Si INI - INTERNATIONAL NEUROSCIENCE INSTITUTE” - HANNOVER TE EEE Lens Patientadministration ‘Mrs. Ebeling INIHannover Grbt Rudolt-Fichimayr-Strae 4 30625 Hannover Mrs, Fublenriede : ‘Mrs. Scilottmann Ms. Finger Telefon: (0511) 27092-1587 ‘Mrs. El Azab, Mona *05.03.1973 Tele (05127082158 pm.international@ini-hannover.de httpy few ini-hucenover.com 17.12.2021 Dear Mrs. El Azab, Prof, Samii has recommended, that you receive clinical treatment in the International ‘Neuroscience Institute. Concerning Corona our current rules are the following: Our patients and their accompanying persons have to send us a negative Covis-19-test result that isn’t older than 3 days before the flight to Germany. As soon as they arrive in Hannover they have to come to INI hospital to do another CoVid-test as outpatient. Then they have to stay quarantined 5 days in hotel and finally come for planned admission and receive one last test. The total costs for your hospital stay (app. 28 days), diagnostic, surgery and necessary medical examinations will amount to approximately € 100.000. This amount _must_be deposited in our bank account prior to admission. After_the payment we will arrange an Admission date for you. ‘You may arrange for a transfer of the deposit to: Account Holder: INI Hannover GmbH Bank: Deutsche Bank AG Hannover Georgsplatz 20 30159 Hannover Account Number: 44.36 655 Bank Code: 250 70070 SWIFT-Code: DEUTDE2HXXX IBAN: E29 2507 00700 44 36 655 00 Patientname: see Should the costs exceed the initially estimated amount during the treatment, the INT reserves to provide appropriate additional amounts of deposit. To avoid any problems we would kindly ask you to send us the proof of payment via mail or fax. INT-Ilerationl Nearscone Insite Hannccer Gb + HRB SEES »Amsgrct Hamer Devise Bask AG Hanover = BAN: DED 2507 0070 O43 66550 » SHFT-BIC: DEUTDEZHXXX ‘Sewer Mer 25/ 208 / 4547» US 14Nr« DEL265 excise Dr. med. Dipl Betis (FH) Marts Ke‘We will always need the IBAN number as well as the BIC/SWIFT-Code of your bank for the reason of German money laundering law regulations as well as the reporting requirement in foreign trade. In case that a fluent communication neither in German nor in English can be guaranteed by the patient himself, we would ask you to organize yourself a private patient coordinator (such as a translator), to support the patient during his admission and further hospital stay. Costs and services of a private patient coordinator (such as translators) are not included in the mentioned deposit. All patient support service matters have to be arranged between the patient and the private patient coordinator themselves. Please note, that the INI as a private institution is not working together with any international insurance companies, as well as we do not accept the treatment form E112. If there is any remaining amount of your deposit this would, of course, be refunded to you ‘with the final invoice 3 months after hospital discharge. For this purpose and further correspondence, please give us your exact mailing address and your banking details. The hospital is only obliged to prepare a final invoice, after the requested amount of deposit or deposits have been paid completely. This includes additional requested amounts during the treatment. Accompanying persons can only be accommodated in the patients’ rooms, if it is medically necessary. The costs for accompanying persons (room and board) are not covered by the deposit. Kindly note that accompanying persons beneath the age of 18 cannot be accommodated in the hospital. We asked you for your understanding that a private room can never be guaranteed. ‘Due to organizational reasons it may be necessary to share a room with another patient during your hospital stay. All accommodation costs for accompanying persons must be paid for at the time of departure. Payment can be effected in cash or by credit card. In order to guarantee a smooth transaction of the payment please inform your bank in order to be able to exceed your daily credit limit.ao INI - INTERNATIONAL NEUROSCIENCE INSTITUTE® - HANNOVER. TEEPE ceo Patientadministration INI Hamre Git Mrs. Ebeling Rudolf-Pichlmayr-Strafe 4 30625 Hannover (Mrs, Fublenviede Mrs. Schlottmann Ms Finger ‘Mr. El Azab, Mona “05.03.1973 Telefon: (0511) 27092-157 Telefax: (0511)27092-154 pm.international@ini-hannover.de Inttpsforow ini-haniover com 16.12.2021 Dear Mr. El Azab, herewith please find our estimated cost calculation for your planned treatment in our hospital Estimated total costs for your hospital stay of approximately 28 days and medical treatment including surgery will amount to about € 100.000 Estimated total costs: asic serv ice Delays x 36530¢] = 10.230,08 ¢] [Single room 28|days x[ _181,62¢| 5.085,36 lintensive care ‘fay x | _260594€| = 7.877,82¢ [Departmental rate 25|days x| 997,15 ¢| 24.928,25 ¢| [Anesthesia i, 2,000.00 lincivictual OR Tee BaSST OF CUATON OF | jintervention, use of Hybrid OR i (MLCT Angio) and use of 7 5.000,00 € Inewrophysiological monitoring [Expected radiologic diagnostics (vray, ; ICT, MRI, MRA, functional MRI) os eee Third parties (laboratories [blood texts, hormone testings, histology, microbiologic testings|; external medical a 7.000,00¢ sasultants [internal medicine, ENT, ophthalmologist etc}) [Accomodation- and examination-costs 101.121,51 ¢| Please note that the prices for 2022 can differ. Please note that this estimated calculation is based on the assumption of normal medical procedures. However, the actual medical procedures will depend on the patient's condition during the hospital stay. If a more extensive medical treatment becomes necessary and/or in case of a more complicated clinical course, the amounts shown above will increase according to the actual duration ofthe hospital stay. Due to various specific regulations of health insurance companies, full reimbursement by health insurances cannot be guaranteed. All amounts payable without deductions. ti son are not included, as well as casts and services of a rivate patient coordinator. All patient support service matters have to be arranged between the patient and the private patient coordinator themselves #65500» SHIFT BIC: DEUTOEZHXIX oceania 25/208 34587» UStltNrs DEISIESL2"S Seen Dr nod Dede Fd) Martin Konert