Day of Surgery

It is your responsibility to make advance arrangements for a responsible adult to drive you home and remain with you for the first 24 hours after surgery. You may not drive yourself, be left alone, or leave the facility in public transportation unless accompanied by an adult. Failure to meet these guidelines could result in the cancellation of your procedure.


If you have had any problems with anesthesia in the past, it would be useful if you can bring any copies of the relevant anesthetic or any related correspondence, with you. Your anesthesiologist will review it.


Please disclose all dental work and devices to your anesthesiologist. There are special risks with restorative and cosmetic dental work and your anesthetic.


Please bring a list of prescription medications you are currently taking.


Please be aware you will be required to sign a consent form for your surgery and your anesthetic.


If you hold power of attorney or guardianship over a patient, you MUST bring a copy of a durable medical POA or Guardianship papers in order to sign consents for that patient.


Please bring your insurance card with you and a form of photo identification.


If you wear contact lenses or glasses, bring a case for their safe keeping. We provide containers for removable dentures and bridgework.


Please shower or bathe prior to your surgery.


Wear casual and comfortable clothing and shoes. Wear something that is easy to change and will allow for bandages following surgery.


Leave jewelry and other valuables at home. For patient confidentiality and privacy protection, please be aware that no recording devices are allowed in clinical and patient areas. 


Your family may wait in the waiting area and rejoin you upon discharge / admission.


Please bring any paperwork you may have received from your surgeon’s office. Please complete any paperwork prior to arrival.

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Your Anesthetic

What types of Anesthesia are available?


Your Anesthesiologist will determine the appropriate anesthetic technique to meet your needs based on your health status and the nature of your procedure.


General Anesthesia:

With this technique, the patient’s body is rendered unconscious and unable to feel surgical pain through a combination of anesthetic gases and intravenous pain medications. As with any anesthetic, general anesthesia has risks but serious complications associated with general anesthesia are extremely rare.


Regional Anesthesia:

An anesthetic technique in which a particular part or area of the patient’s body is rendered insensitive using a local anesthetic or numbing agent. This technique is especially appealing in Orthopedics because the surgeries frequently involve an extremity. Regional anesthesia can manage pain during the surgery and provide long lasting post-operative pain relief. It also reduces the risk of nausea.


Monitored Anesthesia Care:

With this approach, the patient receives pain medication and sedatives through an intravenous line from the Anesthesiologist. Local anesthesia also will be injected into the skin to provide additional pain control during and after the procedure. Your Anesthesiologist will monitor your vital body functions. During this type of anesthesia, the goal is often to minimize the amount of anesthesia. It is likely that you will not be asleep for the entire procedure, but this ensures a more speedy recovery from sedation, often with less risk of nausea.


Local Anesthesia:

The Surgeon will inject local anesthetic to provide numbness at the surgical site. Typically this technique does not require a member of the Anesthesia team, but occasionally the surgeon my request the presence of an anesthesiologist if your underlying medical condition requires close monitoring during surgery. The anesthesiologist will manage your vital signs, and be available in case you do not tolerate the local anesthesia, or the extent of the procedure escalates.


Special note on your teeth, restorative and cosmetic dental work:  

During any anesthetic, especially during General Anesthesia, it may be necessary to place life sustaining, and life saving airway devices. Be aware that no dental restoration, cap, crown, bridge, implant, partial, denture or any other unnatural dental work present, is as sound or strong as natural dentition. It is thus possible that during placement of the aforementioned devices, and perhaps even more commonly, during involuntary emergence biting down, that the dental work can be damaged. Despite the anesthesiologist taking utmost care to protect your dentition, situations may arise, out of his / her control, that could lead to dental damage. Similarly, unsound natural dentition are prone to the same risks. We encourage our patients to disclose all dental work and dental conditions, so that optimal protection can be put in place.

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Your Anesthesia Bill

We accept most major medical insurance carriers. After your procedure, we will bill your insurance carrier on your behalf. A few weeks later, you should receive an EOB statement  ("Explanation of Benefits") from your insurance carrier. On this statement you will see the following:

1. The service performed

2. The date of the service.

3. The description and/or insurer's code for the service. 

4. The name of the person or place that provided the service.

5. The name of the patient.

6. The doctor's fee

7. What the insurer allows: The amount initially claimed by the doctor or hospital, minus any reductions applied by the insurer per contract.

8. The provider discount / write off: This is the amount that the doctor has to write off, and will not be compensated for.

9. Patient responsibility: This is the balance that the patient is responsible for. This amount is usually made up of the following: Copay, Coinsurance and unmet Annual deductible amounts. The patient will be responsible for paying this amount in full to Comprehensive Anesthesia Care (PC). 


Also note, that in addition to the anesthetic fees, there may be separate fees from your surgeon, the facility (hospital), pathology and radiology.


If you do not carry insurance, or is undergoing a procedure not covered by your insurance (cosmetic, infertility, certain oral surgeries etc), you will be responsible for the entire anesthetic bill, payable in advance to your procedure. For an estimate on this amount, you may call our billing office.


TERMINOLOGY:

Copayment (or copay)  is a fixed-dollar amount that you pay each time for certain services.  Most commonly, you will be responsible for a copayment each time you have a doctor's visit and for each prescription medication you fill. For example, with my health insurance, I pay a $15 copayment for each primary care physician visit, $25 copayment for a specialist visit, and $20 for each brand-name prescription. Copayments are most often used in HMOs and for services you receive from a network provider in a PPO.


Coinsurance is a per cent of the cost of your care. You are responsible for paying the co-insurance amount. For example, if a doctor's visit is $100 and you have a 20% coinsurance, you will pay the doctor $20 and your health plan will pay the doctor $80.  Coinsurance is often used when you get services from an out-of-network provider in a PPO. This can be quite costly, especially if you use an out-of-network hospital for a surgical procedure.


Deductible is a fixed amount of money you have to pay before most, if not all, of the policy's benefits can be enjoyed. However, in many health insurance policies, you can use some services, like a visit to the emergency room or a routine doctor's visit, without meeting the deductible first. These services will vary with each type of plan. A deductible amount is calculated yearly, so you have to meet a new deductible for each year of the policy. Before you meet this amount, you are required to pay for health care. Once you meet this deductible, however, the health insurance benefits kick in, and you're then responsible only for paying monthly premiums and coinsurance if applicable. Deductible amounts vary by plan and can be separated into individual or family deductibles. In general, a family deductible is double an individual deductible, but it can include several members of a family.


Anesthesiologist is a physician  (medical doctor) that has specialized in anesthesia, perioperative care, critical care and pain management. This involves a four year residency after medical school. Subspecialization in cardiac anesthesia, pediatric anesthesia, critical care and chronic pain management require a further one to two year fellowship.


CRNA is a Certified Nurse Anesthetist. CRNA's are RN 's that further their studies in anesthesia administration. Currently that involves a Masters degree in nursing, obtained in an acredited Nurse Anesthesia program.



OTHER BILLING QUESTIONS?

For any questions related to your bill, you may contact our billing office at: 1 866 606-0153


You can pay your bill at: https://www.peryourhealth.com/


Checks can be mailed to:

Comprehensive Anesthesia Care, PC

P O Box 11750

Clayton, MO 63105

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