Frequently Asked Questions:

What is an orthopedic surgeon?

What is arthroscopic surgery?

What is joint replacement surgery?

How long do artificial joints last?

What happens during rotator cuff surgery?

What is an ACL reconstruction?

What is the difference between x-rays, MRI, and CT scan?

Should I apply ice or heat to an injury?

What is physical therapy?

What is a tendon? ligament? cartilage?

What is a cortisone/corticosteroid injection?

What is an epidural?

What are NSAIDs and how do they work?

How do I make an appointment to see my doctor?

Will the doctor see me on time?

What should I do if I am going to be late for my appointment?

How do I reach my Orthopedic Team by telephone?

What if I need to reach my Orthopedic team when the switchboard is closed?

When can I expect my telephone call to be returned?

How do I obtain prescription refills?

How do I get my MRI or CT scan scheduled?

How do I obtain my test results?

What happens if I need surgery?

Where will my surgery take place?

What if I need a referral to see the doctor?

What will I be expected to pay at the time of my visit?

Will my insurer pay for my doctor’s visit if he or she is not in my plan?

What if my doctor participates in my insurance plan?

Can I be billed for my doctor’s visit?

What is an Advanced Beneficiary Notice (ABN) and why should I sign it?

What should I do if my insurance or personal information changes?

What if I have questions about doctor bills that I receive?

What is the HIPAA Privacy Practice Notice?

What if I have other questions or concerns?

What is an orthopedic surgeon?
An orthopaedic surgeon is a medical doctor who has received up to 14 years of education in the diagnosis, treatment, rehabilitation, and prevention of injuries and diseases of the musculoskeletal system (bones and joints, muscles, ligaments, tendons, and cartilage). Some orthopaedic surgeons practice general orthopaedics, while others specialize in treating certain body parts such as the foot and ankle, hand and wrist, spine, knee, shoulder, or hip. Some orthopaedists may also focus on a specific population such as pediatrics, trauma, or sports medicine.

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What is arthroscopic surgery?
Arthroscopic surgery is one of the most common orthopaedic procedures performed today. Through the use of small instruments and cameras, an orthoapedic surgeon can visualize, diagnose, and treat problems within the joints. One or more small incisions are made around the joint to be viewed. The surgeon inserts an instrument called an arthoscope into the joint. The arthoscope contains a fiber optic light source and small television camera that allows the surgeon to view the joint on a television monitor and diagnose the problem, determine the extent of injury, and make any necessary repairs. Other instruments may be inserted to help view or repair the tissues inside the joint.

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What is joint replacement surgery?
Joint replacement surgery is performed to replace an arthritic or damaged joint with a new, artificial joint called a prosthesis. The knee and hip are the most commonly replaced joints, although shoulders, elbows and ankles can also be replaced. Joints contain cartilage, a rubbery material that cushions the ends of bones and facilitates movement. Over time, or if the joint has been injured, the cartilage wears away and the bones of the joint start rubbing together. As bones rub together, bone spurs may form and the joint becomes stiff and painful. Most people have joint replacement surgery when they can no longer control the pain in their hip or knee with medication and other treatments, and the pain is significantly interfering with their lives.

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How long do artificial joints last?
On average, artificial joints have a life span of 10 to 20 years. If you are in your 40s or 50s when you have joint replacement surgery, especially if you are very active, you are likely to need another joint replacement surgery later in life.

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What happens during rotator cuff surgery?
Shoulder surgery for rotator cuff problems usually involves one or more of the following procedures: debridement, subacromial decompression, rotator cuff repair.
Debridement clears damaged tissue out of the shoulder joint.
Subacromial decompression involves shaving bone or removing spurs underneath the tip of the shoulder blade (acromion). This creates more room in the space between the end of the shoulder blade and the upper arm bone so that the rotator cuff tendon is not pinched and can glide smoothly.
If the rotator cuff tendon is torn, it is sewn together and re attached to the top of the upper arm bone.

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What is an ACL reconstruction?
ACL reconstruction is a surgical procedure that repairs a torn anterior cruciate ligament (ACL), one of the four ligaments that help stabilize the knee. The ligament is reconstructed using a tendon that is passed through the inside of the knee joint and secured to the upper leg bone (femur) and one of the two lower leg bones (tibia).
The tendon used for reconstruction is called a graft and can come from different sources. It is usually taken from the patient’s own patella, hamstring, or quadriceps, or it can come from a cadaver. ACL reconstruction is most often performed through arthroscopic surgery.

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What is the difference between x-rays, MRI, and CT scan?
X-rays are a type of radiation, and when they pass through the body, dense objects such as bone block the radiation and appear white on the x-ray film, while less dense tissues appear gray and are difficult to see. X-rays are typically used to diagnose and assess bone degeneration or disease, fractures and dislocations, infections, or tumors.
Organs and tissues within the body contain magnetic properties. MRI, or magnetic resonance imaging, combines a powerful magnet with radio waves (instead of x-rays) and a computer to manipulate these magnetic elements and create highly detailed images of structures in the body. Images are viewed as cross sections or “slices” of the body part being scanned. There is no radiation involved as with x-rays. MRI scans are frequently used to diagnose bone and joint problems.
A computed tomography (CT) scan (also known as CAT scan) is similar to an MRI in the detail and quality of image it produces, yet the CT scan is actually a sophisticated, powerful x-ray that takes 360-degree pictures of internal organs, the spine, and vertebrae. By combining x-rays and a computer, a CT scan, like an MRI, produces cross-sectional views of the body part being scanned. In many cases, a contrast dye is injected into the blood to make the structures more visible. CT scans show the bones of the spine much better than MRI, so they are more useful in diagnosing conditions affecting the vertebrae and other bones of the spine.

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Should I apply ice or heat to an injury?
Ice should be used in the acute stage of an injury (within the first 24-48 hours), or whenever there is swelling. Ice helps to reduce inflammation by decreasing blood flow to the area in which cold is applied. Heat increases blood flow and may promote pain relief after swelling subsides. Heat may also be used to warm up muscles prior to exercise or physical therapy.

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What is physical therapy?
Physical therapy is the treatment of musculoskeletal and neurological injuries to promote a return to function and independent living. Physical therapy incorporates both exercise and functional training. Exercise restores motion and strength while functional training facilitates a return to daily activities, work, or sport.

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What is a tendon? ligament? cartilage?
A tendon is a band of tissue that connects muscle to bone. A ligament is an elastic band of tissue that connects bone to bone and provides stability to the joint. Cartilage is a soft, gel-like padding between bones that protects joints and facilitates movement.

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What is a cortisone/corticosteroid injection?
Cortisone is a steroid that is produced naturally in the body. Synthetically-produced cortisone can also be injected into soft tissues and joints to help decrease inflammation. While cortisone is not a pain reliever, pain may diminish as a result of reduced inflammation. In orthopaedics, cortisone injections are commonly used as a treatment for chronic conditions such as bursitis, tendinitis, and arthritis.

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What is an epidural?
An epidural is a potent steroid injection that helps decrease the inflammation of compressed spinal nerves to relieve pain in the back, neck, arms or legs. Cortisone is injected directly into the spinal canal for pain relief from conditions such as herniated disks, spinal stenosis, or radiculopathy. Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief.

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What are NSAIDs and how do they work?
Non-steroidal anti-inflammatory drugs (NSAIDs) are non-prescription, over-the-counter pain relievers such as aspirin, ibuprofen, and naproxen sodium. They are popular treatments for muscular aches and pains, as well as arthritis.
> NSAIDs not only relieve pain, but also help to decrease inflammation, prevent blood clots, and reduce fevers. They work by blocking the actions of the cyclooxygenase (COX) enzyme. There are two forms of the COX enzyme. COX-2 is produced when joints are injured or inflamed, which NSAIDS counteract. COX-1 protects the stomach lining from acids and digestive juices and helps the kidneys function properly. This is why side effects of NSAIDs may include nausea, upset stomach, ulcers, or improper kidney function.

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How do I make an appointment to see my doctor?

If you are new to the practice, please call (305) 937-1999 and ask to speak with one of our New Patient Consultants. Please be prepared to provide the most accurate and complete information possible. This will allow the Consultants to best prepare you for the visit. It is important for you to obtain copies of any pertinent test or scan results, operative reports, and medical records.

If you are an established patient, please call (305) 937-1999 and ask to speak with the Front Desk. It is important for you to advise the Consultant if there is a new injury, a different body part, or a change in your insurance. This will help avoid insurance problems later on. Urgent appointments will be made as soon as possible, generally on the same day or the next, depending on the level of urgency of your problem.

Non-urgent appointments are made as available or as medically indicated.

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Will the doctor see me on time?

We make every effort to see patients on time. Unfortunately, since this is a surgical practice and we see emergencies throughout the day, occasionally a wait is unavoidable. At times patient problems take longer to diagnose and treat than expected which also causes delays. Please be assured that your doctor will spend as much time with you as necessary and will not turn you away in case of an emergency.

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What should I do if I am going to be late for my appointment?

If you are going to be late for your appointment, we request that you call the office as soon as possible to determine whether or not you will need to be rescheduled. Sometimes your doctor may have to leave for surgery and will not be able to see you if you are late. We ask that you not come in earlier than your scheduled appointment as this delays other scheduled patients. We see patients by appointment time, not arrival time.

If you must cancel, we would appreciate 24 hours notice.

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How do I reach my Orthopedic Team by telephone?

If you have an emergency, call 911. Otherwise, the Orthopedic Care Center switchboard is open Monday through Friday from 9:00 am to 5:00 pm. The Medical Assistant or Physician Assistant will triage your phone call in order to assist you as best possible.

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What if I need to reach my Orthopedic team when the switchboard is closed?

For all routine matters, prescription refills or appointment scheduling, please call when the switchboard is open.

For your own safety, medication refills are best handled during your regularly scheduled appointment. Medications cannot be prescribed or refilled after-hours or on weekends.

You must deactivate the caller ID blocking feature in order to allow the On Call physician to contact you. When you reach the On Call physician, please realize that he or she is most likely not familiar with the specifics of your case. The On Call physician may ask you to go to the Emergency Room for further evaluation.

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When can I expect my telephone call to be returned?

If you have an emergency, call 911. Routine calls will be addressed within 48 hours. Urgent calls will be returned within 24 hours.

If you have not received a return call within 48 hours, we ask that you call our Practice Administrator, Nina Bleier, at (305) 937-1999, ext.116.

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How do I obtain prescription refills?

Medications cannot be prescribed or refilled after-hours or on weekends. For your own safety, medication refills are best handled during your regularly scheduled appointment. As such, please plan accordingly.

If a situation arises where you will run out of medications, please call the medical assistant. In addition to the pharmacy name and number, you must specify the medication name, dosage and quantity. Medication refills will take approximately 2 business days. Refills will not be authorized unless your doctor has examined you within the last month.

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How do I get my MRI or CT scan scheduled?

If your doctor orders an MRI, CT Scan or other diagnostic test, his nurse will take care of scheduling it for you with the appropriate center or hospital. They will call you directly to schedule the test at a time convenient for you.

If you are a member of a managed care plan, the plan may require medical records or other information from your doctor before authorizing the test. We ask that you keep this in mind and be patient. We endeavor to schedule all tests in a timely manner. Delays are usually due to insurance company requirements.

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How do I obtain my test results?

After you have had your test, please call our office to make an appointment with your doctor to discuss the results and any necessary follow-up treatment. We do not divulge test results over the phone. It is important that you keep your follow up appointment after any diagnostic test is obtained. If not, you place yourself at risk since adverse results may go undetected

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What happens if I need surgery?

Once you and your surgeon decide on surgical intervention, the Surgical Scheduling Department will make the necessary arrangements. This includes selecting the surgical date as well as obtaining any required preoperative labs, tests or clearance consultations. The Surgical Scheduling Department will also obtain authorization from your insurance company for the proposed procedure.
Please verify that the Surgical Scheduling Department has the most up-to-date address, work phone, home phone and mobile numbers.

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Where will my surgery take place?

The Surgical Scheduling Department will advise you of the location for your surgery. Our surgeons are on staff at Aventura Hospital & Medical Center, the Outpatient Surgicenter of Aventura and the North Miami Beach Surgical Center.

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What if I need a referral to see the doctor?

If your insurance plan requires that you obtain a referral to see our specialists, you must verify that this is obtained prior to every visit. Since this is a requirement of your particular insurance plan, please note that it is your responsibility to obtain a valid referral. Unfortunately, you will need to reschedule your appointment if you are unable to obtain the referral. For your own convenience, you should take care of this several days before your visit.

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What will I be expected to pay at the time of my visit?

Typically, this depends on the specific rules of your insurance contract. All co-payments, deductibles and co-insurances are due at the time of your service. If you are on a health plan for which the office does not participate, then you will need to complete a deposit prior to the visit. All fees are subsequently due at the time of service.

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Will my insurer pay for my doctor’s visit if he or she is not in my plan?

If your doctor does not participate in your insurance plan, all claims, coverage and payment matters are handled by you directly with your insurer. In order to assist you with quick and accurate filing of your claims, we will provide you with a receipt containing all pertinent claims information at the time of payment. This receipt should be attached to your insurer’s claim form and submitted for consideration.

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What if my doctor participates in my insurance plan?

If you are a member of an insurance plan in which your doctor participates, we will bill your insurance directly, provided that we are able to verify your insurance benefits and you have any referral required by the plan. All co-payments required by your plan must be paid at the time of service. We do not bill patients for co-payments.

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Can I be billed for my doctor’s visit?

We require that payment for all services not covered by insurance be made at the time of service. All co-payments must be made at the time of service. You will be billed for any deductibles and co-insurance amounts. For your convenience we accept MasterCard and Visa.

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What is an Advanced Beneficiary Notice (ABN) and why should I sign it?

Health insurance coverage is not a guarantee of payment. The ABN states that in the event your insurance carrier declines to pay for the medical services provided, you agree to be responsible for payment. We must have a waiver from you guaranteeing payment in order to provide you with medical services. You have the right to decline the services and need not sign the waiver. However, in order to receive certain medical services, you are required to sign this waiver to satisfy regulatory requirements.

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What should I do if my insurance or personal information changes?

Please be sure to notify us of any changes to your insurance information, address, telephone numbers or any other pertinent information. Failure to provide us with current insurance information may delay your appointment and/or result in you being billed directly for services.

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What if I have questions about doctor bills that I receive?

For all billing inquiries ask for  Patient Accounts Department when calling our operator at (305) 937-1999.

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What is the HIPAA Privacy Practice Notice?

The HIPAA Privacy Practice Notice is given to you to sign to acknowledge that the office has provided you with a copy of the terms of the federal Health Insurance Portability and Accountability Act (HIPAA). A copy of this act will be provided to you as a new patient.

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What if I have other questions or concerns?

We are here to listen. Should you at any time have questions, suggestions, comments or concerns, please do not hesitate to bring them to the attention of one of our staff members or the Practice Administrator. We are always interested in obtaining feedback.

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