Participating Health Insurance Plans

South Shore Surgery Center is a participating provider in the following health insurance plans:

CIGNA (Great-West)

Emblem

Empire Blue Cross Blue Shield

Fidelis (New York State Catholic Health Plan)

First Health

GHI

Health First

Health Net

HIP

Island Group Administrators

Medicaid

Medicare

Multiplan

Neighborhood Health Plan

NYS No Fault

NYS Workers Comp

POMCO

Suffolk Health Plan

The Empire Plan (NYS Government)

Three Rivers

Tri Care

United Healthcare Community Plan

US Dept of Labor

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Preparing for Your Surgery

For your health and safety, some laboratory tests or medical clearance may be required prior to your procedure. Your surgeon or Southshore Surgery Center may ask you to visit your family doctor to obtain the necessary tests or clearance within 30 days of your procedure.

Within a week of your scheduled procedure a nurse from Southshore Surgery Center will call you to conduct a pre-operative interview. They will ask you questions regarding your past and current medical conditions, allergies and medications you are taking. Please don't hesitate to ask any questions you may have, and be sure to let them know of any special needs.

The nurse will instruct you as to what time you are to stop eating and drinking prior to surgery.

If you take medication for any conditions, ask your doctor and/or the Southshore Surgery Center nurse whether or not to take it the day of your surgery.

For women, if there is a possibility that you are pregnant, please notify your doctor and/or the Southshore Surgery Center nurse.

Leave all valuables at home, including watches, rings, jewelry and wallets.

Please notify your surgeon of any change in your health, such as a cold, fever or sore throat.

For your safety, a responsible adult MUST be available to stay with you during the entire duration of your surgery. 

Children, age 17 years and younger or incapacitated adults must be accompanied by a person with legal guardianship.

You will receive a call for Southshore Surgery Center business office staff regarding your financial information and responsibilities.

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Day of Surgery

The Southshore Surgery Center requires that someone over the age of 18 arrive and stay with you during the duration of your surgery. Please make sure that individual is with you upon check-in.

Arrive promptly at the time instructed, which is usually 30-90 minutes prior to your surgery time. This will allow adequate time for all necessary admission procedures.

Please bring your insurance identification cards and photo ID. If special financial arrangements are necessary, please call the Southshore Surgery Center prior to the day of surgery.

Wear loose fitting comfortable clothing. Leave all valuables, at home.

Items to bring with you include but are not limited to: a list of your current medications, prior obtained prescription for pain medication, containers for eye wear, medical equipment you may use or have received prior to your surgery, any important records such as living will or patient advocate forms and any comfort devices such as a pillow for the ride home.

Upon arrival, you will change into a hospital gown and slippers which we provide. You will be asked to remove contact lenses, dentures, jewelry and any prosthesis.

Your care throughout your stay will be closely monitored by our staff for your safety and comfort.

When you are fully awake, one family member over the age of 15 will be able to join you in the recovery area (Pediatric patients are allowed 2 family members).

Each individual is different however you may expect to be in the recovery area 30 minutes-2 hours.

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At home after surgery

Your surgeon will provide specific instructions for care while recovering at home. In the event of difficulty, please call your surgeon.

For the first 24 hours following surgery, do not engage in strenuous activities, do not drink any alcoholic beverages, drive, or make any critical decisions.

A nurse from Southshore Surgery Center will call you within a day or two to evaluate how you are recovering at home. You will be asked to complete a questionnaire about the care you received. Your comments will enable us to continue to improve our services.

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Patient Responsibilities

Providing accurate and complete information about your present health status and past medical history and reporting any unexpected changes to the appropriate practitioner.

Following the treatment plan recommended by the practitioner involved in your care.

Providing an adult to transport you home after surgery and stay with you as needed.

Indicating that you clearly understand what is expected of you after your surgery/procedure.

Your own actions should you refuse treatment, leave the Facility against medical advice, or choose to purposefully not follow the instructions of your practitioner.

Providing information and/or copies of an Advance Directive such as Living Will or Durable Power of Attorney.

Ask your health professional what to expect for pain management; discuss pain relief options; discuss openly any concerns or fears regarding pain management medications.

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Advance Directives

An advance directive speaks for you if you are unable to speak and helps to assure that your religious and personal beliefs will be respected. It is a useful document for an adult of any age to plan for future health care needs.



Although Southshore Surgery Center does not honor advance directives in regards to Do Not Resuscitate (DNR), upon request we will provide you with contact information and forms to assist in writing an advance directive.

You may also contact your local area office on aging.

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Financial Policy

Southshore Surgery Center’s fees cover the use of the facility only, and do not include laboratory, pathology, surgeon or anesthesiologist fee. You will be billed separately for these services.

As a courtesy, we will bill your primary and secondary insurance carriers or governmental agency directly for the Southshore Surgery Center's charges. Be sure to bring your most current insurance, Medicare, or public assistance card with you on the day of your surgery. If you have more than one insurance carrier, we will also need accurate secondary billing information.

Please be aware of any admission policies your insurance plan may have. You or your physicians may have to adhere to certain requirements in order to insure maximum reimbursement. Failure to obtain pre-authorization, physician referral, or a second opinion may greatly reduce or eliminate your benefits.

Be prepared to bring any co-pay or co-insurance amounts on the day of your surgery. Patients who do not have insurance coverage may also be required to pay a portion of their charges in advance. Also, please make sure you bring a photo ID. We will need to see this as part of your insurance validation. We realize, however, that at times you may require special financial arrangements. In these instances, please phone our office prior to your surgery to discuss alternative methods of payment. Southshore Surgery Center accepts cash, cashier's checks, credit cards, and personal checks with a valid I.D.

Please feel free to contact our business office at any time if you have questions or concerns regarding the facility charges, the financial policy, or billing procedures

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Grievance Process

We strive to maintain a professional and compliant atmosphere. However, issues can arise. The Grievance procedure is a means for patients and related parties to inquire into issues raised and identify whether action needs to be taken to resolve identified issues and prevent recurrence. 

The Facility Administrator will record the grievance complaint and conduct a prompt investigation for quick resolution. Any patient and/or support person, visitor, employee, physician, or vendor may lodge a grievance using the Center’s procedure to formally voice complaints, resolve disputes, or to bring attention to possible violations of patient rights.

No person shall be punished or retaliated against for using the Grievance Procedure. Any grievances, comments and complaints are addressed to the Center Administrator. Complete details and a copy of the Center’s Grievance Policy as well as a Grievance form may be obtained by contacting the Center Administrator.

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Patient Bill of Rights

Patients receiving care in the ambulatory surgery setting have a right to the following:
 
Access to care
• Patients have the right to access necessary surgical and/or procedural interventions that are medicallyindicated.
• Patients, family members, and/or designees are included in ethical discussions of and decisions affecting the patient’s care.
• Marketing or advertising regarding the competence and capabilities of the organization is not misleading to patients and/or support persons.
 
Respectful and considerate care
• Patients will be treated with respect, compassion, and consideration in a clean and safe environment.
• Patients are treated with dignity and without discrimination on the basis of race, color, religion, sex, national origin, disability, sexual orientation, or source of payment.
• The patient has the right to be free of restraint except when indicated to protect the patient or others from injury.
 
Privacy and confidentiality
• Patients have the right to every consideration of personal privacy.
• Any patient case discussion, consultation, examination, and treatment will be conducted so as to protect each patient’s privacy.
 
Information about treatment
• Patients have the right to information about their illness, treatment options, and potential outcomes.
• Patients will receive information as necessary to provide informed consent for any planned procedure.
• Patients have the right to consent or decline in research affecting their care.
• Communication aids (i.e., interpreters, pictures, sign language, etc.) are provided to patients who have language barriers.
 
Refusal of Care
• Patients have the right to refuse care to the extent provided by law and to be informed of the potential consequences of this refusal.
• Patients who are recipients of health care services are responsible for the following. RESPONSIBILITIES Patients receiving care in the ambulatory surgery setting have responsibilities as follows:
 
Communication
• Patients are responsible for providing accurate and complete information regarding their health status, medical history, and current medications, as well as over-the-counter products, herbal remedies, and dietary supplements.
• Patients are responsible for reporting any change in their condition during the present course of treatment and recovery.
• Patients are responsible for participating in care decisions and for asking questions when they do not understand the information provided.
• Patients are responsible to provide information about any living will, power of attorney, or other advanced directive(s).
 
Respecting others
• Patients have the responsibility to be considerate of others, including health care providers, and to respect their rights, privacy, and property.
 
Participation
• Patients are responsible for adhering to the plan of treatment by following instructions, keeping appointments, and cooperating with care providers who assist with carrying out the plan(s) of care, including arranging for a responsible adult to take them home and remain with them for 24 hours if required.
• Patients are responsible for recognizing the effect of lifestyle choices on their personal health.
 
Financial obligations
• Patients are responsible for providing complete and accurate third party payer information and meeting any outstanding financial obligations related to the services received.
• Collaboration and agreement of payment policies and fees for services will be documented.

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HIPAA Compliance Policy

The Facility has established a compliance policy to ensure compliance with the Standards for Privacy of Individually Identifiable Health Information (the “Privacy Regulations”) promulgated under the Health Insurance Portability and Accounting Act of 1996 (“HIPAA”).

This compliance policy is not intended to be a comprehensive explanation of the Privacy Regulations, nor will it provide answers to every possible issue that may arise under the Privacy Regulations. Rather, it is intended to provide guidelines with respect to the steps that the Facility must take in order to achieve compliance with the Privacy Regulations and to sensitize the Facility to potential problems that may arise under the Privacy Regulations. The Facility expects full compliance with the guidelines set forth in this policy statement, and encourages the Facility to seek any further necessary information or clarification prior to engaging in any potentially sensitive actions or activities. See HIPAA Notebook for complete HIPAA policies and forms.

This compliance policy is divided into two main sections: (1) an overview of the Privacy Regulations; and (2) specific compliance guidelines. This policy requires the Facility to:
- Appoint a Privacy/Security Official;
- Inform Patients of the Facility’s Privacy Polices and Procedures by disseminating handouts and posting a disclosure notice;
- Use a Business Associates agreement;
- Clarify discipline for employees and vendors who violate the Privacy Rules and Privacy Policies and Procedures;
- Update the Privacy Policies and Procedures as needed;
- Hold all-employee educational meetings;
- Discuss adoption of the Privacy Policies and Procedures at a Board Meeting; and
- Develop safe guards to protect and de-identify Protected Health Information (as defined in the regulations).

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Ownership Disclosure

We the Physician Owners of Southshore Surgery Center, and want say thank you for your trust in us for your surgical procedure.  We recognize that you have the right to choose the provider of your healthcare services. We are pleased that you have chosen Southshore Surgery Center.

Ambulatory Surgical Centers of America

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Anesthesia Participating Health Insurance Plans

 

Brookhaven Anesthesia Associates, LLP

250 Patchogue Yaphank Road, Suite 3

East Patchogue, New York 11772

(631) 475-7680

PARTICIPATING INSURANCE COMPANIES

Aetna

Local 1199 reimburses at Aetna rate

Cigna – Great West

Emblem Health

GHI – HMO Commercial

Comprehensive Benefits Plan

Flex Select

Network Access

Medicare Advantage

Healthy New York (HNY)

HIP - HIP Classic

HIP Prime

HIP Medicaid

HIP Child Health Plus

HIP Medicare Advantage Plus

Healthcare Partners

Vytra - Vytra PPO

Vytra HMO

Vytra EPO

Vytra Max Access

Empire Blue Cross/Blue Shield

HMO, PPO, EPO

Medicare Advantage Plans

Island Group

 

Magnacare – includes many locals

Medicaid

Medicare

Mulitplan – PHCS – includes many locals

Neighborhood Health Plan

New York State Cancer Services Program – Breast Partnership

No Fault

Oxford – Liberty and Freedom Plans

Railroad Medicare

Tricare

United Healthcare

United Healthcare Community Plan

United Empire Plan

Workers Compensation

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Hospital Affiliation

South Shore Surgery Center has a patient transfer agreement in place with NSLIJ Southside Hospital. located at 301 East Main Street, Bay Shore NY  11706.

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© South Shore Surgery Center 2010 - 2017 | 53 Brentwood Road, Suite F | Bay Shore, NY 11706 | 631-647-5550