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Preparing for Surgery

There are a few things you can do when preparing for outpatient surgery at Aestique Surgical Center.  You may have already received your surgical packet from your doctor’s office. The information here is for your reference. Thank you.

INSURANCES AND PAYMENT OPTIONS
As with any surgical procedures there are four separate bills that you will expect to see:

  1. Facility – Aestique Ambulatory Surgical Center
  2. Surgeon’s Fee – this will be your surgeon’s fee for performing the procedure
  3. Anesthesia
  4. Pathology/Labs – Services for tissue specimens removed during surgery requiring testing (if required)

 

For your convenience, we do accept most insurance plans. For out of network costs, copayments or deductibles, we accept all major credit cards including Visa, MasterCard, Discover, American Express and CareCredit. We will bill you any balance due after your insurance company has paid your claim. We do ask that all balances are paid in full within 90 days. If you encounter a problem paying within the 90 days, please contact our office immediately at 724-832-7555 and ask for our ASC Billing department.   Please remember that insurance is a contract between you, the patient, and your insurance company. Ultimately you are responsible for payment in full to Aestique Surgical Center, regardless of insurance determination to pay.

 

YOUR RIGHTS AND PROTECTIONS AGAINST SUPRISE MEDICAL BILLS

Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.

 

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

 

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

 

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care–like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

 

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

 

Additionally, Pennsylvania law provides that managed care plans, including health maintenance organizations and gatekeeper preferred provider organizations, and subcontractors of managed care plans cannot deny any claim for emergency services on the basis that the patient did not receive permission, prior approval, or referral prior to seeking emergency service. A managed care plan that has no in-network providers available to provide covered services shall cover services provided by an out-of-network provider. The plan shall cover the out-of-network services at the same level of benefit as an in-network provider.

 

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

 

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

 

When balance billing isn’t allowed, you also have the following protections:

  • You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
  • Your health plan generally must:
    • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
    • Cover emergency services by out-of-network providers.
    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
    • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact:

  • The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law.
  • The Pennsylvania Department of Insurance at 1-877-881-6388.

PREPARING FOR SURGERY

  • Please complete any necessary pre-testing TWO WEEKS prior to surgery

Medication/Anesthesia:

  • Recovery time is approximately two hours for General Anesthesia and 45 minutes for I.V. Sedation.
  • You will be instructed by the Pre-Admissions nurse regarding any restrictions with diet & fluid intake.
  • It is necessary that we are informed of all medications that you are taking. If you take any routine medications, please consult us. Generally, you may take all routine medications EXCEPT antacid liquid, insulin, diuretics, or diabetic pills.
  • DO NOT TAKE ANY HERBAL SUPPLEMENTS.
  • Discontinue the use of aspirin, aspirin-containing products, vitamin E, Ginko and Ibuprofen TWO WEEKS prior to surgery. These products inhibit the normal blood clotting process and maycause excessive bleeding and/or bruising during and after surgery. If needed, use Tylenol instead. Other products that contain Aspirin or Ibuprofen and should be avoided include:Advil, Alka-seltzer, Anacin, Ascription, Bufferin, Coricidin, Dristan, Empirin, Excedrin, Fiorinal, Midol, Motrin, Nuprin, Percodan, Sine-Aid and most medications used to treat arthritis.If you take blood thinners such as Coumadin or Plavix, your physician will instruct you when to discontinue.
  • Cleaning: Plastic Surgical Patients – wash the surgical site starting three days prior with an antibacterial soap.
  • Make-up: Please do not wear moisturizers, creams, lotions or any makeup.
  • Contact Lenses: Do not wear contact lenses.
  • Clothing: Wear only comfortable, loose fitting clothing that does not go over your head.  Abdominoplasty/Liposuction patients wear TED hose.
  • Hearing Aid:  If you wear a hearing aid, please bring it with you.
  • Do not bring valuables with you. Please bring only your drivers license and insurance card for identification purposes during registration.
  • Transportation: If you are scheduled to have anesthesia, a family member or responsible adult MUST be available to take you home and stay with you the night of surgery. Aestique® Ambulatory Surgical Center, Inc. cannot discharge you to a taxi or ride sharing service.
  • Smoking: It is recommended that all smokers DISCONTINUE smoking for two weeks prior to surgery and two weeks after surgery. This will allow for ease in breathing both before and after anesthesia is administered and free blood circulation to promote tissue healing.

CONFIRMING SURGERY TIME

  • An Aestique Pre Admissions Nurse will call you two (2) business days before surgery to review your pre-operative instructions and arrival time for the day of surgery.
  • If you do not hear from a Nurse by 2:00pm, please call Aestique at (724)832-3085 or 1-800-832-6501 and request to speak with the Pre-Admissions Nurse.
  • Be prepared to provide 2 phone numbers at which you can be reached should we need to contact you regarding a change in your surgery time.
  • If you need to change or cancel your surgery date, please call Aestique® as soon as possible at one of the above numbers.

FOR YOUR FAMILY MEMBERS

  • During this time, we are limiting surgical patients to only bring one person to their appointment with them.  They will be permitted to wait in our waiting room, or if they prefer, they can give a cell phone number where they can be contacted and wait in their car or offsite.
  • While your family member or friend is waiting for you, Aestique® has a medical day spa. You may make arrangements prior to the day of your surgery for your guest to pamper themselves with a spa treatment. Call 724-832-8266 for further information.

FREQUENTLY ASKED QUESTIONS:

  • Do I need to visit the center before my surgery?
    • No.  There is no need to come in prior to your scheduled procedure with us unless otherwise directed.
  • Why must I refrain from eating and/or drinking prior to surgery?
    • You refrain from eating and/or drinking prior to surgery in order to prevent the risks of aspirating gastric contents during your surgery. This complication is very serious and you need to strictly abide by our recommendations. This has nothing to do with nausea and vomiting after your surgery as some think.We have very clear policies as to specific times before surgery when you must refrain from eating and/or drinking. These are all based on safety standards. We believe that the fasting time should be as short as possible before your surgery. You will not improve your safety by not eating or drinking longer than necessary.
  • Who may accompany me?
    • You are welcome to bring one person with you to the Center. That person will be allowed to wait in our waiting room.  Due to privacy purposes, they will remain in our waiting room throughout the duration of your visit with us.  When a patient is a child often two parents and/or guardians will accompany him or her to the Center. We will do our best to accommodate everyone, however, one parent and/or guardian will be permitted into the recovery room at a time.Please refrain from bringing young children to the Center as guests.
  • Will I be contacted before my surgery?
    • Yes. We call each patient before the surgery to gather information and to helpful to us and hopefully answer any of your questions. Preoperative instructions will be given by the nurse who calls you. You can also call the Center directly with any questions.
  • What should I do if I am not feeling well?
    • If you are not feeling well, please contact your surgeon immediately. During normal business hours, you can call the Center for advice. There are some surgeries which are safer if delayed when you are sick. We need to know specific details to make the decision. Please do not delay in contacting your surgeon or the Center.
  • What should I do if I started my menstrual cycle?
    • This will not affect most surgical procedures. Call us if you have any questions at 724-832-3085.
  • What should I do if I believe that I am pregnant?
    • It is very important for us to be aware of this possibility. If there is any doubt please contact us immediately.
  • May I drive home?
    • Any patient receiving anesthesia will not be permitted to drive until the next day.We would strongly recommend that all patients have a ride home and will be received by a responsible adult when they arrive home. Patients will not be allowed to drive, walk or take public transportation after sedation or anesthesia. Please make the appropriate arrangements.
  • May I speak to my anesthesia provider before the surgery?
    • All patients will be seen by our anesthesia provider on the day of surgery prior to entering the operating room. Sufficient time should be spent to answer any questions you may have. If you need to speak to the anesthesia department before the day of surgery, you are welcome to call the Center and we will arrange for you speak with someone.
  • What if I have special needs?
    • We will make every effort to accommodate any special need you may have. We strongly encourage you to call the Surgery Center in advance so that we can properly prepare to make you comfortable. Do not hesitate to call and suggest anything that may make your day easier.