From: Jerry Orloff
Sent: Thursday, October 25, 2012 12:37 PM
Subject: RD Consult - Info to Acquire to help us make the decision, whether or not to add the patient on...
I put together a list to help you obtain the necessary data set to help us make the decision, whether or not to accept a patient who may have a Retinal Detachment:
1. Name of Referring Physician
2. Type of Insurance - primary and secondary; note: if self pay - patient must be informed that the cost of an RD repair - which must be paid in full on the date of the evaluation and surgery is as follows: Consult: 225 B-Scan (if needed): 150 Surgeon's Fee: 3750 ASC Fee: 2500 Anesthesia: 500 (The usual total cash price is $10,500 - this cash price represents a substantial discount.).
3. Patient Name, Sex, DOB, Address
4. Explanation of Recent Findings, i.e. RD OS, Macula On; symptomatic of vision loss x 2 days
5. History of previous eye injuries, eye surgeries, eye diseases (definitely find out if the patient is phakic or pseudophakic)
6. History of medical illnesses/conditions/hospitalizations
7. Current medications, including all blood thinning agents
8. Drug allergies/NKDA - definitely note any reactions to previous anesthesia or claustrophobia
9. Any other factors that may impact our ability to provide care to the patient - do they have a reliable driver, both to surgery and one day PO as well as someone who can act as a reliable caretaker at home during the PO period, or any factor that would cause the patient to be lost to follow up (i.e. patient moving to California on Saturday).
(NOTE: Bring this information to me I will review the matter with Dr. Vaishnav first - to determine if he is able to accept a particular patient; We will then ascertain ASC/Anesthesia availability and provide this information to Dr. Vaishnav so that he can make the final decision. Do not under any circumstances accept an outside referral of a potential RD on behalf of Dr. Vaishnav without following the detail of this guideline.