If you are scheduled for a procedure with Advanced GI Associates, Please make sure

1. Your information is complete before the procedures' schedule date.
2. All patients would be in need of initial office visit before any procedure to be scheduled.
3. All patients would be in need of an understanding the procedure/s, and being consented to perform the procedure.
4. A video is available for review upon arriving the office. Please have the front desk to play the video for you.
5. All patients need to confirm their appointment for their procedure the day prior to their procedure including date and time.
6. All fees for the visit and procedure/s encounter are due at the time of procedure.

For all procedures, patients need to follow the following instructions:

• All patients need to have a medical review of medications and history by physician prior to procedure.
• All patients need to not have food (solid or semi liquid), gum or medications the night (12am) prior to procedure.
• All diabetic patients need to discuss their medications with physician in their initial evaluation.
• All patients need to be off Aspirin, and non steroidal anti-inflammatory (NSAID) agents such as:  Aleve, Motrin, Naproxen, Lodine, Celebrex, Ibuprofen, 3-5 days prior to procedure.
• All patients need to be off blood thinners 3-5 days prior to procedure and 3-5 days after. You may need to consult your primary care and / or cardiologist before the procedure.
• Some patients may need medical clearance from other specialists or primary care prior to procedure.
• You may need antibiotics or other medications during or after the procedure.

Sedation and Anesthesia

Advanced GI Associates offers three different sedation/anesthesia options for GI procedures/interventions:

1. Conscious Sedation provided with medications - Deeply sedated but not unconsious.
   
2.  MAC (Monitored Anesthesia Care, local anesthesia with IV sedation).  
   
3. General Anesthesia (mainly for ERCP, Endoscopic Retrograde Cholangio Pancreatography)
   

The type of anesthesia you will receive for your procedure will be dependent on several factors:  the physician’s recommendation based on your medical history and/or medical conditions, the CRNA’s recommendation, and the patient's preference.  

Be advised that if MAC (Monitored Anesthesia Care) is recommended, it will be billed as a separate procedure (unlike, conscious sedation, which is bundled into the facility fee).  Furthermore ,  MAC anesthesia is coded for anesthesia necessity (not procedure necessity); therefore, payment may be different than your procedure/facility fees. If you decide you want to have MAC anesthesia, and there is no medical necessity, you will be responsible for the bill. 

For the following procedures:

• 1) Upper Endoscopy with or without biospy, with or without gastrostomy tube. (EGD +/- PEG)
• 2) Endoscopic Ultrasound with or without fine needle aspiration biopsy ( EUS +/- FNA)
• 3) Endoscopic Retrograde Cholangio-Pancreatography with or without sphincterotomy and stent placement (ERCP +/- Sphincterotomy/Stent placement)

 The instruction are:

NO Food, Drink, Gum, or Medications after midnight, the night prior to procedure.

(NPO after midnight)

• 4) For  Colonoscopy

The instructions are:

- No solid food the day prior to procedure

- Only Clear liquid diet the day before the procedure

- No dairy products (you may have coffee or tea withour milk or creamer)

- No red colored food

- Please discuss with your physician If you are diabetic. You may need to take half dose of your insulin or other diabetes medications the day prior to procedure and no meds on the day of procedure. Please take your preparation medications the day prior to procedure as instructed.

-NO Food, Drink, Gum, or  Medications after midnight, the night prior to procedure date.

(NPO after midnight)

Colonoscopy  procedure video:

Importance of Screening Colonoscopy:

• 5) If you are going to have a combined procedure of colonoscopy with any other of the above procedure/s, the instruction for colonoscopy would override the other procedure/s. Meaning, you follow the colonsocopy procedure instructions.

On the day of your procedure

You also need to know the following on the day of your procedure:

• We strongly encourage you to be on time at the time of your procedure and show up at least one hour earlier than your appointment time.
• Please make sure you have your appointment card, insurance card/s, list of your medications, and pertinent information regarding your procedure/s  available at the time of registration in admitting facility.

• You need to ask a loved one/s to be present at the time of your procedure recovery time to take you home after recovery.

• You will not be allowed to leave the facility after recovery of your procedure alone or with an unknown third party such as a cab driver,
  

• We strongly encourage you to speak with your health care provider before leaving the facility.

• You may resume your work the next day.

  
  

  If you have questions regarding your procedure after hours you may call:

  301 552 0870