Patient Information

Ascent Urology is structured to provides patient with a superior Urologic Healthcare experience.

Operating Locations

Office and Consultations

Spring Medical Arts Building
6226 E. Spring Street, Suite 260

Operating Locations

Long Beach Memorial Medical Center | MemorialCare
Website | Dr. Liu’s MemorialCare Profile

Los Alamitos Medical Center
Website

Outpatient Surgical Procedures

MemorialCare Outpatient Surgical Center Long Beach
Website

Accepted Insurance Plans

Ascent Urology was created to provide the highest level of patient care, treatment and satisfaction. In order to achieve this, we found it useful and necessary to limit the scope of insurance plans we can accept.

Ascent Urology is contracted with Medicare.

Our patient population comprises of:

  • Medicare participants with Parts A and B coverage
  • Most major PPO Insurance Plans with Out-of-Network (OON) coverage and benefits
  • Self-Pay Patients

Ascent Urology is considered an Out-of-Network (OON) Provider.

Currently we are not contracted with, and therefore are unable to accept, any HMO Plans or Medi-Cal plans.

Please contact our office staff to verify insurance eligibility.

On-Time & Cancellation Disclaimer

Ascent Urology strives to balance:

  • providing all of its patients with enough time to fully and comfortably discuss their urologic and health history with
  • being able to see and treat all patients that have made an appointment in a punctual manner.

For this reason, we kindly request that you plan to show up 5 minutes early to your scheduled appointment time, providing you have already completed and returned all the necessary New Patient Intake Forms.

New Patient Intake Forms may be furnished and completed in our office waiting room prior to your appointment only if you plan on arriving at least 1 hour prior to your scheduled appointment time. Please advise our staff at the time of scheduling if you plan on doing this.

We kindly ask that all scheduled appointments be honored, as a missed appointment is a time that could have otherwise been assigned to another patient in need. Therefore, we request that all patients that intend to cancel their appointment provide notification 48 hours prior to the scheduled time. By doing so, this will hopefully allow us the opportunity to fill that time.

Unfortunately, we cannot guarantee that a late arrival (more than 10 minutes past the allotted time) will be able to be rescheduled in the same day. Similarly, we cannot guarantee that a missed (no-show) appointment will be able to be re-scheduled in a timely manner, as our schedule is created weeks in advance.

If you think you will not be able to make your appointment please contact our staff immediately to notify them.

New Patient Forms

After speaking directly with our staff, verifying eligibility, and making an appointment, we will send you our New Patient Intake Forms via email. These do not have to be printed, they can be completely filled out, signed and submitted online (contact our office to receive print or digital forms).

If time allows prior to your appointment, and it is your preference, printed copies can also be sent to your residence via USPS.

All Forms Must Be Complete

We recognize these forms are lengthy and do take some time to fill out, depending on one’s health history. However, most of our patients report that they can complete them in less than 30 minutes. Only with their full completion will we have a holistic assessment of your health and be able to more accurately diagnose and treat you.

All of these forms need to be completed to the best of your ability, signed and returned prior to your appointment.

Unfortunately, a failure to fully complete and sign all of the provided forms prior to your arrival for your appointment, will likely result in rescheduling of your appointment at a later date.

Valid ID Required

Finally, you must bring a valid government-issued form of photo ID (Driver’s License or passport) and provide valid insurance documentation at the time of your appointment (if applicable).

Secondary Languages

At this time, we do not provide these forms in Spanish or any other languages.

Although some of our staff does speak Spanish, they are unable and unauthorized to provide translation for any medical, legal or financial documents we furnish and require.

Therefore, we strongly suggest you have a trusted family member, friend or certified translator provide you with a thorough translation prior to filling out or signing any form you do not fully understand.

En este momento no ofrecemos estas formas en español o cualquier otro idioma.

Aunque algunos de nuestros empleados si hablan español, no son capaces o tienen la autoridad para proveer traducción por cualesquiera documentos médicos, legales o financieros que necesita Ascent Urology.

Por lo tanto, sugerimos fuertemente que Usted pide un miembro de su familia, un amigo de confianza, o un Traductor certificado, que puede proveer una traducción completa por cualquier forma que no se entiende antes de cumplir o firmar.

Required Forms

Please contact our office to receive print or digital versions of these forms.

Z

Ascent Urology Intake Form (Demographics and Health History)

l

Patient Consent for Use and Disclosure of Protected Health Information (HIPAA Compliance)

Financial Responsibility Agreement (Financial Disclosures)

No-Show Authorization Form (Patient Responsibility Agreement)

Optional Forms

Email Authorization Form (Electronic Communications Agreement)

You may elect to not complete this form, however it will prevent Ascent Urology from being able to communicate with you via email.

Credit Card Authorization Agreement (Financial Disclosures)

You may elect to not complete this form, however you will not be able to make payments to Ascent Urology with a credit card. Instead, payment by cash or check will be required prior to treatment.

Patient Information & Guides

General Pre-Operative Guidelines
Blood-thinning medication (including daily aspirin, ibuprofen, Plavix, Xarelto, Perdaxa, Coumadin, etc.) must be stopped 1 (one) week prior to your surgery, pending the prescribing physician’s approval.

Do not eat or drink anything 8 (eight) hours prior to your surgical start time. This includes water, ice, coffee, tea, and even bubblegum.
EXCEPTION: If you regularly take a beta-blocker (e.g. Metoprolol, Sotalol, etc.), you may still take it the morning of surgery with a small sip of water.

Vitamins generally should be stopped 1 (one) week before surgery.

Medications (such as for diabetes, thyroid conditions, and high blood pressure (EXCEPT for beta-blockers), and any medications prescribed for mental health wellbeing may be taken up to one day before surgery.

General Post-Operative Guidelines
Post-Operative Instructions vary depending on course of treatment, surgery and patient demographics.

Specific written and verbal guidelines for Post-Operative care will be provided directly to the patient prior to surgery.

For Outpatient surgeries and procedures, the hospitals and surgery center require that a family member or acquaintance pick up patients post-procedure. They do not allow patients to utilize ride-sharing services, such as Uber and Lyft by themselves. Ride-sharing services may only be used if the patient is accompanied by a family member or acquaintance.

Elation Passport Portal

For current patients who have decided to make an account with Elation Passport, please click on the appropriate link below to Log In.

Contact Our Office

Ask a question or book an appointment below.
* this form is not secured to HIPAA standards; please do not submit sensitive information.

For emergencies call 911 or visit your nearest hospital.

562.247.0883

562.512.9986

6226 E. Spring St #260
Long Beach, CA 90815