USAP Patient Guide

PREPARING FOR YOUR PROCEDURE Español

Table of Contents

TYPES OF ANESTHESIA BEFORE: ONCE YOUR PROCEDURE IS SCHEDULED BEFORE: THE DAY BEFORE DURING: THE DAY OF DURING: WHAT TO BRING DURING: WHEN YOU ARRIVE

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AFTER: WHAT TO EXPECT PEDIATRIC PROCEDURES LABOR & DELIVERY PROCEDURES BILLING INFORMATION

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THIS DOCUMENT IS DESIGNED TO PROVIDE BASIC INFORMATION YOU MAY NEED FOR YOUR PROCEDURE • Please be sure to follow any instructions given by your surgeon, primary care physician or facility. • If your surgery date changes, you may still receive this guide; feel free to keep it for future reference. If you have canceled your surgery, or you no longer require anesthesia for your procedure, please disregard this information. • Notify your surgeon right away if there are any changes in your condition such as cuts or scrapes near the incision/surgical site, fever, cold, sore throat, new cough, stomach flu and/or shortness of breath.

USAP is privileged to be a partner in your care.

USAP clinicians are advocates for your health and will work with you to provide the best possible experience for you before, during and after your procedure. When appropriate, clinicians will also use patient-centered Enhanced Recovery After Surgery (ERAS) pathways to reduce your length of stay, decrease surgical stress, optimize your physiological function, and facilitate a faster recovery. A USAP anesthesia clinician will meet with you in pre-op at your medical facility the day of your surgery to discuss your medical history and review your personalized anesthesia care plan. We encourage you to ask questions and provide input. During your procedure, your anesthesia clinician will be by your side to monitor you, make sure you remain safe and comfortable, and work to minimize any side effects. If you have questions and would like to speak with an anesthesia clinician before your procedure, please call your medical facility.

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Types of Anesthesia After carefully considering the type of procedure, your medical history, and any concerns you may have, your anesthesia clinician will talk with you about the type of anesthesia that is best suited for you. Please keep in mind that the type of anesthesia may be determined by your procedure, so to keep you safe there may not be a choice in the anesthesia you receive.

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THESE ARE THE MAIN TYPES OF ANESTHESIA (FOR MORE INFORMATION, VISIT USAP.COM):

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GENERAL ANESTHESIA provides a total loss of consciousness, meaning you will be fully asleep. You will not be aware of any pain or feeling during your procedure. This type of anesthesia uses a combination of IV medicine (given through a tube in your vein) and gases (that you breathe through a mask or breathing tube). After, you may experience mild to moderate nausea and vomiting and/or a sore throat after removal of a breathing tube. MAC (MONITORED ANESTHESIA CARE OR CONSCIOUS SEDATION) uses IV medication to help you relax and decrease pain. You will not be completely asleep, but you may sleep and will be very groggy. REGIONAL ANESTHESIA blocks pain to a specific area of your body. You will not feel pain, but you will also not lose consciousness (you will not be fully asleep) unless other medication is used. Your anesthesia clinician will inject medication near a nerve, and you may also get other medications through an IV to help you relax. A PERIPHERAL NERVE BLOCK stops sensation through a nerve or group of nerves and is common for procedures on hands, feet, arms, legs or the face. EPIDURAL OR SPINAL ANESTHESIA is given through an injection in the spine to block pain for a large area of the body such as the abdomen, hips or legs.

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Once Your Procedure is Scheduled

As soon as your procedure is scheduled, tell your surgeon/facility about all the prescriptions, over-the-counter medications and supplements you are taking. Your medical team will help you determine when to safely stop taking these medications before your procedure . Try to exercise. Walking for 20 to 30 minutes at least three times a week can help prepare you for a procedure by strengthening your muscles and improving your heart and lung function. Try to eat healthy foods such as lean proteins, fruits and vegetables. These will give your body the nutrients it needs while being easier to digest. Stay hydrated. The recommendation is for women to drink 11.5 cups and men to drink 15.5 cups of water each day, but this can vary based on your environment, how active you are, medications you take and any conditions you have. Being hydrated can help make your veins more accessible for blood work or IVs. Try to decrease the amount of caffeine and alcohol you drink as they can cause dehydration. Try to quit smoking or decrease the amount you are smoking. Evidence shows that stopping smoking before and on the day of surgery decreases risks of heart, lung and wound complications. A helpful website for quitting smoking is smokefree.gov.

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The Day Before Your Procedure

• Follow your surgeon’s/facility’s instructions about when to stop taking medications. • Do not drink any alcohol. • Do not smoke or use chewing tobacco. • Do not use other recreational drugs. • Follow your surgeon’s/facility’s instructions about when to stop eating and drinking. • You should shower the evening or morning before your procedure while following any instructions you were given and using any provided soaps.

The Day of Your Procedure In general, you will be advised to stop eating and drinking at specific times before your procedure. You should confirm any instructions for eating and drinking with your surgeon and anesthesia team. If your surgery is in the afternoon or evening, please ask your care team about having a light breakfast.

• Do not shave the operative area. • Do not apply lotions, makeup, nail polish, hair spray, perfume, cologne, or false eyelashes. • Remove ALL jewelry and body piercings. • You may brush your teeth, but do not swallow any water. • Remove contacts and wear glasses, as needed.

Follow all medication instructions given by your surgeon/facility.

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What to Bring

• Proof of insurance • Two forms of identification (ID) • A form of payment (if you owe a copay) • Cases for glasses, hearing aids, etc. • Cervical collar, brace, crutches, walker, cane, etc., as instructed by your physician • A list of your home medications that you can leave with the medical facility (do not bring the actual medication unless otherwise instructed) • Portable oxygen device, CPAP or BiPAP machine (including mask and tubing), if applicable • Pacemaker or internal defibrillator card, if applicable • The responsible adult who will drive you home and stay to support you for at least the first 24 hours after your procedure

Avoid bringing anything valuable to the medical facility unless you have someone to hold it for you. Each facility is different and there may not be a safe place to store items such as your purse/wallet or phone during your procedure.

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When You Arrive

• You will be asked to change into a hospital gown. No personal clothing or personal items will be allowed into the operating room. • The pre-operative nurse will review your history, medications and allergies, and take your vital signs. An IV may be placed. • If applicable, lab work or other tests may be conducted, and women of childbearing age may be screened for pregnancy. • You will have the opportunity to meet with your anesthesia team before surgery.

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What to Expect After Your Procedure

• You will be taken to the recovery room where your vital signs will be monitored. Do not get out of bed alone as you may not be able to balance or support yourself. • Your comfort is important to us, so please let the nurses know if you experience pain or nausea so they can help treat it with medications and other measures like positioning. • The nurses will contact your support person when your procedure is complete. Once you are well enough, your support person will be able to visit you. • If you stay in the hospital after your procedure, your nursing team will work with you to incorporate safe movement and gradually reintroduce foods back into your diet. • When you are able to go home will depend on your type of procedure, when your pain is under control, and when your vital signs are stable. Before leaving, you will be given discharge instructions for how to care for yourself post-procedure and what to do if you have any concerns or start to feel unwell.

POST-CARE FEEDBACK SURVEY After your procedure, you may receive a text or email asking you to complete a short survey about your anesthesia experience. We value your feedback and use your responses to make sure we continue to provide high-quality care to our patients. Click here to learn more.

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Pediatric Procedures We understand that going through a surgical procedure can be unsettling for children and their families. We want to assure you that your child will be in experienced and caring hands. Our clinicians will provide thorough explanations and guidance, ensuring you have a clear understanding of what will occur before, during and after the procedure. To reduce anxiety and increase comfort, we will also share age-appropriate information with any child who wants to participate in the discussion.

FOR MORE INFORMATION AND ANSWERS TO COMMONLY ASKED QUESTIONS ABOUT ANESTHESIA DURING PEDIATRIC PROCEDURES, VISIT: USAP.COM/PEDIATRICS

Labor & Delivery Procedures

USAP is a group of highly experienced clinicians dedicated to providing an individualized plan of care for the safety of you and your baby. We understand that every woman’s labor and level of pain is unique, and many factors contribute to the level of pain relief you might need. The anesthesia team will begin by assessing your overall health and preferences to customize relief options that fit with your medical history and personal birth plan. FOR MORE INFORMATION AND ANSWERS TO COMMONLY ASKED QUESTIONS ABOUT ANESTHESIA DURING LABOR & DELIVERY, VISIT: USAP.COM/PATIENTS/LABOR-AND-DELIVERY

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Billing Information

USAP’s billing team is dedicated to making your anesthesia billing experience as seamless as possible. The information below will help you understand your anesthesia bill.

ANESTHESIA BILLING Your anesthesia services are billed separately from other medical services. The facility bill may include anesthesia charges related to the equipment, drugs and other supplies used for your care. USAP’s anesthesia bill is for the professional services provided by expert anesthesia clinicians (Anesthesiologist, CRNA and/or CAA). FOR PROCEDURES COVERED BY INSURANCE Your insurance company will be billed for your anesthesia services, and we will make all reasonable efforts to obtain payment from your insurance company. Please provide complete demographic and insurance information to your referring physician and facility. We use this information to submit your insurance claim. You will be responsible for the payment of any deductibles, co-payments, denied or non-covered services. Regardless of the type of insurance coverage, patients are ultimately responsible for payment of their medical bills. FOR PROCEDURES NOT COVERED BY INSURANCE If you do not have insurance, or insurance does not cover your procedure, you will be personally responsible for full and timely payment of your bill. See “Financial Assistance” information on the following page, if needed.

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CARE TEAM BILLING USAP often uses an Anesthesia Care Team, which includes a physician anesthesiologist and either a certified registered nurse anesthetist (CRNA) or a certified anesthesiologist assistant (CAA). In cases where an Anesthesia Care Team is involved, we are required by some insurance companies to send two identical claims—one for the physician and one for the CRNA/CAA. This method follows the insurance company's billing requirements and is not duplicate billing. The total paid for the two claims is similar to what would be paid for a single anesthesiologist if a CRNA/CAA was not involved. Your total out-of- pocket cost will not increase when we follow these insurance requirements. ESTIMATES USAP is committed to providing patients with transparent pricing so you can understand your potential out-of-pocket costs. Our Patient Advocacy team is available to offer price estimates and to answer specific questions about insurance coverage. FOR MORE INFORMATION, VISIT: WWW.USAP.COM/ESTIMATES FINANCIAL ASSISTANCE Financial Assistance may be available if you have trouble paying your bill, regardless of whether you have insurance. USAP has a dedicated team of Patient Advocates to help patients in need of financial assistance. FOR MORE INFORMATION, VISIT: WWW.USAP.COM/PATIENT-ADVOCACY CONTACTS For any billing or insurance questions, please call the number on your statement or call us at 1-888-339-USAP(8727) . FOR MORE INFORMATION, VISIT: WWW.USAP.COM/BILLING-INFORMATION

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THANK YOU FOR ALLOWING US TO BE A PART OF YOUR CARE.

FOR MORE INFORMATION, VISIT: USAP.COM

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