Patient Information

Insurance Accepted

• Aetna
• BCBS PPO & HMO
• Care Credit at BRSC
• Cigna
• Coventry
• Gilsbar
• Humana
• Medicaid (traditional, LA Health Connection, UHC, Healthy Blue, Ameri Health)
• Medicare
• Medicare Replacement Coverage
• Office of Groups Benefits
• PHCS
• PPO Plus
• Tricare
• United Healthcare
• Verity
• Workers Compensation

Billing Information

Price Transparency

Translation Services – Languages

Stratus Audio Available Languages – Language of lesser diffusion: anticipate extended wait time or need for prescheduling the call.

StratusVideo.com. or 727-451-9766

• Acholi*
• Afrikaans*
• Akan*
• Akateko*
• Albanian
• Amharic
• Arabic
• Armenian
• Assyrian
• Azerbaijani
• Bambara*
• Bantu*
• Belarusian*
• Bengali
• Bosnian
• Bulgarian
• Burmese
• Cantonese
• Cape Verdean-Creole
• Catalan*
• Cebuano*
• Chaldean
• Chuj*
• Chuukese*
• Croatian
• Czech
• Dari
• Dinka*
• Dutch*
• Ewe*
• Falam
• Fanti*
• Farsi (Persian)
• Flemish*
• French
• French-Canadian
• Fujianese
• Fulani
• Fuzhou*
• Ga*
• Georgian*
• German
• Greek
• Gujarati
• Haitian
• Creole
• Hakha-Chin
• Hausa*
• Hebrew*
• Hindi
• Hmong
• Hungarian
• Igbo*
• Ilocano*
• Indonesian
• Italian
• Japanese
• Kanjobal
• Karen
• Karenni
• Khmer (Cambodian)
• Kikuyu*
• Kinyamulenge*
• Kinyarwanda
• Kirundi
• Korean
• Kosraean*
• Krio*
• Kunama*
• Kurdish
• Kurdish-Bahdini*
• Kurdish-Fayli*
• Kurdish-Kurmanji*
• Kurdish-Sorani*
• Lao
• Lingala
• Lithuanian*
• Luganda*
• Luo*
• Maay
• Macedonian*
• Malay*
• Malayalam*
• Mandarin
• Mandigo*
• Mandinka*
• Mara*
• Maraka*
• Marathi*
• Marshallese*
• Masalit*
• Mien*
  Mina*
  Mixteco Alto*
• Mixteco Bajo*
• Mizo
• Moldavian*
• Mongolian
• Nepali
  Nigerian Pidgin*
• Nuer
  Oromo
  Pashto
• Pohnpeian
• Polish
• Portuguese
• Pulaar*
  Punjabi
• Quiche*
• Rohingya
• Romanian
• Russian
• Samoan*
• Sango*
  Serbian
  Shanghainese*
• Slovak*
• Somali
• Soninke*
• Sudanese
• Swahili
• Swedish*
• Sylheti*
• Tagalog
• Taishanese
• Taiwanese
• Tamil
• Tedim
• Telugu*
• Thai
• Tibetan*
• Tigrinya
• Tongan*
• Turkish
• Twi
• Ukrainian
• Urdu
• Uzbek
• Vietnamese
• Visayan
• West African Pidgin
• Wolof
• Yiddish*
• Yoruba Zo*
• Zomi*
• Zophei*

Patient’s Rights and Responsibilities

The staff of this health care facility recognizes you have rights while a patient receiving medical care. In return, there are responsibilities for certain behavior on your part as the patient. This statement of rights and responsibilities is posted in our facility in at least one location that is used by all patients. Your rights and responsibilities include:

A patient, patient representative or surrogate has the right to

• Receive information about rights, patient conduct and responsibilities in a language and manner the patient, patient representative, or surrogate can understand.
• Be treated with respect, consideration, and dignity.
• Be provided with appropriate personal privacy.
• Have disclosures and records treated confidentially and be given the opportunity to approve or refuse record release except when release is required by law.
• Be given the opportunity to participate in decisions involving their health care, except when such participation is contraindicated for medical reasons.
• Receive care in a safe setting.
• Be free from all forms of abuse, neglect or harassment.
• Exercise his or her rights without being subject to discrimination or reprisal with impartial access to medical treatment or accommodations, regardless of race, national origin, religion, physical disability, source of payment, or any other basis (gender, sexual orientation, etc.).
• Voice complaints and grievances, without reprisal.
• Be provided, to the degree known, complete information concerning diagnosis, evaluation, treatment, and know who is providing services and who is responsible for the care. When the patient’s medical condition makes it inadvisable or impossible, the information is provided to a person designated by the patient or to a legally authorized person.
• Exercise of rights and respect for property and persons, including the right to

• • Voice grievances regarding treatment or care that is (or fails to be) furnished.
  • Be fully informed about a treatment or procedure and the expected outcome before it is performed.
  • Have a person appointed under State law to act on the patient’s behalf if the patient is adjudged incompetent under applicable State health and safety laws by a court of proper jurisdiction. If a State court has not adjudged a patient incompetent, any legal representative designated by the patient in accordance with State law may exercise the patient’s rights to the extent allowed by State law.

• Refuse treatment to extent permitted by law and be informed of medical consequences of this action.
• Know if medical treatment is for purposes of experimental research and to give his consent or refusal to participate in such experimental research.
• Have the right to change providers if other qualified providers are available.
• A prompt and reasonable response to questions and requests.
• Know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
• Receive, upon request, prior to treatment, a reasonable estimate of charges for medical care and know, upon request and prior to treatment, whether the facility accepts the Medicare assignment rate.
• Receive a copy of a reasonably clear and understandable, itemized bill and, upon request, to have charges explained.
• Formulate advance directives and to appoint a surrogate to make health care decisions on his/her behalf to the extent permitted by law and provide a copy to the facility for placement in his/her medical record.
• Know the facility policy on advance directives.
• Be informed of the names of physicians who have ownership in the facility.
• Have properly credentialed and qualified healthcare professionals providing patient care.
• Know your physician has malpractice insurance, as required by the state.

A patient, patient representative or surrogate is responsible for

• Providing a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, unless specifically exempted from this responsibility by his/her provider.
• Providing to the best of his or her knowledge, accurate and complete information about his/her health, present complaints, past illnesses, hospitalizations, any medications, including over-the-counter products and dietary supplements, any allergies or sensitivities, and other matters relating to his or her health.
• Accept personal financial responsibility for any charges not covered by his/her insurance.
• Following the treatment plan recommended by his health care provider.
• Be respectful of all the health providers and staff, as well as other patients.
• Providing a copy of information that you desire us to know about a durable power of attorney, health care surrogate, or other advance directive.
• His/her actions if he/she refuses treatment or does not follow the health care provider’s instructions.
• Reporting unexpected changes in his or her condition to the health care provider.
• Reporting to his health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
• Keeping appointments.

COMPLAINTS
Please contact us if you have a question or concern about your rights or responsibilities. You can ask any of our staff to help you contact the Administrative Director at the surgery center. Or, you can call 985-449-1244.

We want to provide you with excellent service, including answering your questions and responding to your concerns.

You may also choose to contact the licensing agency of the state of Louisiana.

If you are covered by Medicare, you may choose to contact the Medicare Ombudsman at 1-800-MEDICARE (1-800-633-4227) or online at http://www.medicare.gov/claims-and-appeals/medicare-rights/get- help/ombudsman.html

The role of the Medicare Beneficiary Ombudsman is to ensure that Medicare beneficiaries receive the information and help you need to understand your Medicare options and to apply your Medicare rights and protections.

Pediatric Patient’s Rights and Responsibilities

IN ACCORDANCE WITH HEALTH AND SAFETY CODES, THE CENTER AND MEDICAL STAFF HAVE ADOPTED THE FOLLOWING:

Patient and Patient/Guardian have the right

1. To care and services without regard to sex or culture, economic, educational, or religious background or the source of payment for your child’s care.
2. For considerate and respectful care.                                                     
3. To know the name of the physician who has primary responsibility for coordinating your child’s care and the names and professional relationships of other physicians who will see your child.
4. For the parent/guardian to receive information from the child’s physician about the child’s  illness, his or her course of treatment and his or her prospects for recovery in easy to understand terminology.
5. For the parent/guardian to receive as much information about any proposed treatment or procedure as he/she may need in order to give informed consent or to refuse this course of treatment.  Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved and knowledge of the name of the person who will carry out the procedure or treatment.
6. For the patient/guardian to participate actively in decisions regarding the child’s medical care. To the extent permitted by law, including the right of the parent/guardian to refuse treatment.  The child will be included in all decisions as much as possible dependent on their age and developmental state.
7. Full consideration of privacy concerning the child’s medical care program.  Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly. The parent/guardian has the right to know the reason for the presence of any individual.
8. To confidential treatment of all communications and records pertaining to the child and their care stay in the Center.  The written permission of the parent/guardian shall be obtained before the child’s medical records can be made available to anyone not directly concerned with their care.
9. To reasonable responses to reasonable requests that the parent/guardian or child may make for services including: (a) explaining to the child that is it all right to be afraid and it is okay to cry; (b) keeping the child with the parents as much as possible within the written policy and guidelines of the Center; and ( c) allow the child to keep a favorite toy, blanket or the like with them at all times as appropriate.
10. For the parent/guardian to leave the Center with the child prior to the procedure and/or against the advice of the child’s physicians.  The Center will follow all State and Federal laws with regards to reporting suspected neglect or abuse.
11. To reasonable continuity of care and to know in advance the time and location of appointment as well as the physician providing the care.
12. To be advised if the Center/personal physician proposes to engage in or perform human experimentation affecting the child’s care or treatment.  The parent/guardian has the right to refuse to participate in any such research projects.       
13. To be informed by your child’s physician or a delegate of the physician of their continuing health care requirements following discharge from the Center.
14. To file a complaint with the Department of Health during normal work hours if you have concerns about the care being provided in this licensed ambulatory surgery center. You may also wish to discuss your concerns with the Administrative Director for this facility.

FAMILY RESPONSIBILITY

Parents/family shall have the responsibility for:

1. Continuing their parenting role to the extent of their ability.
2. Being available to participate in decision-making and providing staff with knowledge of  parents/guardian whereabouts.
3. Pre-operatively receive information from the physician an explanation of the procedure, associated alternative treatment, the risks, and projected outcome of surgical procedure.
4.  Full consideration of privacy concerning the child’s medical care.  Case discussion, consultation, examination, and treatment are confidential and should be conducted discreetly.  Parent/guardian has the right to know the reason for the presence of any individual.

• Be advised if your child’s physician proposes to engage in or perform human experimentation affecting your child’s treatment.

Note: A family consists of those individuals responsible for the physical and emotional care of the child on a continuous basis regardless of whether they are related.

COMPLAINTS

Please contact us if you have a question or concern about your rights or responsibilities. You can ask any of our staff to help you contact the Administrative Director at the surgery center.  Or, you can call 985-449-1244.

We want to provide you with excellent service, including answering your questions and responding to your concerns.

You may also choose to contact the licensing agency of the state of Louisiana, Agency for Health Care Administration.

If you are covered by Medicare, you may choose to contact the Medicare Ombudsman at 1-800-MEDICARE (1-800-633-4227) or online at www.Medicare.gov/ombudsman/resources.asp

Advance Medical Directive

An advance medical directive is a form that lets you plan ahead for the care you’d want if you could no longer express your wishes. This statement outlines the medical treatment you’d want or names the person you’d wish to make health care decisions for you.

Advance Directives protect your rights for medical care. All Louisiana adult members have a right to make Advance Directives for their healthcare decisions. This includes planning treatment before you need it.

How to Make an Advanced Directive

To make an Advance Directive, complete the “Louisiana Advance Health Care Directive Form.” This form can be found on the DHH website at www.dhh.louisiana.gov. You can also call Member Services at 1-866-595-8133 for help in finding the form. Once complete, ask your doctor (Primary Care Provider) and/or provider to put the form in your file.

Together with your doctor (Primary Care Provider) or other provider, you can make decisions to set your mind at ease. It can help your health care providers understand your wishes about your health. An Advance Directive will not take away your right to make your own decisions and work only when you are unable to speak for yourself.

Examples of Advance Directives

A Living Will

• This form lets you list the care you want at the end of your life.
• A living will applies only if you won’t live without medical treatment. It would apply if you had advanced cancer or a massive stroke.
• It takes effect only when you can no longer express your wishes yourself.

A Durable Power of Attorney for Health Care

• This form lets you name someone else to be your agent.
• This person can decide on treatment for you only when you can’t speak for yourself.
• You do not need to be at the end of your life. He or she could speak for you if you were in a coma but were likely to recover.

A “Do Not Resuscitate” (DNR) Order

Louisiana Healthcare Connections will tell you about any changes to state law affecting Advance Directives. We will send you this information as soon as possible but no later than 90 days after the date of the change. Ask your doctor or call Louisiana Healthcare Connections to find out more about Advance Directives.

To Report a Complaint: You should not be discriminated against for not having an Advance Directive. Please contact the DHH Office of Health Standards Unit at 1-225-342-0138 to file a complaint if your Advance Directive was not followed.

Privacy Notices

The HIPAA Notice of Privacy Practices for Protected Health Information (PHI). This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review the Notice of Privacy Practices carefully.