Instructions prior to surgery

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Instructions prior to surgery

Patient pre-registration and medication reconciliation forms

Completing the forms below and bringing them with you on the day of your surgery will greatly assist us in ensuring we have accurate insurance information, medical history and list of medications that you are currently taking:

We are required to provide you with the following information prior to your surgery. Please review the forms below.

 

 

Compliance HelpLine

Suffolk Surgery Center is committed to providing a culture of compliance. Suffolk Surgery Center desires for all patients, employees, and vendors to be able to freely report suspected fraud, abuse, and/or compliance issues in a safe and reliable manner. The purpose of the Hotline is to provide an alternative method of reporting suspected Suffolk Surgery Center compliance violations of any federal or state laws or Suffolk Surgery Center policies and procedures. The Hotline is an anonymous dedicated line with a private voicemail box.
Tell us about any concerns regarding improper or unethical activity such as violations of professional standards of practice or business ethics, breach of patient privacy or confidentiality, information system security breach, inaccurate billing, or conflicts of interest. This list does not include all of the possible violations that could be reported to the Compliance Officer but provides examples of potential compliance related matters.
Reporting is available 24 hours a day, seven days a week. The phone number (855-295-0005) automatically patches you into a voice mailbox where you can leave a message about your concerns. Suffolk Surgery Center employees do not answer your calls. When you call the Hotline you should leave a message describing the suspected compliance problem in as much detail as possible. You do not need to leave your name or any information that may identify yourself. However, providing such information may assist our compliance team in investigating the matter. The Compliance Officer will review the messages regularly. All reports are treated with respect and may be made anonymously. No one will retaliate against any person making a report in good faith