Orthopedic Surgery Prep | Capital Orthopaedics & Sports Medicine

Surgery
Prep

Is it necessary for me to visit a primary care physician before orthopaedic surgery?

In order for an anesthetic to be administered to a patient for surgery, the patient must be cleared by their primary care provider (PCP) as safe to do so. Your PCP will also talk with you about what medications to discontinue prior to surgery (if any), and when to take your daily prescriptions on the day of your procedure.

We encourage you to not to schedule this appointment with primary care until your surgery date has been selected, because the exam must be done within a specific time period prior to your procedure.

Why am I getting different bills from different companies?

The total cost of surgery is made up of three parts: the surgeon’s fees, the facility fee, and the anesthesia fee. The surgeon’s charge will be billed to you by Capital Orthopaedics, the facility charge will be billed to you by the surgery center or hospital at which your procedure is performed, and the anesthesia charge will be billed to you by the anesthesiologist. (The anesthesiologist bill could look different from the facility’s.)

What is a global period?

The first 90 days after the date of surgery are called your “global period”. Most often, this phrase is used in reference to how copays are not collected for postoperative appointments during this time period. (The global period does not encompass x-ray or injection costs, so charges for services such as those will be billed to you if performed.)

Will you contact my insurance company for authorization?

Capital Orthopaedics will verify that your insurance is current and active prior to surgery. For some companies, this is done online — while for others, it’s done over-the-phone. Whether an authorization is required depends on your insurance and what type of procedure is planned. We will obtain any necessary certification, and someone from our staff will always call you directly if there is a known issue. To make this process as smooth as possible, please be sure that we have the correct information on file for your coverage, especially if your insurance has recently changed.

Do I need to contact my insurance company?

It is always our recommendation that you familiarize yourself with and make yourself aware of your insurance coverage. There will likely be some type of out-of-pocket cost throughout the course of your treatment, so reading about your plan and/or talking to someone from your insurance company to discuss what cost(s) you will be responsible for will make you feel more comfortable going into surgery and reduce any potential surprises afterward.

How much will my surgery cost?

The price of surgery is made up of three parts: the surgeon’s fees, the facility fee, and the anesthesia fee. If you call our billing department, we can work to provide an estimate of what the surgeon’s fees will be. We can also give you the contact information for the surgery facility and anesthesiologist, enabling you to obtain an estimate for their charges, as well. It’s important to note that the estimates you are provided are the amounts to be billed to your insurance company. The amount your insurance will pay is based on the contracted rates between the payor (the insurance company) and payee (surgeon, facility, and anesthesiologist) in addition to what percent of your out-of-pocket you’ve met prior to surgery.

Do I have to bring money with me the day of surgery?

Capital Orthopaedics does not require payment for the surgeon’s charge ahead of time; this will be billed to you in the weeks following. However, a deposit may be required by the facility where you're having the procedure. We recommend calling the surgery center or hospital at which your operation is scheduled to discuss this if you have concerns; otherwise, they will provide this information in the day(s) leading up to surgery.

What time do I have to be at the hospital or facility?

You will likely be expected to arrive at the location of surgery 1-3 hours prior to the procedure time–this will depend on the type of surgery, type of anesthesia, and other various factors. The surgery facility will call you before your procedure date to communicate what time you should arrive to check in. Depending on the facility, you could get this call 4 days prior to surgery or 1 business day before. It is important to note that procedure and check-in times are dictated by the facility itself, not your surgeon or anyone at our office. More often than not, your surgeon and team do not know when you’re expected to check in. If you are concerned about your check in time or have not yet heard from the facility by mid-late afternoon the business day prior to your surgery, you should call them directly. If you are having issues reaching someone there, you are always welcome to reach out to us.

What should I wear to surgery?

We recommend that you wear comfortable, loose-fitting clothing to surgery (i.e. pajamas, sweatpants). It is also advisable to wear a zip-up, button-up, etc. on top so that you do not have to pull anything over your head (specifically if you are having surgery anywhere on your upper body). Do not wear any makeup, jewelry, lotions, perfumes, etc. Arrive with clean skin that is ready to enter a sterile field.

Can I eat breakfast before surgery or have coffee?

You are required to be NPO beginning at midnight the day of your surgery. NPO translates to nothing by mouth. And nothing really means NOTHING-including food of any type, coffee, water(even sips), gum, chewing tobacco, etc. Reducing the volume and acidity in your stomach before an operation greatly lowers the chances of regurgitation and potential, subsequent aspiration (food or liquid getting into the lungs). This is a rule from the anesthesia department(s) to keep patients safe, and your surgery will likely be cancelled if you fail to comply.

How long will I be out of work?

Some patients may require time off work following surgery. The duration of that of time off depends completely on 1) what surgery you have and 2) what you do for work. Some surgeries (i.e. those that are minimally invasive, not under general anesthesia, are not being done on a body part that directly affect the patient’s work activities, etc.) could return to work the day after their procedure. Other surgeries may require that the patient remains out of work for several days or even weeks, potentially. You should discuss questions or concerns regarding work and time off with your physician and team prior to your surgery. If you have scheduled surgery and realize you forgot to ask about this, you can send a message to your team through the patient portal or call our main number (515-440-2676) at any time.

How do I get short-term disability or FMLA forms completed?

The first step in this process is obtaining these forms from your employer. If your company does not have an HR department, we recommend you inquire to your direct supervisor for assistance.
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You can either ask your employer to send these forms directly to our office via fax, email, post, etc. or you can provide them to us directly.
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This paperwork typically cannot/will not be filled out by staff until a surgery date has been scheduled; otherwise, they will not be able to sufficiently provide answers to the questions asked.
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Legally, we cannot release patient health information without signed consent from the patient (or legally authorized representative.) This consent form can be found HERE on our website to be filled out, signed, and submitted all online. You may also stop by the office at any time to fill out a form in-person, or request that a form be sent to you via post, fax, or email.
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Due to the number of requests we receive for this paperwork to be completed and, in turn, the amount of valuable time the process requires from both physicians and staff — there is a $25 fee associated with this paperwork.
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We ask that you allow 7-10 business days for these forms/requests to be completed, so please plan accordingly. (If you find it is taking longer — reach out to ensure that the paperwork made it to us. It's also good to verify you have a valid release of information form on file and have paid the required fee.) We always welcome you to check on the status of your paperwork by submitting a question via the patient portal or by calling the main office at 515-440-2676.

Send short-term disability or FMLA forms to our main fax number at 515-440-2677
or email them to medicalrecords@dsmcapitalortho.com.

What is cardiac clearance?

Cardiac clearance is a type of medical clearance required before surgery for patients who have current and/or past heart issues. Another reason it may be required that you obtain cardiac clearance is if the EKG performed at your pre-operative physical comes back abnormal. Most always(though some exceptions exist), a cardiologist will need to see you in the office for an appointment to assess what level of risk undergoing anesthesia/having surgery poses to your heart.

What kind of restrictions will I have after surgery?

It is likely that you will have some limitations and activity restrictions following any type of surgery you have. What these are and how long they last are completely different based on multiple factors.The only restrictions that apply across all specialties, all types of surgery, and for all patients are: 1) You are not permitted to drive yourself home from a hospital or outpatient facility after a same day surgery. This rule applies regardless the category of anesthetic used (yes, even straight local/numbing). Surgery centers and hospitals will also not allow the person driving you home to be a stranger (i.e. taxi, Uber/Lyft/other ride share driver). This is not a rule made by Capital Orthopaedics & Sports Medicine, but the facilities at which our physicians perform surgery and it happens to be the protocol enforced at every single one. 2) You are not permitted to drive or operate a motor vehicle at any point during your post operative recovery (whether that’s 1 day or 3 weeks post op) if you are taking pain medication. This is not only against medical advice but illegal. Every other restriction, limitation, or rule following your procedure and the rehabilitative aftermath will depend on the type of surgery, your surgeon, and how you, the patient, are recovering.

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