Outpatient Services

Finding the Right Provider

It is important to check with your HMO, PPO, or health insurance provider to determine whether outpatient services are covered. Your particular health plan coverage may limit your choice of services.

Selecting a quality outpatient center prior to having a medical procedure is the best way to make sure that you'll receive excellent care. Friends and family who have used outpatient services may tell you about their personal experiences. Often, your doctor will know about the quality of outpatient services in your area. You may want to begin your search by discussing your options with your doctor. Next, verify which outpatient services are covered by your insurance company. The following questions may help you find the outpatient service center that best fits your needs:

• Does the facility accept your health insurance, HMO, or PPO coverage? Does your insurance cover all of the costs you expect to be charged?
• Is the outpatient service center conveniently located or within a reasonable distance of your home or work?
• Is more than one facility in your area qualified to provide the service you need?
• Will the facility communicate well with your doctor and provide needed information in a timely manner? Can your doctor verify the accuracy of any tests taken?
• Is the outpatient service center accredited by a national medical board or other recognized agency? You can obtain this information by calling your state medical board or the Joint Commission on Accreditation of Healthcare Organizations. For more information, see the Quality of Outpatient Services section of this topic.
• Is the facility clean, organized, comfortable, and private? You'll need to visit the facility for this information. You may want to ask the facility or others who have used the facility if the recovery room is well-staffed. Is there a waiting room for your family?
• Is information readily available to you? Will you receive instructions before, during, and after a procedure or test?
• Are brochures or literature available that explain the outpatient center's services and fees? Does the facility provide information on financial assistance?
• Do you have other health conditions that should be considered? Can the facility accommodate treating your other conditions if needed? Does your doctor think there is a risk that you may need specialized attention or emergency services during the procedure?
• Can you obtain all the care you need at the facility? Will the center provide all the medicines or other treatment needed? Will you have to go somewhere else for follow-up care?
• What kind of experience does the staff have? How long has the outpatient service center been operating? What are the specialties of the doctors providing the care? Are they board-certified in their specialty areas?

You may have additional questions based on your own health issues and the type of procedure or test you need. Asking questions, listening to the recommendation of your doctor and those you trust, and visiting the facility can provide the information you need to make the best decision for your health care.

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Author:	Caroline Rea, RN, BS, MS	Last Updated: April 17, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Brent Shoji, MD - General Surgery
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