Knoxville Orthopaedic Surgery Center (KOSC) requires that the following notice be reviewed by each patient prior to a scheduled procedure in order to comply with federal and state laws and rules regarding advance directives. Advance directives can be statements that indicate the type of medical treatment an individual does or does not want if he or she is unable to make those determinations, or they can authorize others to make medical decisions for them if they are unable to do so.
In Tennessee, patients have several options for making advance directives:
These generally state the type of medical care an individual wants or does not want if he or she becomes unable to make his or her own healthcare decisions.
Click the link below for advance care plan forms and note that they must be signed and witnessed or notarized prior to your arrival on surgery day.
These forms allow an individual to name someone to make healthcare decisions for him or her if he or she becomes unable to make healthcare decisions.
If an adverse event occurs during your treatment at Knoxville Orthopaedic Surgery Center, the medical team will initiate resuscitative or other stabilizing measures and will then transfer you to an acute care facility for further treatment or evaluation. A copy of your advance directives will be sent with you if you are transferred and KOSC will keep a copy in your record.
During the admission process, you will be required to sign the notice of policy regarding advance directives, indicating that you understand the policy regarding resuscitative efforts.
We want to help you receive your maximum allowable benefits if you have medical insurance.
If you have medical insurance, you will be responsible for paying deductibles and co-pays at the time of service. We will process your initial insurance claim. Your insurance carrier will be billed, and if payment is not received in a reasonable amount of time, you will be asked to resolve any issues with your insurance company. If we do not receive payment from the insurance provider, we will bill the guarantor for full payment. It is your responsibility to contact the insurance carrier.
We are a provider for both Medicare and Medicaid. All Medicare members will be responsible for deductibles and the 20% Medicare allowable.
If you are paying out of pocket, you are responsible for payment in full on the date of service unless other financial arrangements have previously been made. For funds not paid, a 24% collection fee will be added for placement with a collection agency. Checks returned for insufficient funds will be charged $39. Patient will be responsible for any attorney fees associated with their account.
You will receive separate billing from your physician, anesthesiologist, pathology provider, durable medical equipment vendor and any medications prescribed for home use. These services may be subject to interest, collection fees and/or reasonable attorney fees for any unpaid balances.
As we partner with you for your surgical care, we want you to be informed, participate in decisions and communicate openly with our staff to ensure that your care is effective and reflects your values and preferences.
While you are receiving services at Knoxville Orthopaedic Surgery Center (KOSC) you have the right to:
- Considerate and respectful care, regardless of disabilities, age, race, color, religion, sex or national origin. This includes interpretive services and assistive devices when needed.
- Appropriate pain assessment and management.
- Be informed about your diagnosis, possible treatments and likely outcome and to discuss this information with your doctor. You have the right to be addressed by your preferred name, to know the names and roles of people treating you and to participate in the development of your plan of care. If you are unable to participate in decisions about your care, your designated representative or other legally designated person may act on your behalf.
- Consent to or refuse a treatment, as permitted by law, throughout your stay. If you refuse a recommended treatment, you are entitled to other appropriate care and services that KOSC provides or transfer to another healthcare provider.
- Have advance directives, such as an advance care plan or appointment of healthcare agent. These documents express your choices about your future care or name someone to decide if you cannot speak for yourself. In accordance with federal and state law, KOSC is notifying you that if an adverse event occurs during your treatment, the medical team will initiate resuscitative or other stabilizing measures and will transfer you to an acute care facility for further treatment or evaluation. It is still important that you provide KOSC with a copy of your advance directive since it will be sent with you should you require a transfer to a higher level of care.
- Privacy, safety and security. KOSC staff, your doctor and others caring for you will protect your privacy, safety and security as much as possible.
- Expect that treatment records are confidential unless you have given permission to release information or reporting is required or permitted by law. When KOSC releases records to others, such as insurers, it emphasizes that the records are confidential.
- Review your medical records and to have the information explained, except when restricted by law.
- Expect that KOSC will give you necessary health services to the best of its ability. Treatment, referral or transfer may be recommended. If transfer is recommended or requested, you will be informed of risks, benefits and alternatives. You will not be transferred until the other institution agrees to accept you. In the event of a disaster, you may be evacuated to another facility. The facility will be selected based on your condition and the services available.
As a patient you are responsible for:
- Being respectful of the needs of other patients and all KOSC staff.
- Cooperating with staff efforts to assess and manage your pain as safely as possible.
- Providing information about your health, including past illnesses, hospital stays, and use of prescription and over-the-counter medicines, including vitamins and herbal supplements as well as any allergies or unanticipated reactions to these substances.
- Asking questions when you do not understand information or instructions.
- Telling your doctor if you believe you cannot follow through with your treatment.
- Providing a written advance directive copy to KOSC, your family and your doctor if you have one. You are responsible to think about your wishes for care at the end of life and to communicate your wishes to your family as well as to caregivers.
- Accepting those intrusions on your privacy that are necessary for providing care.
- Respecting the privacy and security of others.
- Securing your own valuables.
- Being open and honest with caregivers. You have a responsibility to give permission for release of your records when this is necessary for coordinating your care or for arranging payment.
- Making reasonable requests for service.
An Ambulatory Surgical Center (ASC) such as KOSC serves many purposes. ASCs work to improve people’s health; treat people with injury and disease; educate doctors, health professionals, patients and community members; and improve understanding of health and disease in a cost effective, convenient environment. In carrying out these activities, KOSC works to respect your values and dignity.
This notice explains how medical information about you may be used and disclosed and how you can access this information. It also describes the privacy practices of Knoxville Orthopaedic Surgery Center (KOSC) and the physicians who provide services to patients at the facility. Please review it carefully.
Under federal law, your protected health information (PHI) is protected and confidential. Protected health information includes information about your symptoms, test results, diagnosis, treatment and related medical information as well as payment, billing and insurance information.
We use your health information for treatment, to obtain payment, and for health care operations including administrative purposes and evaluation of the quality of care that you receive. Under some circumstances, we may be required to use or disclose the information without your permission. Our business associates must also follow privacy rules.
Treatment: We will use and disclose your health information to provide you with medical treatment or services. For example, nurses, physicians and other members of your treatment team will record information in your record and use it to determine the most appropriate course of care and to recommend alternative treatments. We may also disclose information to other healthcare providers who are participating in your treatment, to pharmacists who are filling your prescriptions and to family members who are helping with your care.
Payment: We will use and disclose your health information for payment purposes. For example, we may need to obtain authorization from your insurance company before providing certain types of treatment. We will submit bills and maintain records of payments from your health plan.
Healthcare operations: We will use and disclose your health information to conduct our standard internal operations, including proper administration of records, evaluation of the quality of treatment and to assess the care and outcomes of your case and others like it.
We may use your information to contact you with appointment reminders. We may also contact you to provide information about treatment alternatives and other health-related benefits and services that may be of interest to you.
We may use or disclose identifiable health information about you for other reasons, even without your consent. Subject to certain requirements, we are permitted to give out health information without your permission for the following purposes:
Required by law: We may be required by law to report gunshot wounds, suspected abuse or neglect, or similar injuries and events as required by law enforcement.
Public health activities: As required by law, we may disclose vital statistics, diseases, information related to recalls of dangerous products and similar information to public health authorities.
Health oversight: We may be required to disclose information to assist in investigations and audits, eligibility for government programs and activities or for fraud investigations.
Judicial and administrative purposes: We may disclose information in response to an appropriate subpoena or court order.
Law enforcement purposes: Subject to certain restrictions, we may disclose information required by law or law enforcement officials.
Deaths: We may report information regarding deaths to coroners, medical examiners, funeral directors and organ donation agencies.
Serious threat to health or safety: We may use and disclose information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Military and special government functions: If you are a member of the armed forces, we may release information as required by military command authorities. We may also disclose information to correctional institutions or for national security purposes.
Research: We may use or disclose information for approved medical research following strict internal review to ensure protection of information.
Workers’ compensation: We may release information about you for workers’ compensation or similar programs providing benefits for work-related injuries or illness.
You have the following rights regarding your health information. Please contact the executive director listed below to obtain the appropriate form for exercising these rights.
Knoxville Orthopaedic Surgery Center
256 Fort Sanders West Blvd.
Knoxville, Tennessee 37922
Request restrictions: You may request restrictions on certain uses and disclosures of your health information. We are not required to agree to your request but if we agree to these restrictions, we must abide by those restrictions unless the information is needed to provide emergency treatment. You must submit your request in writing. The request must include what information you want to limit, whether you want to limit our use, disclosure or both, and to whom you want the limits to apply.
Confidential communications: You may ask us to communicate with you confidentially by, for example, sending notices to special addresses or not using postcards to remind you of appointments. You must submit your request for alternate communications in writing. The request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
Inspect and obtain copies: In most cases, you have the right to look at or get a copy of your health information. There may be a nominal fee for the copies.
Amend information: If you believe that information in your record is incorrect, or if important information is missing, you have the right to request that we correct the existing information or add the missing information. You must submit your request to amend in writing with a reason for the request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. We may deny the request if you ask us to amend information that: was not created by KOSC; is not part of the health information kept by or for the facility; or is accurate and complete.
Accounting of disclosures: You may request a list of instances where we have disclosed health information about you for reasons other than treatment, payment or healthcare operations. You must submit your request for an accounting of disclosures in writing. The request should indicate in what form you want the list.
Notice of a breach: You have the right to be notified upon a breach of protected health information.
Out-of-pocket payments: If you paid out of pocket in full for a specific service, you have the right to ask that information about that service not be disclosed to your health plan. You must submit your request in writing for non-disclosure.
Paper copy: You have the right to obtain a paper copy of this notice even if you receive it electronically. You may ask for a copy of the notice at any time.
We are required by law to protect and maintain the privacy of your health information, to provide this notice about our legal duties and privacy practices regarding protected health information and to abide by the terms of the notice currently in effect.
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will have copies of the current notice in the facility and there is a copy available in the patient packet.
If you are concerned that we have violated your privacy rights or if you disagree with a decision we made about your records, you may submit your concerns in writing to the contact person listed above. You may also send a written complaint to the U.S. Department of Health and Human Services. The person listed above will provide you with the appropriate address upon request. You will not be penalized in any way for filing a complaint.
Knoxville Orthopaedic Surgery Center and the physicians who practice here are independent contractors and do not hereby assume any liability for the services or conduct of others.
Effective Date: The effective date of this notice is 12/01/2009.
All patients are invited to complete a satisfaction survey. The survey provides feedback on how we may improve our processes. You will be asked on admission to give an email address or will be given a paper copy. We utilize an independent program for the survey (your email address will be confidential). You may file a formal grievance or express a concern by writing the contact person listed above.
The Accreditation Association for Ambulatory Healthcare
5250 Old Orchard Rd.
Skokie, IL 60077
The Tennessee Department of Health, Division of Health Care Facilities, Centralized Complaint Intake Unit
227 French Landing, Suite 501
Heritage Place Metrocenter
Nashville, TN 37243
877-287-0010 (Monday-Friday, 7 a.m.-7 p.m.)
The Medicare Beneficiary Ombudsman
Medicare patients: The website for patients to file a complaint on their quality of care, file a claim, check the status of a claim, file an appeal and obtain the form for authorization to disclose PHI from a Medicare provider is https://www.medicare.gov/claims-appeals.
TennCare Solutions Unit
P.O. Box 593
Nashville, TN 37202-0593
Fort Sanders West is a Smoke Free campus. KOSC is a non-smoking facility.
Knoxville Orthopaedic Surgery Center (KOSC) complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Knoxville Orthopaedic Surgery Center does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.
KOSC 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, etc.)
KOSC provides language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you need these services, please let us know.
If you believe that KOSC 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:
Director of Compliance
256 Fort Sanders West Blvd., Suite 200
Knoxville, TN 37922
You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, please call 865-231-9482 for assistance.
You also can 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/portal/lobby.jsf or:
U.S. Department of Health and Human Services
200 Independence Avenue SW
Room 509F, HHH Building
Washington, D.C. 20201
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
UOSC can provide language services and written instructions in Spanish and other languages as needed.
Pricing disclaimer: The prices below are for self-pay patients only. Payment is due at the time of procedure. These prices do not apply if we are filing insurance for your surgery. The prices below are for the facility fee only. They do not include any implants used during your procedure. You will be given an estimate of the implant cost prior to your surgery.
These prices not do not include surgeon or anesthesiologist fees, which will be billed separately.
- Hammertoe correction: $1,523 per toe
- Osteotomy with bunionectomy: $1,074 per toe
- Lapidus bunionectomy: $1,506 per toe
- Carpal tunnel release: $936 per hand
- Trigger finger release: $780 per finger
- Total knee: $8,750
- Unicompartmental knee: $8,750
- Total hip: $8,750
- Total shoulder: $8,750
Physical medicine & rehab
- Epidural steroid injection: $432 per level
- Facet injection/medial branch block: $502 per level
- Radiofrequency ablation: $936 per level
- Shoulder arthroscopy with rotator cuff repair: $3,240
- Shoulder arthroscopy with subacromial decompression: $2,237
- Single-level anterior cervical discectomy & fusion: $7,500
- Two-level anterior cervical discectomy & fusion: $8,000
- Knee arthroscopy: $1,523
- ACL repair: $3,240
Knoxville Orthopaedic Surgery Center, LLC
Patient notification disclosure of physician ownership
Physicians with a financial interest in Knoxville Orthopaedic Surgery Center, LLC include:
Paul Becker, M.D.
Russell Betcher, M.D.
Herman Botero, M.D.
Douglas Calhoun, M.D.
Michael Craig, M.D.
Jay Crawford, M.D.
Bruce Fry, D.O.
Curtis Gaylord, M.D.
G. Brian Holloway, M.D.
Robert Ivy, M.D.
Paul Johnson, M.D.
Luke Madigan, M.D.
James Maguire, M.D.
Gregory Mathien, M.D.
Matthew Nadaud, M.D.
Matthew Rappe, M.D.
Benjamin Rogozinski, M.D.
Cameron Sears, M.D.
James Chris Sherrell, M.D.
Adam T. Short, M.D.
Rob Smith, M.D.
Edwin Spencer, M.D.
M. Chris Testerman, M.D.