Introduction

Many of the preliminary tasks surrounding your joint replacement surgery will be handled days or even weeks before you are admitted to the hospital. Some of these tasks are administrative; others may involve health services providers affiliated with your physician.

As a joint replacement surgery patient, you have a great deal to do before surgery. Besides your personal physical and emotional preparations, you'll need to set aside time to handle some pre-surgical tasks.

Make the pre-surgery process a little less stressful by gathering all of your personal and medical information and keeping the information together in one place. Make copies of all of your documents and make sure your spouse or caregiver has a complete set of copies. Be sure to copy your insurance and prescription cards, medical alert information (allergies, conditions) and any documentation you receive from your doctor, hospital and insurance company related to your joint replacement surgery.

Below are several forms you can complete to help you organize some of your personal and medical information.

• Medical history worksheet
• Medicine information worksheet
• Emergency info

Many physicians' offices contact insurance companies for their patients to obtain benefit information and authorization for surgical procedures. Some insurance companies require the patient to make direct contact with them before insurance coverage can be authorized. Consult your health insurance carrier for their requirements.

If necessary, your physician and the hospital will help you make payment arrangements for your surgery or for the portion of the surgery not covered by your health insurance. Many healthcare providers have individuals on staff dedicated to helping patients with both insurance and financial concerns. Take advantage of these resources early in the process.

Prior to your joint replacement surgery, your doctor may order additional diagnostic tests and lab work. If such work is ordered, be sure to verify the necessary paperwork has been sent, to both the lab testing facility and to your insurance company. Some health service providers require written authorization from the doctor before any test will be performed. Additionally, your insurance carrier may require additional tests be confirmed by your surgeon or be conducted at facilities that are part of your particular provider network. Be sure if you are to have tests or lab work performed that you schedule the work well in advance of your surgery to ensure that your doctor will have the results in plenty of time. Follow up with the lab and your surgeon's office to verify your test results have been passed along and reviewed by your doctor.

Also, your surgeon may suggest you donate your own blood for use during surgery. This is called autologous blood donation, and is the preferred method of blood donation for surgery patients. Two to four pints of blood are usually taken in two separate donation sessions; the first donation must be given within 42 days of surgery, and the last no less than seven days before surgery. Your surgeon's office can help you make arrangements with the hospital or local blood bank center for the blood to be drawn. Also, at the time of donation you must be healthy, without a cold, flu or infection, as you could get the same illness back if your blood is used during surgery.

When you scheduled your joint replacement surgery with the scheduling nurse in your surgeon's office, he or she probably gave you specific instructions for pre-registering at the hospital. If not, contact your surgeon's office and ask for information. Most insurance plans require a "pre-certification" or "pre-authorization" for services performed at the hospital. Typically you will be asked to present your medical history, your insurance information and authorization requirements, your emergency and personal information (next of kin, caregiver, religous affiliation), whether you have completed pre-surgery tests and lab work, and whether you have transportation to and from the hospital. If you need to make payment arrangements, you may be asked to contact the billing department directly.

In most states, someone on the hospital staff will discuss advance medical directives, which are decisions you make about life-sustaining treatments. These directives include a Living Will (your wishes regarding withdrawal of life-support if you are not able to communicate them), a DNR order (do not resuscitate), and Durable Power of Attorney (for health care, which allows you to appoint someone to make your health care decisions if you are not able). These and other patients' rights are usually covered during the pre-registration process. If you are not approached first, ask the individual taking your pre-registration information.

Additionally, many hospitals offer pre-surgery tours. Consider taking the tour with your spouse or caregiver if you are unfamiliar with the facility where you will be admitted. Some hospitals offer pre-operative classes for surgery patients and some offer classes specific to joint replacement. Check with your surgeon or hospital provider for more information on the services they provide.

Also, if you do not already have a parking permit for a disabled person, apply for a temporary permit several weeks prior to surgery. Contact the Department of Motor Vehicles in your state or check with the doctor's office. Some doctors have the application form on hand.

Throughout the pre-surgery and surgery process, you'll be asked to sign your name to many documents. Thoroughly read all medical forms and make sure you understand everything before you sign. Common forms you'll be asked to sign include an authorization for release of information to your insurance company and consent for treatment, by both the hospital and your surgeon. You may also be asked to sign forms indicating that you have been given, and understand, pre-surgery instructions, you understand your rights as a patient, and you will be responsible for charges not covered under your insurance plan. Regardless of the form, make sure you understand what you are signing and why. If you don't understand, ask questions until you do.