Orthopedic Surgery Frequently Asked Questions

How do I make or reschedule an appointment?

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.

What if I require emergency care?

A physician is on-call 24 hours a day. If you have a medical emergency, please come to the Emergency Room at Boston Medical Center, or call our office at 617.638.5633.

What are your office hours?

Our main office telephone number is 617.638.5633, and will be answered by one of our staff members Monday - Friday from 7:30 AM - 4:30 PM. For emergency calls after hours, you will be connected to our Answering Service, who can then contact the covering on-call physician. For appointments, please refer to appointment information noted above.

How soon can I get an appointment?

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.

Should I bring x-rays or MRI test results with me?

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.

How long will my appointment take?

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.

Do you offer interpreter or translation services?

Boston Medical Center's full-time medical interpreter staff provides coverage for more than 30 languages. If you require an interpreter for your visit, please inform us when you make your appointment.

What should I do if I see another patient who arrived after me called from the reception area before I am called?

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.

What do I need to know if I was injured in a work-related accident?

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.

What do I need to know if I was injured in a motor vehicle accident?

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.

Where are you located?

Boston Medical Center
Department of Orthopedic Surgery
Shapiro Ambulatory Care Center
725 Albany Street
4th Floor, Suite 4B
Boston, MA 02118.

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

Where should I park?

Parking is located nearby at the 710 Albany Street Parking Garage. Metered street parking is also available in the neighborhood surrounding BMC.

Do you offer valet service?

Valet parking is available in front of the Menino Building at 840 Harrison Avenue for $15.00 per day.

How do I get a copy of my medical records?

Your medical records are maintained by Boston Medical Center. If you require a copy of your full medical record, please contact the Medical Records Department at 617.414.4201.

Can I receive copies of my x-rays, CT scans and MRI's that were done at BMC?

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.

I have a form that the doctor needs to fill out. How do I ensure that this form gets completed and mailed/faxed?

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.

How can I get a refill or new prescription?

If you require a refill on your prescription, please call 617.638.5633. Prescriptions will be refilled Monday - Friday 8:30 AM - 4:30 PM. Please have the medication name, dosage and your pharmacy's telephone number available when you call. We will make every effort to refill your prescription within 24 hours. In some cases it may be necessary for the physician to see you again before we can refill a prescription.

If I need surgery, how soon will I be able to schedule a date?

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.

What is BMC Orthopedic Department's financial policy?

We appreciate you choosing our physicians for your orthopedic needs. We are dedicated to providing you with the best medical care possible. However, please understand that payment of your bill is part of your treatment. Please refer to our financial policy for more information about co-payments, referrals, bills, etc.

What insurance plans does BMC contract with?

We have contracts with the following insurance carriers:

• Aetna/US Healthcare
• Blue Cross Blue Shield
• BMC Healthnet
• Cigna
• Commonwealth Care Alliance
• Evercare
• GIC Indemnity/Commonwealth Indemnity
• Great-West Healthcare
• HCVM
• HMO Blue
• Harvard Pilgrim Health Care
• Mass Health
• Maine Medicaid
• Medicare
• Network Health
• New Hampshire Medicaid
• Neighborhood Health Plan
• Railroad Medicare
• Rhode Island Medicaid
• Secure Horizons
• Tricare/Sierra
• Tufts
• United Healthcare

For information on Understanding Insurance-Speak, download this information kit.

What does the fee for an office visit include?

Your fee is based on the time your surgeon spends with you during your visit, the complexity of your medical condition, and any treatment that is provided. But proper attention to your care also requires that the surgeon or members of his staff spend additional time beyond that which we spend with you in the office. Such time may be used to:

• Create or maintain your permanent medical record.
• Review current x-ray or scan reports, compare them with reports of previous scans, and, when the studies are abnormal, consult with the radiologist.
• Prepare and mail consultation reports to referring or consulting physicians and other health care providers.
• Prepare referral letters to additional specialists, as needed.
• Prepare patient education materials.
• Conduct medical research relevant to your case.
• Communicate with pharmacies about your prescriptions.
• Complete insurance applications and claim forms.
• Conduct utilization review negotiations with insurance companies.
• Draft letters of medical necessity to obtain medical services, instruments or prescriptions that you need.
• Arrange for hospital admissions and follow-up consultations with nurses, physicians and house staff.
• Draft reports and forms, including home health care orders and nursing facility orders.

All these activities add to our cost of doing business. Still, we are committed to providing you the best possible care at the lowest cost.

I have some questions about my bill. Who should I call?

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 Patient Financial Services at 617.638.6157.

What is "fracture care"? Why am I being charged for a surgical procedure when I never had surgery?

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

How do you handle Workman's Compensation Claims?

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.

I am experiencing unexpected or severe pain, redness, swelling, etc. Who can I call to discuss these concerns or any other orthopedic concerns that may come up?

If you have a medical emergency, please come to the Emergency Room at Boston Medical Center, or call our office at 617.638.5633. A Physician Assistant or Nurse Practitioner will return your phone call to discuss your concern and help determine whether a visit to the Emergency Room is necessary.

I have a dentist appointment. Do I need to take antibiotics before my appointment?

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.

What is a Resident? What is a Fellow? Are they doctors?

Yes, they are both doctors. A resident has completed medical school and a one- or two-year internship. They are enrolled in a five-year residency program, at the end of which they are fully equipped to enter orthopedic practice.

Fellows have completed their five-year residency and are further specializing in an area of orthopedic surgery. Fellowships last for one year.