How do I get insurance approval for surgery?

Your insurance approval will be handled by your surgeon’s administrative assistant.  Often you do not need to do anything but wait for the administrative assistant to contact you to let you know you have been approved.  In some instances appeals need to be made to your insurance company for denial of services, especially in case of more complex procedures such as cartilage repair or meniscal transplantation. If this is the case the administrative assistant will contact you and instruct you on how to proceed. Please note that denial letters will generally state that the procedure was deemed "experimental" and therefore denied. This is just means that the insurance lacked some information to approve your procedure, or that they disagree with Dr. Gomoll's argument why you need the procedure, not that the procedure itself is experimental surgery. The only time Dr. Gomoll performs experimental surgery is as part of a medical trial, for which you will need to give specific consent long prior to the procedure.

Most insurance approvals are good for 6 months to one calendar year from the date of approval.

 

When will I find out my surgical time?

The appropriate surgical facility will give you a call the day before surgery to notify you of your arrival time/surgical time.

Dr. Gomoll works with his team of dedicated clinical staff and assistants to deliver safe, high-quality, expert care.

  • Hospital for Special Surgery: 212-606-1000

If unable to reach anyone, please contact Dr. Gomoll's office directly at 212-606-1775.

If you are traveling from out of town, please call the hospital (numbers above) and let them know how they can reach you in regards to your surgical time. Let them know your cell phone number and where you will be staying the night before your surgery.

 

Before Your Surgery

What should I do to prepare for my surgery?

  1. Do NOT eat or drink anything after mid night prior to your surgical date
  2. Arrange for a family member or friend to accompany you to the hospital the day of your surgery.
  3. Plan ahead for transportation home or to the hotel the day of your planned discharge.
  4. Remember to adjust your work/social schedule accordingly during your anticipated recovery time.
  5. While taking narcotic pain medication, you will not be permitted to drive. You may need to arrange for transportation to your initial follow-up visit.
  6. Unless told otherwise, you will need to have a follow-up visit 10-14 days after surgery.
  7. You may see Dr. Gomoll or one of his physician assistants for your first post-op appointment depending on the nature of the procedure performed or based on your preference.

What should I bring with me the day of surgery?

  1. Photo ID
  2. Insurance Card
  3. Friend or family member who will be available the entire time and take you home after surgery
  4. Wear comfortable, loose fitting clothing
    • Shoulder/elbow surgery: zip-up or button down shirt
    • Knee surgery: loose fitting pants or shorts
  5. Leave jewelry, money and valuables at home.

 

Medications to Stop Before Surgery

14 days before surgery, you need to stop:

Any Narcotic (example: Vicodin, Norco, Darvocet, Percocet or Oxycontin)

  • Advil to aspirin like products to stop 14 days before surgery

7 – 10 days before, you need to stop:

Any medications prescribed by your physician, please consult with the prescribing physician and Dr. Gomoll before stopping prior surgery (example: Plavix, Coumadin, Warfarin, prescribed Aspirin).

Please also stop over-the-counter supplements that can cause bleeding such as Turmeric or Vitamin E.

You can continue to take:

  • Tylenol
  • Celebrex
  • Glucosamine Chondroitin Sulfate
  • Daily Vitamins

On the morning of surgery:

  • Take only medications that are for your heart (hypertension, arrhythmias, etc.)
  • If you use an inhaler, please bring it with you
  • If you are taking diabetic medications, you should check with your internist to determine if you should take these medications on the morning of surgery

If you are taking any other medications that are not listed, please consult with your internist prior to surgery to determine if you should continue taking the medication or to see when you should stop and resume the medication.

Information to make your stay easier

You can find information about HSS, hotel partners, transportation and the local neighborhood by following this link