prophylaxis (for long surgeries), hair/shaving prep (where applicable).

OR transfer: to the operating room 30 minutes before surgical start. Companion waits in the pre-OR area or in the room — coordinator provides flight-style updates.

Anaesthesia induction: general anaesthesia by the anaesthesiologist (or regional + sedation, depending on the case). All vital monitoring + invasive monitors (if needed).

Surgery: the planned procedure by the surgeon. Surgical duration varies — simple septoplasty 1-2 hours, functional rhinoplasty 3-4 hours, head & neck cancer surgery 4-8 hours. Coordinator updates the companion if duration is exceeded.

Recovery room: 1-3 hours after surgery. Vital monitoring, pain control, nausea management, return of consciousness. Decision on whether ICU transfer is needed (24-hour observation for complex cases).

Reunion with companion: after transfer from recovery to ward / ICU room. Coordinator briefs the companion on the surgical result and next steps.

Operative report: written the same day or the next morning (in English). Operative findings, what was done, any implants/prosthesis used, unexpected findings and a summary of post-op recommendations.

Day 1 post-op: pain control, IV fluids + antibiotics, first mobilisation (in bed, then standing), feeding start (oral fluids → soft food), sleep monitoring. Physician visits morning and evening.

Drains and sutures: drains may have been placed depending on surgery type. Drains removed within 24-72 hours. External sutures removed in 5-10 days; internal sutures may be absorbable (per case).

Dressing changes: daily or every two days by the nursing team. Wound cleaning + photo record (if needed). Infection risk monitored.

Nutrition: ENT-specific feeding protocols (rhinoplasty — soft food 5-7 days; total laryngectomy — NG-tube feeding 7-10 days → oral transition after swallow study). Dietician evaluation.

Physical follow-up: transfer from ICU to ward, ward mobilisation, final pre-discharge evaluation. Follow-up intensity varies by ASA risk class.

Early-complication detection: infection (fever > 38.5°C, local redness), bleeding (increased drain output, hypotension), thrombosis (leg swelling, pain). These are monitored 24/7 by the nursing team.

Interpreter support: a language interpreter is available 24/7 for visits, dressing changes and patient-nurse communication.

Companion: stays in the patient room free of charge (1 person). Meals provided by the hospital. The companion may attend dressings/procedures (patient's choice).

Discharge criteria: vital signs stable, pain controllable with oral analgesics, eating, sufficient mobilisation, wound status appropriate, companion able to manage.

Discharge package: detailed discharge summary (English + your-language summary), prescribed medication list + instructions for each, alarm-flag list (when to return to hospital), next follow-up appointments, 24/7 coordinator emergency line.

Hotel transfer: organised by the coordinator. Affiliated hotels (medical tariff) pre-arranged. Apart-hotel preference possible (for long stay).

Stay duration: 3-7 days depending on surgery (simple septoplasty 3-4 days, functional rhinoplasty 5-7 days, head & neck cancer surgery 7-14 days). Finalised in step 4 plan.

Hotel recovery: wound monitoring (companion sends daily WhatsApp photo to coordinator), oral medications, light activity (walking), relevant restrictions (rhinoplasty — glasses, sun, heavy lifting; total laryngectomy — shower cover).

Post-op check-ins: 1-2 check-up appointments during this period (e.g. day 5 and day 10 post-op). Endoscopy (if needed), external suture removal, wound assessment, photo.

Coordinator support 24/7: WhatsApp, phone and hotel visit if needed. This is included in the standard package for all international patients.

Istanbul activity suggestions (if recovery-appropriate): historical areas (Hagia Sophia, Sultanahmet) within walking distance, calm restaurants for light meals — coordinator provides a list to your companion.

Return-home preparation: final check before flight (often 3-5 days after discharge), in-flight medical certificate (if needed), medication dosing during travel, companion notes.

Outbound transfer: airport transfer by coordinator, seat suggestion (depending on surgery type), in-flight exercises (DVT prevention), advice on managing visible items (e.g. nasal dressing at TSA-style airport checks).

3-month tele-follow-up: tele-consult calls at 3, 6 and 9 months in the first year (short, 15-20 min). Functional outcome, wound status, cosmetic result (if applicable), photo comparison. Surgeon response within 24 hours.

6-month restaging (oncology cases): for head & neck cancer patients, 6-month restaging imaging and tumor-board re-evaluation. Imaging may be done in your home country and the report shared with us; we provide the interpretation.

12-month tumor-board follow-up (oncology cases): full restaging at month 12 — PET-CT + neck MRI + tumor-board follow-up meeting. Critical milestone for loco-regional control and survival (detailed on the multidisciplinary tumor board page).

Annual follow-up (subsequent years): annual physical exam + symptom-driven imaging. Yearly up to 5 years, then every 2-3 years (depending on general status and risk factors).

If a complication arises: message the 24/7 coordinator line — coordination with a physician in your home country is arranged, return to Istanbul possible if needed (common for urgent oncologic findings).

Post-op photo/video record (for cases like rhinoplasty): month-1, 3, 6, 12 photo comparison — shows long-term quality. Shared with you and, with consent, can be added to an anonymised portfolio.

Second-opinion and insurance-reimbursement support: interpretation of home-country check-ups and provision of additional documents for insurance claims — included in the standard package for 1 year.