Review Prior to Surgery

Do You Accept My Insurance?
Most insurance companies and employers favor outpatient surgery. Some tailor reimbursement schedules as an incentive to use outpatient centers. We suggest that you confirm your coverage. Always check with your insurance provider.

What Am I Responsible For As A Patient?
Providing to the best of your knowledge, accurate and complete information about your present health status and past medical history, and reporting any unexpected changes to the appropriate physician(s).

  • Following the treatment plan recommended by the primary physician involved in your case.
  • Providing an adult to transport you home after surgery and an adult to be responsible for you at home for the first 24 hours after surgery.
  • Indicating whether you clearly understand a contemplated course of action, and what is expected of you and asking questions when you need further information.
  • Your actions if you refuse treatment, leave the facility against the advice of the physician and/or do not follow the physician’s instructions relating to your care.
  • Ensuring that the financial obligations of your healthcare are fulfilled as expediently as possible.
  • Providing information about and/or copies of any living will power of attorney or other directive that you desire us to know about.

Patient’s Rights
To listen to these rights in English. click here.
To download these rights in Vietnamese, click here.

As a patient you have the right to:

  • Considerate, respectful care at all times and under all circumstances with recognition of your personal dignity.
  • Personal and informational privacy and security for self and property.
  • Have a surrogate (parent. legal guardian. person with medical power of attorney) exercise the Patient Rights when you are unable to do so, without coercion, discrimination or retaliation.
  • Confidentiality of records and disclosures and the right to access information contained in your clinical record. Except when required by law, you have the right to approve or refuse the release of records.
  • Information concerning your diagnosis, treatment and prognosis, to the degree known.
  • Participate in decisions involving your healthcare and be fully informed of and to consent or refuse to participate in any unusual, experimental or research project without compromising your access to services.
  • Make decisions about medical care, including the right to accept or refuse medical or surgical treatment after being adequately informed of the benefits, risks and alternatives, without coercion, discrimination or retaliation
  • Competent, caring healthcare providers who act as your advocates and treats your pain as effectively as possible
  • Know the identity and professional status of individuals providing service and be provided with adequate education regarding self-care at home, written in language you can understand.
  • Be free from unnecessary use of physical or chemical restraint and or seclusion as a means of coercion, convenience or retaliation.
  • Know the reasons for transfer either inside or outside the facility.
  • Impartial access to treatment regardless of race, age, sex, ethnicity, religion, sexual orientation, or disability.
  • Receive an itemized bill for all services within a reasonable period of time and be informed of the source of reimbursement and any limitations or constraints placed upon your care.
  • File a grievance with the facility by contacting the Administrator, via telephone or in writing. when you feel your rights have been violated.

Regina Boore, RN, BSN, MS, CASC

Administrator

3333 W Coast Hwy.. Suite 100
Newport Beach, CA 92663
(949) 645-6272

  • Report any comments concerning the quality of services provided to you during the time spent at the facility and receive fair follow-up on your comments.
  • Know about any business relationships among the facility, healthcare providers, and others that might influence your care or treatment.
  • Know the reason(s) for your transfer either inside or outside the surgery center.

File a complaint of suspected violations of health department regulations and/or patient rights Complaints may be filed at:

Orange County District Office
Attn: Jacqueline Lincer. District Administrator
2150 Towne Centre Place. #210
Anaheim. CA 92806
(714) 456-0630
(800) 228-5234 Toll Free
(714) 456-0643 Fax
Office of the Medicare Beneficiary Ombudsman
http://www.cms.hhs.0ov/center/ombudsman.asp

Advance Directives:
It is the policy of Newport Bay Surgery Center, regardless of any advance directives or instructions from a health care surrogate or power of attorney, that an unexpected medical emergency, which occurs during treatment at this facility, will be aggressively managed with resuscitative or other stabilizing measures followed by emergency transfer to the closest emergency room. The receiving hospital will implement further treatment or withdrawal of treatment measures already begun in accordance with patient wishes, advance directive or health care power of attorney. Acknowledgement of this policy does not revoke or invalidate any current health care directive or health care power of attorney.

You can download Advance Directives forms from the following website:
http://www.uslivingwillredistry.com/forms.shtm
Download the Advanced Directives Patient Information Form

Financial Disclosure:
Newport Bay Surgery Center is privately owned and your physician may have a proprietary interest in this facility. You, as the patient, have the right to choose the facility of your choice for health related services.

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