Anesthesia in the Greenville Hospital System
Greenville Anesthesiology, P.A. is a professional corporation comprised of physicians who specialize in anesthesiology. Each of our physicians has completed an extensive educational program in anesthesiology and is either board-certified by the American Board of Anesthesiology, or is in the board-certification process. The physicians of Greenville Anesthesiology, P.A. provide anesthesiology services at Greenville Memorial Hospital, Patewood Memorial Hospitals (inpatient and outpatient), Cross Creek Surgery Center, Greer Memorial Hospital, Hillcrest Memorial Hospital, and Shriners Hospital for Children.
Anesthesia Care Team
The physicians of Greenville Anesthesiology, P.A. provide round-the-clock state-of-the-art care in surgical and obstetrical anesthesia and pain management. We practice the ďTeam CareĒ mode of anesthesia, consisting of an anesthesiologist and a nurse anesthetist (a registered nurse with intensive care experience who has special training in the administration of anesthesia). These professionals are assisted by anesthesia technicians, who provide essential maintenance and support functions. The members of the anesthesia care team work together to create and implement an anesthetic plan tailored to the specific needs and desires of each patient.
An anesthesiologist, assisted by a registered nurse, interviews all patients before surgery to assess the patientís condition and to plan the most appropriate anesthetic for each patient. The anesthesiologist who does the preoperative evaluation may or may not be the anesthesiologist responsible for that patient at the time of surgery. Many factors enter into the anesthesia plan, including the age and general health of the patient, the type of surgery anticipated the surgeonís needs, and the patientís preferences. In the operating room, an anesthesiologist and a nurse anesthetist together begin the anesthetic. Once the patient is safely under anesthesia and the surgery is underway, the anesthesiologist may leave the operating room to attend to other patients. The patient is never left unattended: either the nurse anesthetist or the anesthesiologist (or both) is always with the patient, closely monitoring to maximize patient safety and comfort.
The Anesthesia Care Team approach provides the flexibility to respond to virtually any problem or emergency that may arise in the operating room. There are always at least two sets of hands available to manage the patient and to provide the best medical care possible. In addition, an anesthesiologist is always available to diagnose postanesthesia problems in the Recovery Room and to prescribe appropriate therapy. This flexibility is not available to an anesthesiologist practicing alone.
As with all medical procedures, anesthesia has inherent risks. Fortunately, recent advances and newer medications have made the risks of anesthesia quite small. Serious complications are now rare. The anesthesia care team will constantly monitor the patientís condition throughout the surgical procedure, and will be prepared to respond to any anesthetic problems should they arise. The patient can help to minimize the risks associated with anesthesia by carefully following the instructions given during the pre-operative evaluation.
Recovery Room (Post Anesthesia Care Unit)
At the completion of surgery, the patient is ordinarily taken to the recovery room to allow the residual anesthetic medications to wear off. Specially trained nurses monitor the patientís progress, administer medications for pain or nausea, and make the patient as comfortable as possible. When the patient has sufficiently Ďrecoveredí, he or she is then discharged to a hospital bed or sent home. As always, an anesthesiologist is available to advise and direct these nurses in the provision of post-operative care.
Types of Anesthesia
General anesthesia, or being put to sleep, involves the administration of medications (usually by an intravenous route) that cause the patient to lose consciousness and become unable to feel pain. This state is maintained by the continual administration of medications, often including anesthetic gases, throughout the surgical procedure.
Regional anesthesia involves using local anesthetics to block the nerves supplying a particular area of the body. It is referred to this way because a Ďregioní of the body is anesthetized, in contrast to general anesthesia in which the entire body is anesthetized. Regional techniques include spinal and epidural anesthetics, which anesthetize the lower part of the body by injecting medications near or around the spinal column. Axillary, interscalene, and Bier blocks are techniques to anesthetize the shoulder or upper extremity and are very useful in surgery of the shoulder, arm or hand. There are many other less-often used nerve blocks which may be employed. Patients receiving a regional anesthetic generally receive intravenous sedation during the surgical procedure, which allows surgery to be performed with less anxiety and awareness on the patientís part. Monitored Anesthesia Care involves the use of intravenous sedation along with careful observation and monitoring of the patient while surgery is performed under local anesthesia. The patient can be sedated as heavily as he or she wishes during surgery.
This technique allows the surgeon to concentrate on the operation while members of the anesthesia care team concentrate on the patientís comfort and safety.
While the patient is in the recovery room, post-operative pain will be treated by the anesthesiologist. Once the patient leaves the recovery room, the surgeon takes over the management of the patientís pain. Depending on the type of surgery, the patientís medical condition, and the patientís and surgeonís desires, other types of post-operative pain management techniques are available, including epidural analgesia. Epidural analgesia involves pain relief through the administration of local anesthetic and other pain medications into the epidural space near the spinal cord. Under local anesthesia, a small plastic catheter is inserted into the epidural space from the back. This catheter is taped in position, and after surgery a computerized pump infuses pain medications through this catheter. This technique enables substantial pain relief without many of the usual effects seen with pain medications, since only a small amount of the pain medication administered reaches the blood stream. Epidural analgesia can be applied after chest, abdominal, pelvic or lower body surgery. An anesthesiologist will visit each patient receiving epidural infusions daily, or more frequently if necessary, to review the patientís progress and to make appropriate adjustments to therapy.
The physicians of Greenville Anesthesiology, P.A. providing your anesthesia care are private practitioners of medicine. You will receive a separate bill for their services. The anesthesiologistís professional fee includes the pre-operative evaluation, the administration of the anesthetic, and the supervision of the patientís recovery room stay. Many factors influence our professional charges, including the patientís physical condition, the surgical procedure performed, and the duration of the surgery (and anesthesia). Anesthesia charges are not dependent on the type of anesthesia administered. Any post-operative pain management provided by Greenville Anesthesiology, P.A. after the patient leaves the recovery room will also be charged to the patient as a separate item.
The ďanesthesiaĒ charges on the patientís hospital statement are for hospital-employed personnel, including the nurse anesthetist and the anesthesia technicians, as well as anesthesia supplies, equipment, and medications. Health insurance plans will generally cover a portion of our professional fees. However, you should be aware that insurance coverage does not guarantee full reimbursement for physician charges. The ultimate responsibility for payment of professional charges lies with the patient receiving the service. The billing office of Greenville Anesthesiology, P.A. will be happy to assist patients in filing insurance claim forms, but we cannot be responsible for collection of payments from the insurance company or for negotiation of insurance settlements.
The professional charges of Greenville Anesthesiology, P.A. are consistent with those of comparable physicians in South Carolina and in the Greenville area. On occasion, certain insurance companies take the position, often without any substantiation, that our fees exceed the ďusual, customary and reasonableĒ charge for a given service. This is designed to delay or reduce payments that the insurance company must make. This tactic by the insurance company results in an unexpected and unfair burden to the policy holder, because the policy holder remains responsible for the unpaid amount.
Greenville Anesthesiology, P.A. will be happy to answer any questions you have about our professional fees; please contact our billing office at (800) 242-1131.
The physicians of Greenville Anesthesiology, P.A. accept assignment on all Medicare patients. By accepting assignment, we are limited by law as to the amount we can charge the patient for our services. Medicare will pay 80% of the allowed charges; the remaining 20% as well as the deductible amount are the responsibility of the patient. If you have a Medicare supplemental policy, our billing office will be happy to assist you in filing the necessary forms.
South Carolina Medicaid
The physicians of Greenville Anesthesiology, P.A. accept assignment on Medicaid claims and by doing so our fees are limited.
Managed Care Plans
The physicians of Greenville Anesthesiology, P.A. participate with many other health care plans. Our participation may or may not be the same as your surgeon or the hospital. Please contact our billing office at (800) 242-1131 to determine whether we participate with your insurance carrier.