Written by: Dr. Chelsea Viola
*This blog post contains affiliate links.
Facing foot and ankle surgery can be a daunting prospect, but proper preparation can make a significant difference in your overall experience and recovery. This guide is designed to walk you through the essential steps to ensure you are well-prepared for your upcoming surgery, including navigating your insurance plan to understand coverage details. Throughout this post, there will also be information on what role Vale Foot and Ankle Surgery, PLLC plays and products we recommend for you and for your home.
Step 1: Consultation with Your Surgeon
Before diving into the logistics, schedule a comprehensive consultation with your surgeon. Discuss the details of the procedure, potential risks, and expected recovery timeline. Ask any questions you may have and seek clarification on post-operative care. This is the first step as it is the most important. We want you to be as comfortable as possible with the surgeon’s plan. Please make sure our office has your email address and phone number so you can be added to the Patient Portal. Utilize the Patient Portal to ask further questions to your surgeon prior to your procedure. You can always call our office to have our staff ask questions of the surgeon, but sometimes the Patient Portal is faster. If you have many questions, we do recommend scheduling a second surgical consultation appointment.
If you decide you’d like to proceed with an operating room procedure with one of our surgeons, you will receive our Surgery Folder, which has similar information to what you’ll read in this post. Our surgical coordinator, Marianne, will then contact you either in person or via phone.
Step 2: Confirming Insurance Coverage
Understanding your insurance coverage is crucial to avoid unexpected costs. Contact your insurance provider to verify the specifics of your plan. Key questions to ask include:
- Is the surgeon in-network?
- Are the facility and anesthesiologist covered?
- What pre-authorization or documentation is required for coverage?
- What is my deductible?
- What is my co-insurance?
- What will I be responsible for paying?
Step 3: Pre-Authorization Process
Many insurance plans require pre-authorization for surgeries. Work closely with your surgeon’s office to ensure all necessary documentation is submitted in advance. This may include medical records, a letter of medical necessity, and any other forms your insurance provider requires. Approximately thirty (30) days prior to your scheduled procedure, Vale Foot and Ankle Surgery, PLLC will contact your insurance company to start this process. We will provide all necessary documentation. Where there is a disagreement between your surgeon and your insurance company regarding medical necessity for a procedure, our surgeons will often speak directly with your insurance company’s medical team to resolve this issue. This is called a “peer-to-peer” review.
Step 4: Medical Clearance
Once you have a scheduled surgery date, you will be able to obtain medical clearance from your primary care doctor. Vale Foot and Ankle Surgery, PLLC will send a “medical clearance order” to your primary care doctor requesting this clearance. This is a physical appointment that you have to make with your primary care doctor. It is our policy at Vale Foot and Ankle Surgery, PLLC that all of our patients are required to have a medical clearance performed by their primary care doctor, regardless of age. The clearance appointment has to be completed within thirty (30) days of the surgery. In addition to the appointment, this usually includes bloodwork and an EKG. Confirm with your insurance whether these tests are covered and if there’s a specific facility you should use. Please keep in mind, if you have a cardiologist, pulmonologist, nephrologist and/or hematologist/oncologist, you will need medical clearance from those specialists in addition to your primary care doctor.
Step 5: Financial Planning
Once you have a clear understanding of your insurance coverage, discuss potential out-of-pocket costs with your surgeon’s billing department. Create a financial plan to cover deductibles, co-pays, and any other expenses. We do offer payment plans or financial assistance to those patients who qualify.
As the patient, you will be billed for our Vale Foot and Ankle Surgery, PLLC surgeon’s fee, in addition to a “facility fee” billed out by the hospital or surgical center where surgery is being held. Based on each facility, there may also be an additional anesthesia and/or laboratory fee. You are encouraged to reach out to the facility where your surgery is being held for clarification on their fees, as they are authorized to bill you for this “facility fee.” Our office will only provide information regarding our surgeon’s fee.
Step 6: Preparing Your Home
Make your recovery more comfortable by preparing your home in advance. Consider the following:
- Create a comfortable recovery space with easy access to essential items.
- Arrange for someone to assist you during the initial days post-surgery.
- Stock up on groceries and prepare easy-to-make meals.
- Will you be weight bearing or non weight bearing? This distinction dramatically changes the way you will move around the house.
If you are required to be non weight bearing, your surgeon may talk to you about a preoperative appointment with physical therapy specifically for non weight bearing training, coordination, and proper use of crutches, a walker or a knee scooter. You may be able to obtain a knee scooter, walker, or crutches at a surgical supply store. Only some insurances will pay a portion or the full amount of these products. Please call your insurance provider to determine coverage and which surgical supply store you should use if coverage is provided.
Products We Recommend For You and Your Home:
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Step 7: Post-Operative Care Plan
Work with your surgeon to develop a post-operative care plan. This should include details on medications, potential for physical therapy, and follow-up appointments. Having a clear plan in place will contribute to a smoother recovery process. Our office requires an immediate preoperative appointment with the surgeon. This appointment is designed to address any questions you may have regarding the surgery itself and confirm the postoperative plan. We also require it in order to fully discuss the informed consent forms and dispense the proper Durable Medical Equipment (DME) products, like the CAM (Controlled Ankle Motion) walking boot. Please verify with your insurance their policies on coverage for Durable Medical Equipment, as we will bill this product to your insurance and it could end up being an additional fee for you.
Step 8: Arrange Transportation
Coordinate transportation for the day of surgery and any follow-up appointments. Ensure you have a reliable and supportive friend or family member available to assist you. Some of you may be in a CAM (Controlled Ankle Motion) walking boot to your right foot. Unfortunately, you cannot safely drive while wearing that boot on your right foot. Having transportation is a major safety component of your postoperative course. You will likely not be driving until the surgeon authorizes the boot to be removed.
By following these steps, you can navigate the preparations for your foot and ankle surgery with confidence. Clear communication with your surgeon and insurance provider, coupled with careful planning, will contribute to a successful surgical experience and a smoother recovery journey.
Visit our Minimally Invasive Surgery information page for more!
If you’d like to schedule an appointment, you can contact us here and our New Patient Forms are available to download, print, and fill out at home. Then bring the forms to your surgical consultation with us for even faster care. We hope to see you soon!