Your Appointment

Maryland Surgery Center is committed to ensuring that your experience with us is relaxed and worry-free, from consultation through recovery. To assist us, we ask that you read and comply with all guidelines.

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.

Advance Directives

An advance directive speaks for you if you are unable to speak and helps to ensure 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 Maryland 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. Information can also be obtained at: (410) 576-7000
www.oag.state.md.us/HealthPol/index.htm

You may also contact your local area office on aging.

Financial Policy

Maryland 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 Maryland Surgery Center’s charges. Be sure to bring your 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. Maryland Surgery Center accepts cash, cashier’s checks, credit cards and personal checks with a valid ID.

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. Call 301.770.8700 for more information.

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, Brooke Smith at 301.770.8700 or bsmith@capsc.us.

Additional information can be obtained from or to file a complaint with the State of Maryland contact:

Office of Healthcare Quality
Spring Grove Hospital Center
Bland Bryant Building
55 Wade Avenue
Catonsville, Maryland 21228

or call 877.402.8218 or go online at
http://www.dhmh.maryland.gov/ohcq/faq_help/file_a_complaint.htm or www.medicare.gov or 1.800.MEDICARE (1.800.633.4227)

or thru the Medicare Website at : www.medicare.gov/ombudsman/activities.asp

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 medically indicated.
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.

HIPAA Compliance

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 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 Policies 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
Develop safe guards to protect and de-identify Protected Health Information (as defined in the regulations).

Ownership Disclosure

We the Physician Owners of Maryland Surgery Center 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 Maryland Surgery Center.

Israel Alter, M.D.
Jacqueline Apgar, M.D.
Eric Ashkin, DO
Darryn Band, M.D.
Jessica Berger-Weiss, M.D.
Andrew Block, M.D.
Roy Brooks, M.D.
Tamara Coates, M.D.
Craig Dickman, M.D.
Thomas Ein, M.D.
Roy Khoury, M.D.
Michele Klein, M.D.
Jill Ladd, M.D.
Stephen Lakner, M.D.
Diane Lauirn, M.D.
Dorothy Lee, M.D.
Robert Levitt, M.D.
Randolph Lizardo, M.D.
Steven Maggid, M.D.
Richard Margolis, M.D.
Leslie Masiky, M.D.
Imad Mufarrij, M.D.
Brad Norman, M.D.
Adrienne Potts, M.D.
V. Ashok Rangnath, M.D.
George Resta, M.D.
Heather Sine, M.D.
Laurie Tyau, M.D.