Advance Directives

An advance directive speaks for you if you are unable to speak and helps to assure that your religious and personal beliefs will be respected. It is a useful document for an adult of any age to plan for future health care needs.

Although Surgery Center of Northeast Texas does not honor advance directives, upon request we will provide you with contact information and forms to assist in writing an advance directive. Information can also be obtained at Texas State Department of State Health Services, 512-458-1111.


Grievances and Grievance Procedure

We strive to maintain a professional and compliant atmosphere. Issues can arise. The Grievance procedure is a means for patients and related parties to inquire into issues raised and identify whether action needs to be taken to resolve identified issues and prevent recurrence. The Facility Administrator will record the grievance complaint and conduct a prompt investigation for quick resolution.

Any patient and/or support person, visitor, employee, physician, or vendor may lodge a grievance using the Center’s procedure to formally voice complaints, resolve disputes, or to bring attention to possible violations of patient rights. No person shall be punished or retaliated against for using the Grievance Procedure.

Any grievances, comments and complaints are addressed to the Center Administrator. Complete details and a copy of the Center’s Grievance Policy as well as a Grievance form may be obtained by contacting the Center Administrator.

Additional information can be obtained from/or to file a complaint with the Texas Department of State Health Services contact Facility Licensing Group at 1100 West 49th St., Austin, TX 78756, 888-973-0022, www.dshs.state.tx.us, www.medicare.gov, 1-800-MEDICARE (1-800-633-4227)


Financial Policy

Surgery Center of Northeast Texas fees cover the use of the facility only, and do not include laboratory, pathology, surgeon or anesthesiologist fee. You will be billed separately for these services.

As a courtesy, we will bill your primary and secondary insurance carriers or governmental agency directly for the Surgery Center of Northeast Texas charges. Be sure to bring your most current insurance, Medicare, or public assistance card with you on the day of your surgery. If you have more than one insurance carrier, we will also need accurate secondary billing information.

Please be aware of any admission policies your insurance plan may have. You or your physicians may have to adhere to certain requirements in order to insure maximum reimbursement. Failure to obtain pre-authorization, physician referral, or a second opinion may greatly reduce or eliminate your benefits.

Be prepared to bring any co-pay or co-insurance amounts on the day of your surgery. Patients who do not have insurance coverage may also be required to pay a portion of their charges in advance. Also, please make sure you bring a photo ID. We will need to see this as part of your insurance validation. We realize, however, that at times you may require special financial arrangements. In these instances, please phone our office prior to your surgery to discuss alternative methods of payment. Surgery Center of Northeast Texas accepts cash, cashier’s checks, credit cards, and personal checks with a valid I.D. We also accept Care Credit.

Please feel free to contact our business office at any time if you have questions or concerns regarding the facility charges, the financial policy, or billing procedures. Call 903-792-2108 for more information.


Notice Of Nondiscrimination

Discrimination is Against the Law

SCNETX complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

SCNETX does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

SCNETX:

• Provides free aids and services to people with disabilities to communicate effectively with us, such as:
 •Qualified sign language interpreters
 •Written information in other formats (large print, audio, accessible electronic formats)

• Provides free language services to people whose primary language is not English, such as:
 •Qualified interpreters
 •Information written in other languages

If you need these services, contact [Robin Walter –administrator @903-792-2108]

If you believe that [SCNETX] has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
Robin Walter-Administrator , 1902 Moores Ln Suite B Texarkana Texas 75503, 903-792-2108 phone,
903-792-0606 Fax, robin.walter@amsurg.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Robin Walter-Administrator is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at:

https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf
or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue SW., Room 509F,
HHH Building, Washington, DC 20201
1-800-868-1019, 800-537-7697 (TDD).

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.


Ownership Disclosure

We are the Physician Owners of the Center, and we would like to take this opportunity to Thank You. We recognize that you have the right to choose the provider of your healthcare services. We are pleased that you have chosen Surgery Center of Northeast Texas.

Carey Alkire, MD
James Booker, MD
Bradley Byrne, MD
Jeffrey DeHaan, MD
John Dietze, MD
Dennis O’Banion, MD
Christopher Payne, MD
Jason Pickelman, MD
Glen Rountree, MD
Gregory Smolarz, MD
Harold Weems, MD
Joshua Wiggins, MD
Mitchell Glass, DDS
AMSURG