Orthopedic Surgery Frequently Asked Questions

Office visits are by appointment only, please call 617.638.5633. Our practice is located in the Shapiro Ambulatory Care Center at 725 Albany Street, 4th Floor, Suite 4B.

To get to BMC's campus, please refer to the Visiting Us section.

If you are unable to keep your appointment, please call us as soon as possible so that we may offer your appointment time to another patient needing care.

Please arrive at your scheduled appointment on time. If you arrive late, you will be asked to either reschedule your appointment or to wait until the end of the clinic to be seen.

The nature of our specialty requires that certain injuries be treated on an emergency basis, or the physician may need to spend extra time with patients who have complicated injuries. We try to keep these emergencies from delaying your appointment. We appreciate your understanding in these unavoidable situations.

We try to schedule you for the earliest available appointment. We also take into consideration the urgency of your injury and the availability of the physician.

If you have obtained an x-ray from a facility other than Boston Medical Center, please bring the films with you to your appointment. If you have obtained an MRI or other imaging study from any facility including Boston Medical Center, please bring it with you to your appointment.

No two visits are alike. The length of your visit depends on several factors, including the complexity of your injury, the need for further x-rays, cast removal or application, and whether surgery or hospital admission is required. Your time is valuable and we make every effort to see you in a timely manner.

You may notice patients that arrive after you have been waiting, and seem to be called to an examination room before you. Please be advised that often there is more than one doctor working at the same time and this patient may be seeing the other doctor. Some of these patients may also be going to Radiology for x-rays. We make every effort to see patients in the order of their appointment time and in the order in which they arrive.

If you are injured as a result of a work-related accident, please provide the following information at your first visit:

• Your employer's address and phone number
• The worker's compensation insurance carrier name, address and phone number
• The claim number

For all worker's compensation or motor vehicle accident cases, you must also provide us with your health insurance card and a referral (if applicable). If your claim is later denied, we will then bill your health insurance plan.

If you were injured in a motor vehicle accident, please provide the following information at your first visit:

• Auto insurance company name, address and phone number
• The policy number
• The claim number for the vehicle you were in at the time of the accident

For all worker's compensation or motor vehicle accident cases, you must also provide us with your health insurance card and a referral (if applicable). If your claim is later denied, we will then bill your health insurance plan.

If you were injured in a motorcycle accident, your motor vehicle insurance may not cover health benefits. Please fill out the Motorcycle Accident Form and bring with you to your appointment.

Your radiology films are filed with the Radiology Department (they are not filed in the Department of Orthopedic Surgery). To request a copy of your films on CD, call Radiology at 617.414.5882. To request an actual printed film, you will need to go to the Dept. of Radiology, Menino Building, 1st Floor. There will be a charge for actual copies of your films; no charge if films are printed on a CD.

If you have any forms that need to be filled out by the physician, such as insurance forms or work capacity forms, please bring these forms to your appointment. If you cannot wait until your next visit, you may mail, fax or hand-deliver the forms to our office. Please allow 72 hours for forms to be completed.

Surgery will be scheduled according to the severity of the need for surgery and the availability of your doctor. A surgical scheduler will work with you to complete any necessary paperwork and to schedule the surgery at a mutually agreeable time.

Please look at the top of your bill. If it says "Boston University Orthopedic Surgical Associates, Inc.", you may call 1.800.456.1552 with any questions. These bills represent the physician's charges only.

Because we are a hospital-based practice, you may receive separate statements from the hospital for the facility charges. If you have any questions regarding your account with Boston Medical Center, please contact 1.888.489.0169.

Your insurance company requires that we bill our services to you using a coding system known as CPT or Current Procedural Terminology. The codes used to describe the services we performed for you are found in the "surgery" section of the CPT codebook. This does not mean we are implying that you had an operation. This is merely the way the CPT book is organized for ease of use by both insurance companies and physicians.

According to CPT guidelines, fracture care is billed as a "package" service. This means that at the time of initial care, a bill is generated that includes evaluation of the fracture, the first cast or splint application, and 90 days of normal, uncomplicated follow-up care.

The items/treatment that are not included in the package and require a separate charge are:

• X-rays
• All casting supplies, including those used in the first cast or splint application
• Any replacement cast or splint application
• The evaluation and management of any additional, separate or new problems or injuries
• The treatment of complications

Our worker's compensation program has been designed to provide quality care to patients, reduce the time spent out of work, and minimize permanent disabilities. Our surgeons and staff are dedicated to coordinating the care for worker's compensation patients. Our goal is to communicate effectively with the case managers by promptly providing complete information and responding quickly to any questions or concerns. Our surgeons, working together with the patient and case manager, attempt to introduce the patient back to work as early as medically possible. The surgeons will often encourage light-duty or modified job responsibilities in support of the case manager's effort to re-establish the patient into the workforce.

For the Case Manager/Claims Adjuster

We value your time and make every effort to ensure the visit process is as efficient as possible. Please introduce yourself at our reception area so that we may notify the doctor of your arrival.

After each visit you will receive:

• A summary office note with diagnosis
• An updated treatment plan
• Work status
• Next appointment date

All notes should be available for review within three business days of the appointment.

For Case Managers/Claims Adjusters/Utilization Review Nurses/Employers:

Our physicians are more than willing to prepare an in-service at your location on orthopedic injuries and treatment options. If you are interested in scheduling an in-service, please contact Joanne Garcia at Joanne.Garcia@bmc.org with your contact information and topic requests.

Patients with orthopedic total joint replacement require a course of antibiotics in conjunction with any invasive dental procedures for a period of two years after the procedure. If you are planning a dental procedure, please contact our office at 617.638.5633 for a prescription for the proper antibiotic and inform your dentist that you have had a total joint replacement.

For dental cleaning, extractions, crowns, bridges and periodontal surgery, the American Academy of Orthopedic Surgeons recommends:

• Patients not allergic to Penicillin: Keflex or Amoxicillin - 2 grams p.o. one hour prior to procedure.
• Patients allergic to Penicillin: Clindamycin - 600 mg p.o. one hour prior to procedure.
  There is no second dose recommended.

For patients that have not had total joint replacement, antibiotics are not required. This includes patients who have had insertion of metal plates, screws or rods. If your dentist requires a doctor's note, please contact our office at 617.638.5633 and we will gladly fax a note to your dentist or provide so you can bring with you to your appointment.