FAQs – Making your first appointment:

How do I make my first appointment with a physician at JRI?
Please call the main telephone number to Joint Replacement Institute at (213) 484-7600.  If you do not know which physician to make your appointment with, the receptionist will help you choose the appropriate physician for you.  Please have your insurance card available when you make this call.  We will need the insurance company name, the ID number on your card, the group number and the insurance phone number.  You can also e-mail a request for an appointment to JRIinfo@verity.org.  Please provide the above information with your request.

What other information will I need to provide?
You will be sent a “new patient” packet to be completed and hand carried with you to your first appointment.  The packet includes forms to be filled out regarding your current medical history, personal/demographic information, financial responsibility document and other legal documents.  Please be sure to include all of the current medications you are taking on the “current medications” sheet.  

How long before my appointment time should I arrive for my first visit?
Please arrive 15 minutes early to allow for the registration process. Having your forms completed prior to your visit will expedite this process.  If you did not receive and/or complete your forms, plan on arriving 30 minutes prior to your appointment.

What else should I bring for the first appointment?
Please bring your drivers license or state ID, insurance card (primary and/or secondary insurance cards), and current x-rays should you have these in your possession.


FAQs – Telephone Consultation:

How do I arrange for a telephone consultation?
Please call the main telephone number to Joint Replacement Institute at (213) 484-7600, or e-mail your request to JRIinfo@verity.org.  You will be sent a consultation packet to be filled out and sent back to JRI.

Once I send in my packet, how soon will it take to schedule my telephone consult?
This could take up to 2 weeks after receipt of your packet.  It will depend on the surgeon’s schedule and your availability.

Will my insurance company be billed for my telephone consultation?
This is not a billable service to insurance carriers.  Payment is required in advance and seeking reimbursement is left up to the patient.

How current should the x-rays that I send be?
No older than 6 months would be preferable.

My local orthopedist believes I am a candidate for a hip surface replacement. Why do I need to pay for a telephone consultation?
The JRI surgeon will take the time to review all of your records and interview you to evaluate if hip resurfacing is the appropriate treatment for you.

FAQs – Cash Patients with No Insurance Coverage:

Will the JRI physicians and St. Vincent Medical Center take cash for a clinic visit with the surgeon?
Yes.  Please call the office for a break down of what the charges will be for an initial consult and/or any follow up visits.

I wish to proceed with surgery.  Do I need to pay upfront or can I make payments?
Regrettably, payment is expected upfront.  You will receive a copy of the executed cash agreement which includes a break down of charges and the amount and form of payment each provider accepts.


FAQs – Surgery

What is the process for insurance approval once it is determined that I need surgery?
Depends on insurance: HMO – this can vary from 7 to 30 days; PPO – precertification process could be anywhere from 3-7 business days depending on your type of surgery.

If this is a hip resurfacing, this process may take longer. If the request for hip resurfacing surgery is denied it is your responsibility to initiate an appeal with your insurance carrier.

How soon can my surgery be scheduled once my surgery is approved by my insurance?
Once your surgery is approved, scheduling will be coordinated to fit both your schedule and the surgeon’s availability.

If I proceed with surgery, what amount will my insurance company pay? How much will I be paying out of pocket?
Please contact your insurance company and speak with a customer service representative who can give you detailed information about your coverage.

Will I need to see the surgeon for a pre-op appointment?
Yes.  These appointments will be coordinated by the assigned surgery coordinator.

When can I have dental work done?
NO dental work 14 days prior to surgery and 90 days after surgery.  You will need to have antibiotics given by your dentist with any dental work, even a routine cleaning.  Your surgeon will tell you how long after your surgery (how many years) you will need to take antibiotics at the time of dental work.  If your dentist is not able to prescribe the antibiotic, please call the office for instructions.

For emergency dental work (broken tooth, etc.) – please call for instructions: an antibiotic will be prescribed.

What medications should I stop before my surgery?
This will be outlined in your surgery packet.  You will need to discontinue all anti-inflammatory medications. These include: ibuprofen, motrin, aspirin, and all aspirin containing products such as Alka Seltzer, Bufferin, Anacin, Pepto-Bismol; all anti-inflammatories such as Indocin, Naprosyn (Aleve), and Tolectin, Herbal products such as St. John’s Wort, Arnica or Ginkgo Biloba.

Note: Coumadin & other blood thinners must be discussed with your primary care physician (PCP) before surgery.

What can I take for pain prior to my surgery?
Tylenol with Codeine, extra strength Tylenol, Tylenol PM, or what your primary care physician or surgeon prescribes.

How many days is the hospital stay?
Two to three days. It also depends on how many days your insurance authorized, and how well you progress after your surgery.


FAQs After Your Surgery:

When can I shower after surgery?
You can shower any time but the JRI physicians recommend that you do not get the incision wet until post-op day 5.  Keep the incision covered with a water-proof dressing while in the shower until post-op day 5.  After that, it is OK to get the incision wet in the shower but do not submerge the incision in a bath tub, pool, hot tub, etc. until 3 weeks after surgery.

If there is drainage from the incision site after your discharge home, you should not shower and should call the clinic to notify the staff.  Our staff will notify the physician assistant or surgeon for further instruction.

When does the dressing need to be changed?
The dressing can be changed any time it looks soiled or becomes wet after a shower.

Should the steri-strips be removed?
No, they will peel away and fall off naturally on their own.  Trimming the ends that may curl up with a small pair of scissors will help keep them from snagging on clothing.  Do not pull the strips over the incision.  Wait for them to fall off.

What should I do for swelling in my legs after surgery?
Take short walks several times a day.  Elevate your legs when resting.  Avoid prolonged (>30 minutes) periods of sitting.  Ice can be applied over the surgical area for 20 minutes, once each hour.  Please do not apply ice directly to skin.

How long will I be wearing white compression stockings?
Dr. Schmalzried – usually not required.

Dr. Mynatt – usually not required.

How long will I need to use crutches/walker?
It varies with each patient. Most patients will use crutches for 2-3 weeks then transition to either 1 crutch or a cane for the next week or two. The decision to wean from the crutches is based on your level of comfort.  Never walk without support if you are limping!!

After surgery how long do I need to wait to come back and see the surgeon?
Dr. Mynatt – 2 weeks (will be seen by the PA only); at 6 weeks post-op will be seen by the MD and have x-rays taken).

Dr. Schmalzried – 6 weeks (will see MD and x-rays will be taken)

Note: Out of town post-op patients should mail their x-rays to JRI for:

Dr. Mynatt and Dr. Schmalzried at 6 weeks.

Your surgeon will call you to review your x-rays.

Who will provide my P.T. prescription and when?

For Dr. Mynatt and Dr. Schmalzried’s patients, a prescription for Physical Therapy will be enclosed in your pre-operative packet that you receive prior to surgery.  Please call the office if you did not receive one.

When do I begin my physical therapy after surgery?

Dr. Mynatt and Dr. Schmalzried – plan to begin your therapy as soon as you are discharged.

If you live close to St. Vincent Medical Center you may wish to come to the Physical Therapy Department here.  If so, call (213) 484-7937 to make an appointment.

If not, make an appointment with a facility of your choice.

When can I start driving?
After you are off narcotic pain medication. The doctor cannot legally authorize you to drive. This decision is ultimately up to each patient, and depends on which side you had the surgery. Since the gas/brake pedal is on the right side, patients with surgery on this side usually require more time. Check with your auto insurance liability policy to see if there’s a clause that discludes coverage for any period of time after major surgery.

For example: Left hip/knee patients need to be off medications. Right hip/knee patients need to have good control of the right leg and must be off medications.

Where do I get my disability forms?
From your employer or for California residents, go on-line to the Employment Development Department at www.edd.ca.gov.  Please fill out your portion of the form completely and submit to the Medical Assistant.  Be sure to sign and date your forms.

After my discharge from the hospital, when is it important for me to call the office?
If you develop a fever of 101 degrees or higher.

If you experience drainage from your surgical wound site.

If you have unusual pain in your calf or behind your knee.

If you experience swelling in your leg(s) that does not go down after elevating your leg(s) (ankles higher than heart level).

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