Frequently Asked Questions (FAQ)

Preparing for your office visit

When coming to the office, please bring the following:

• a list of your medicines,
• a list of your allergies, medical problems and prior operations or injuries, and
• your ID and insurance information.

The best way to know if your insurance company has authorized your visit with us is if you have received written notice. If you have not received notification from the insurance company, you can check with your primary physician (who referred you) to find out when they asked the insurance company for the authorization. Then you can call the insurance company. If the insurance company has not authorized your visit, you may be financially responsible for the full amount of our charges, or you may decide to reschedule your appointment. In some cases your insurance may refuse to authorize your visit. In that case, if you contact us in advance, we will discuss whether we can adjust our fees to be similar, though possibly greater than, your usual co-pay.

Your primary physician should notify you what day and time you are scheduled to see us. If they have not notified you, there is a possibility that they have not yet made the referral or perhaps they are waiting for something (e.g. a test result). If we have not met you before, we would need to verify who you are before we can provide any information over the phone. For these reasons, it is best to call your referring doctor to verify the appointment date and time.

Preparing for surgery

If you are having colon surgery or colonoscopy, you must remain on clear liquids for the 24 hours before surgery. For most other procedures, you may eat as you please. You must take no food or water after midnight on the day of your procedure. The morning of the procedure, only take the medicines which we have recommended with a small sip of water. If you eat or drink on the day of surgery, your operation may be canceled and have to be rescheduled for another day.

Because surgery is unpredictable (it can take longer or shorter than expected, or be delayed by emergencies), the surgery time we give you is an estimate. This estimated time is written on the instructions we give you at your preoperative visit.

Unless we have recommended otherwise, you should be at the hospital or procedure center about 2 hours before your scheduled procedure. This allows time for you to change clothes, have a nursing evaluation, sign (more) papers, and have an IV (intravenous catheter in your arm or hand) started before you meet the anesthesologist.

If you are over 50 or have major medical problems (such as a prior heart attack, diabetes, or seizures) we will arrange for you to see your medical doctor before surgery. The chemicals that you receive during anesthesia can affect your heart, lungs, liver and other organs. If your organs are diseased before surgery, your risk of anesthesia will be higher than for someone with healthy organs. It is for your safety that we have your medical doctor determine that you are in the best medical condition that you can be before we subject you to the negative effects of anesthesia.

Depending upon your health, we may do only minimal testing. Young, healthy individuals may need only a simple blood and urine test. Elderly, ill patients with numerous medical problems may require blood, urine, heart or lung testing, plus various X-rays. The tests done before surgery are tailored to your medical status and anesthesia risks.

Common questions after surgery

When you hurt after surgery, this is usually normal. Begin by taking the pain medicine which was prescribed for you. If the pain is not very severe you may be able to take an over-the-counter pain medicine, like Tylenol (acetominophen) or Motrin (ibuprofen). If you have known stomach problems (like ulcers or previous stomach surgery), you should avoid ibuprofen and many other anti-inflammatory medicines. If you have no known stomach problems (and no allergies), you can usually add ibuprofen (but not Tylenol) to the pain medicine that you are taking.

Sometimes you have increased pain because you have been too active. Your body will generally indicate that you have been too active. If so, rest and apply ice to the affected area (if possible). Be a little less active until you are a little farther along in your healing.

In unusual circumstances, pain which will not get better can be the result of a problem. If you have any concern that this might be the case, call the office and speak to Dr. Ozeran or the surgeon on-call at (530) 755-3507; choose voice prompt #3 after hours.

If you are nauseated, first try limiting the amount of solids you are taking. Next try limiting your liquids to only those you can see through (clear liquids), including juice, water, soup broth, jello, ice chips, popsicles. If you are still neauseated, try medicine to treat the nasuea. If you do not have any, call the office to obtain a prescription.

If you are vomiting and can't keep anything down for more than a day even after trying the maneuvers described, call the office. You may need to be given fluids and medication by IV, or you may have a complication from your surgery which requires admission to the hospital or possibly another procedure. If you are vomiting and develop a fever or stop urinating, or your urine is very dark and in small quantities, or if you have any heart, lung or kidney problems, call the office right away to be evaluated at (530) 755-3507; choose voice prompt #3 after hours.

A small fever, perhaps to 100 degrees, in the absence of wound redness or drainage, without nausea or vomiting, is probably not serious. If it persists for 2 or 3 days, call the office. You should always call the office for high fevers (over 100.5) to discuss whether any evaluation or treatment is necessary. You may take an antipyretic (something to bring down the fever) as long as it is over-the-counter and you follow the directions and restrictions on the box. Do not take an antibiotic you may have laying around. Take only antibiotics we previously prescribed for you to take. Do not apply antibiotic ointment to any wounds unless you have discussed it with us first.

If the incision is draining or bleeding first cover it with a sterile gauze. If you do not have a sterile gauze, a nonsterile (clean) gauze may be used. Otherwise use a paper towel from a previously unopened package. Then call the office to speak with Dr. Ozeran or the on-call surgeon at (530) 755-3507; choose voice prompt #3 after hours.

If the incision is red, bruised or swollen this may be normal. A small amount of redness staying within a quarter inch of the incision is usually not concerning. If it seems to be slowly expanding, call the office during business hours. If it seems to be rapidly expanding (doubling in size every few hours) or you are also having fever or vomiting, call the office immediately and speak with Dr. Ozeran or the on-call surgeon at (530) 755-3507; choose voice prompt #3 after hours.

A moderate amount of bruising is normal, and after a hernia repair can even turn the penis or scrotum almost black in color. Bruising is not usually of concern unless there is increasing swelling. Swelling that is not changing in size, is usually due to the body responding normally to the surgery. If swelling is rapidly getting larger (it looks like it might double in size by morning), call the office immediately at (530) 755-3507; choose voice prompt #3 after hours. Otherwise, call the office during regular hours to speak with Dr. Ozeran.

Insurance questions

Each commercial health insurer offers physicians a detailed, one-sided contract that guarantees that the health insurer always gets their way, even if a rational person would choose something different that helped you (our patient) and us. These contracts cannot be changed. I have tried, but the insurers insist that the contracts are "take it or leave it". So, at least for now, I have left them. Part of the way the insurers force most doctors into signing these unfair contracts is by making it more expensive for you (our patients) to come see us when we tell the insurers "No".

In our practice, we see this reduction in the number of patients in our office as a benefit to you. In some cases you will pay a little more. In all cases, we will reduce the time you wait in our office, you will get an appointment sooner, and you will have more appointment dates and times open to you. Further, you will always spend as much time as you need in our office without feeling rushed (except, perhaps, when an emergency occurs). We feel that despite any increase you may pay, that the service we provide to you is worth the cost and is of high value. We would like to hear from you if you disagree.

At present, we are only contracted with Medicare. This policy allows us to spend more time with our patients, have them seen in the office with a much smaller wait, and saves you time. Some of the insurers will allow us to bill them first and you pay your share afterward. In other cases, we would bill you and you would be reimbursed by your health insurer at the 'out of network' rate. This would cost you somewhat more than if you went to another surgeon in our community who did have a contract with your health plan. We can also see any patient who is willing to pay for their care. If you call the office in advance we will give you an estimate of what your costs might be.

Even though we may not be contracted with your insurance, the facilities we use usually are contracted. In order to save significantly on the facility costs (which are usually thousands of dollars), we may need to obtain an authorization from your health plan in advance. Each health plan takes a different amount of time to give their OK. When we schedule your surgery ask what the average time is with your plan.

Other questions

Our surgical practice usually sees new patients by referral from a primary medical physician. If you are already our patient for another problem, you may call to request that we see you for a new problem. Otherwise, it is better for you to request a referral from your medical doctor. There are many problems which may seem surgical but are in fact treated medically, at least initially. You and we would both be disappointed by the time lost if you came in for a problem which would normally be treated by your primary medical doctor. If you call to arrange an appointment, we will ask a number of questions to determine if you should see your medical doctor first.