Surgical Assistant

Your surgeon will assess your medical history and the specifics of the surgical procedure to decide if a surgical assistant is necessary for your care team. Complex surgeries often require a specially trained surgical assistant to ensure the highest safety and optimal results. Additionally, many hospitals mandate the presence of a qualified surgical assistant as part of their facility policies.

Surgical first assistants come from diverse professional backgrounds. Nurse Practitioners and Physician Assistants may serve in this role if they have undergone additional surgical training or fellowships. Registered Nurses with surgical experience can complete a specialized program to
become Registered Nurse First Assistants (RNFAs). Furthermore, surgical scrub technicians who complete advanced training and obtain licensure can work as Licensed Surgical Assistants (LSAs). All first assistants must pass a thorough background check to be credentialed at each hospital. They work directly under the surgeon’s supervision during procedures and undergo annual reviews to ensure the highest standards of care.

The surgical assistant supports the surgical team and the surgeon throughout the procedure. Before your surgery, they will review your medical history and discuss the procedure with the surgeon. During the operation, they collaborate with the team to address your specific needs, ensure that all necessary supplies and equipment are available, and assist in positioning you safely once you are under anesthesia. The assistant works alongside the surgeon to assist with exposure, hemostasis, and other techniques to ensure the procedure is as safe and efficient as possible. In robotic surgeries, while the surgeon operates from the console, the assistant remains at the patient’s side to manage the operative field and handle their own laparoscopic ports. First assistants are trained in robotic, open, and laparoscopic procedures, and many surgeons work with the same assistants to maintain consistency and efficiency.

Urology Clinics of North Texas employs a range of surgical first assistants, each selected for their clinical expertise, safety, and training. These assistants may be independent practitioners, part of surgical assisting groups, or UCNT employees. The selection of your surgical assistant will depend on:

• Surgeon preference
• Availability of the assistant on the scheduled surgery date
• Hospital location and the credentialing requirements of the facility

Independent and surgical group first assistants have their own billing practices. Many are out-ofnetwork with insurance plans due to historical issues with negotiating fair market rates. The first assistant will provide you with a receipt so you can submit an insurance claim. Most commercial insurance plans cover claims for first assistants, though reimbursement amounts and specifics depend on your individual policy.

Unfortunately, Medicare and Medicare Replacement Plans do not cover services provided by RNFAs, LSAs, or CSFAs. Previously, UCNT has assisted patients with these costs, but due to recent changes in CMS reimbursement rates, we can no longer offer this support. Starting September 1, 2024, patients will be responsible for covering the cost of the first assistant.

UCNT requires these assistants to:

• Provide advance notice or a letter (for non-emergent cases) about their insurance network status or if they are a cash-pay provider only
• Disclose the out-of-pocket cost for your procedure and offer payment plan options if needed
• Adhere to state and federal regulations regarding billing practices and balance billing laws
• Comply with the Federal No Surprise Act
• For more information on your rights regarding “surprise billing,” please visit https://urologyclinics.com/no-surprise-act/.