YOUR SURGERY

SCHEDULING YOUR SURGERY

Preoperative health questionnaire
Before the day of surgery, “pre-op” diagnostic testing may be required, such as lab work, EKG, etc. To make this most convenient for our patients, the pre-op nurse will call you and review your medical history and current medications. You have the option of downloading the patient history forms and fax the completed forms to the nurse for review at 707.528.6587.

Preoperative phone call
One of our nurses will call you prior to your visit, usually one to seven days prior to your surgery. We will confirm your arrival time, provide directions to ASI and answer your questions. We will also discuss any health issues indicated on your patient health questionnaire or obtain a health history if you have not already returned your health questionnaire. The preoperative call nurse will also emphasize the importance of adhering to our No Eating and Drinking requirements.

Changes in your health
If you notice a change in your health (i.e., cough, cold, fever, etc.) it is IMPORTANT to notify your physician and the ASI before your scheduled surgery date. 707.528.6331.

DAY OF YOUR SURGERY

Who to Bring:
You MUST be accompanied by a responsible adult who will drive you home after surgery.

What to Wear:
Wear loose-fitting, clean, comfortable, easily changed clothes (like jogging suits) and flat shoes to Advanced Surgery Institute. Do not wear jewelry, and please leave valuables at home, as we cannot be responsible for their safe-keeping.

What to Bring:
Please bring your medical insurance cards because our receptionist will need them in order to finalize your registration process. Also, bring protective cases for your contact lenses, eye-glasses and hearing aids. If you are taking regular medications, please bring them with you so that our anesthesiologists can see exactly what medications you are taking in the event that you have not already provided a written list.

When to Arrive:
When you arrive approximately 1 hour prior to surgery, please check in with the receptionist and complete necessary registration or insurance information. If you require general or regional anesthesia an anesthesiologist will meet with you to discuss and arrange for anesthesia care. Free parking is available for Advanced Surgery Institute patients and their families. During peak hours, we provide a parking attendant in order to secure our designated parking spaces for our patients.

EXPLANATION OF WAITING TIMES BEFORE SURGERY

Our staff at Advanced Surgery Institute of Santa Rosa recognizes that your time is important and that prolonged waiting before a procedure is both unnerving and inconvenient to you and the people who have accompanied you to our center.

We utilize our computer data and requests of your surgeons/physicians to construct a schedule that attempts to be as close to anticipated reality as humanly possible. However there are many factors outside of our control that can alter the progression of starting times, resulting in delay or change (even forward!) in the time of your procedure. Example of these factors are:

1. Prolongation of a surgery before your procedure, whether at our center or another facility where your surgeon might be working.

2. Prolongation of office duties, delaying your surgeon’s arrival.

3. Emergency procedures that your attending surgeon must address.

4. Late arrivals of patients who were scheduled to arrive before you.

Whenever there is a change in your anticipated procedure starting time, our staff will try to keep you informed and provide updates to the best of our ability. If your surgeon is involved in an emergency procedure or another surgery, we may not be able to provide you with frequent updates. Nevertheless, always feel free to ask one of our staff and we will do the best we can to provide you with reliable information.

Why do we ask you to come in prior to your surgery time?
We ask you to come in before surgery early enough to provide us with adequate time to perform your front desk admission process, admit you to our preoperative area, institute monitoring and Intravenous preparation, antibiotic administration (if applicable), and permit interview by your Anesthesiologist (if applicable) and your treating Physician. The same 4 events listed above can sometimes lead to a longer than anticipated stay in our preoperative area.

We certainly hope that we will minimize your waiting time and provide your services as close to the scheduled time as possible. However, we hope that you will understand that delivery of the best care to each patient does not always conform to our computer’s plan! And if you do encounter a delay, please let us know what we can do to make your wait more comfortable.

Thank you,

Ann Hurd, RN
Administrator ~ Director of Nursing
Advanced Surgery Institute of Santa Rosa

 

CHECKLIST

– Call your physician immediately if you notice a change in your health between the time you saw your surgeon and the day of your procedure.
– Eat a light dinner the evening before your surgery. DO NOT EAT ANYTHING AFTER MIDNIGHT. FOLLOW THE EATING, DRINKING, AND MEDICATION INSTRUCTIONS provided by your physician.

– Wear loose, comfortable clothing.

– HAVE A RESPONSIBLE ADULT ACCOMPANY YOU TO THE CENTER AND DRIVE YOU HOME FOLLOWING YOUR SURGERY.

YOUR SURGERY CANNOT PROCEED WITHOUT YOUR COMPANION.

– Bring your driver’s license.
– Bring your medical insurance cards.

– Bring any medications that you take regularly.
– Bring containers to store your contacts, eyeglasses, hearing aid, etc.
– Do not bring jewelry or other valuables, including wedding bands or body piercing.
– Do not wear makeup, hairpins, nail polish, contact lenses.

FOLLOWING YOUR SURGERY

When surgery is completed, you will be taken to the recovery room until you feel able to sit up and dress. The length of time you will need to rest before leaving will depend on the nature of your surgery.

We permit a family member or friend to join you in our recovery room when possible. In order to prevent overcrowding we must limit visitors to one person at peak times. Therefore we ask that you not bring children or others who cannot remain unattended in the waiting room.
We want to be particularly responsive to the needs of children. As soon as they arrive in to the Recovery Room and settled, parents will be encouraged to come in to be with your child.

Before You Leave:

Please be certain you understand your physician’s instructions. You will receive instruction from our nurses regarding medication, diet, and rest requirements. The day of surgery and perhaps at the time of discharge, you may feel sleepy, tired and dizzy. Our advice is to go home and rest for the remainder of the day. For your own safety, it is important that you do not drive, operate machinery, drink alcohol or make any important decisions for at least 24 hours after leaving Advanced Surgery Institute. For this reason, we require that you be accompanied upon departure.

At Home:

You should plan to have a responsible adult stay with you the night after surgery. If you experience difficulties or complications once you return home, please contact your surgeon immediately. If you cannot reach your surgeon and your condition requires immediate attention, you must call 911 or be driven to the nearest emergency room. You may also call the staff at the Advanced Surgery Institute any time between 7.00 a.m. to 5:00 p.m. Monday through Friday. For your safety, please do not wait to call for assistance if you have a medical need outside our normal hours of operation.

ANESTHESIA
After registering with the front desk, a nurse will escort you to the Pre-operative area. After changing clothes into a patient gown and robe, a short medical history will be taken and reviewed by a physician Anesthesiologist. During that time, the Anesthesiologist will discuss with you the alternative anesthesia methods appropriate to your surgery or procedure. Once a course of action has been agreed upon by you and the Anesthesiologist, the pre-operative nurse will ask for your signature on an Anesthesiology consent form. You are encouraged to read the consent carefully as it confirms your understanding of the procedure and possible risks/complications.Several links are provided below for additional information on ambulatory anesthesia, children and anesthesia, seniors and anesthesia, anesthesia and herbal supplements and pain management. This information is provided through the American Society of Anesthesiologists and the Society of Ambulatory Anesthesiologists. The information contained through these links is in general terms. You are encouraged to discuss any questions or concerns with your physician or anesthesia provider on the day of the procedure.

DIABETES
Diabetic patients need to pay particular attention to their diet and medication on the day of surgery. Individual management of each diabetic provides the best and safest management. Prior to the day of surgery, patients should contact the physician who manages their diabetes. This will allow a specific plan for their diabetic management on the evening before the day of surgery.In general, the following guidelines are suggested for diabetic patients:

Type 1, juvenile or insulin dependent diabetics:

Patients on insulin pumps should continue using their pumps up to, during and after surgery using a basal rate only Their routine use may be resumed after they commence their usual diet.
Patients on long acting insulin such as NPH, Lente or Ultralente should take their evening dose as usual but reduce any morning doses by 1/3 if the surgery is in the morning, or by ½ if in the afternoon. Regular insulin should be held until a regular diet is resumed.
Patients on long acting insulin such as Lantus should reduce their evening dose prior to surgery by 20%. Regular short acting insulin should be withheld until diet is resumed after their surgery.

Type 2, adult onset diabetes or non-insulin dependent diabetics:

Patients should avoid taking their oral diabetic medication the night before surgery. This medication may be resumed the night after their surgery once they have resumed their diet.
Patients with type 2 diabetes who take insulin should follow the guidelines for type 1 diabetes.

All diabetic patients should continue to monitor their blood sugars before and after their surgery. Blood sugars will be monitored during your stay by the Advanced Surgery Institute staff. Because anesthesia and surgery is a stressful time, blood sugars may fluctuate and require more frequent monitoring during the first few hours after surgery.

Fasting guidelines are the same for diabetic or non-diabetic patients.

If you take medications regularly for heart and lung conditions (such as angina, chest pain, high blood pressure or asthma) or for seizure (epilepsy) control, we recommend that you continue to take them on your usual schedule including the day of surgery. These may be taken with water. However, the preoperative nurse may request that you hold your last dose of certain blood pressure medicines, such as lisinopril and other ACE inhibitor medications. During your preoperative phone call, our nurse will discuss your medications and indicate which ones, if any, to not take on the morning of surgery.

We recommend most adult patients with diabetes not eat anything after midnight before surgery and that they not take insulin or other diabetic medications the morning of surgery. The parents of children with diabetes should contact their physician or an anesthesiologist at Advanced Surgery Institute for individual instructions.

INSURANCE & BILLING
Our staff at Advanced Surgery Institute realize just how confusing, frustrating, and time-consuming medical billing can be. Navigating through insurance company EOB’s (Explanation of Benefits), co-payments, deductibles, physician office statements, and facility fees is not a fun way to spend your day. To make the task easier, we offer this guide to medical billing for the services you have received at Advanced Surgery Institute.You will receive the following categories of statements:

Advanced Surgery Institute Facility Statement
Insurance Company Explanation of Benefits (EOB)
Surgeon or Treating Physician Statement
Anesthesiology Provider Statement
The Advanced Surgery Institute Facility Bill presents charges for your services at our center. The bill does not include fees for your Surgeon or for your Anesthesiologist.

COPAYMENTS & DEDUCTIBLES:

Your insurance may require you to provide co-payments for your procedure and require that your deductible be met before receiving additional benefits. Prior to your surgery, ASI will verify your insurance coverage and contact you to inform you of your co-payment and deductible responsibilities. We require co-payments and payment of deductibles at the time of service. We accept cash, check, all major credit cards and CareCredit.

SELF PAY:

If you are not covered by insurance, we will require payment in full prior to your procedure. We will contact you prior to your procedure to inform you of the facility fee.

ANESTHESIOLOGY:

Anesthesia Analgesia Medical Group, INC
Questions regarding Anesthesiology fees should be addressed to the contact numbers on their billing statements:

1. Anesthesia Analgesia Medical Group INC: (707)524-4690

SURGEON OR TREATING PHYSICIAN:

Your surgeon or treating physician will provide you with their own statement covering their professional services. Please contact the surgeon/physician office to discuss billing issues.

CONTACT NUMBERS:

For questions regarding your ASI facility bill, please call our on-site business office at
(707)236-8111.

Our goal is to provide you a personalized, professional service from start to finish.