Shoulder joint effusion treatment in 169 Orthopedic surgery clinics in Americas

First-class hospital, very beautiful and organized, not to mention its huge size!!! Top service!

Execelente hospital

Legal

It's similar to a public hospital, I have my doubts if the state isn't behind it. Because it looks like a public office, no one saw it, no one knows anything, everything takes time, any decision. Everything has to go back and ask to insist on something you need, you have to press if nothing works. It's a piece of junk, I use it because my plan pays for it at this hospital. I've been seen in the emergency room a few times in 2020. and 2021 22 or 23. It's even clean where we walk and in the rooms, like the doctors, 70% are old doctors, it gives me the impression that they are legacies of public service, they serve as public servants. But I started looking only for newer doctors. There they have improved care.

Terribly, my elderly father, 86 years old, with shortness of breath, spent more than 6 hours waiting and couldn't get help, he gave up. Unprepared employees, talking, laughing without being interested in providing a good service. I don't recommend it even to my biggest enemy... management should change because they are not good professionals

We all know that the nursing profession is highly responsible and requires a lot of attention from this professional as it takes care of human life. We all know how much excessive heat harms attention and the quality of service, whether in any area, but especially for those who need to take care of their health. life, as is the case of technicians and nurses. It turns out that the corridors on the HED bed floors do not have air conditioning for employees, with temperatures above 40⁰ in the summer, these poor professionals are forced to work dripping with sweat, sometimes even with deconcentration and their memory fails, and they can come making mistakes unintentionally due to the strong heat in the corridors, wrong medication for patients, etc. Patients have air conditioning in their rooms, but the corridors and other facilities where technicians and nurses circulate do not have air conditioning. This is inhumane and those who can pay the price for this are the patients since the HED administration sacrifices its nurses by not providing the basic things that are the appropriate temperature to work, how can you work in such heat? How to concentrate? So every time a family member is admitted there, they will be cared for by professionals who are under strong pressure and heat.

The structure of the building is good, but the service is lacking. In the office building there is no air conditioning and it is 35ºC hot. It is absurd that a private hospital environment does not have a decent structure to serve its clients!

I underwent a total thyroidectomy surgery on 08/17 and I was very well taken care of, from the time I arrived until I left (08/18). I would like to thank the entire team of Dr. Reginaldo Fujita, all the nurses and doctors in the recovery sector and all the nurses, physiotherapists and other employees in the hospitalization sector, for their love, care and patience. The structure of the hospital is wonderful (bedroom, operating room, recovery room)!!! My only complaint is about parking…..absurdly expensive. My mother paid 122.00 to stay 1 day with me!

I had septum surgery at this hospital and it went smoothly. Nurse Roberto took care of me with care. I stayed in room 509 where everything was organized and clean. Dr. Moacir's surgical team is very careful.

I had my children at the hospital, I had other procedures and today I am hospitalized having a tubal ligation. My biggest disappointment!! The other times I had no problem, but now. Simple surgery that ended at 9:00, I stayed in the recovery room for more than three hours, nurses passed in front of me They ignored my questions, my husband had no news (they said they had warned me) a total disregard. I came to the room and got something to eat for another 9 hours after the surgery. I was in pain and it took more than an hour to take medication. Total disrespect towards me.

I do not recommend the maternity ward at this hospital to anyone. I went through a traumatic process on the day of birth. They induced my labor without my permission, after the birth they left me in the waiting room for more than 10 hours, and hungry. I paid for the most expensive apartment, as the agreement covered everything. When I went to the room, a doctor asked me to take off my underwear and open my leg in front of more than 5 residents (I was bleeding). The experience was so bad that a year passed and I'm still angry about it to this day.

Worst experience of my life I had in this hospital. I was 23 weeks pregnant + 5 days pregnant, a high-risk and cerclated pregnancy, when my water broke on Sunday night, 17/09/23, I went straight to the maternity ward at the mater dei hospital, where they immediately came in with a medication and I did not remain hospitalized there, because my obstetrician assured me that in Vila da Serra I would have better care, especially because she works in that hospital. He guaranteed that my place in the bed, along with that of my baby who would later be born, were guaranteed at the hospital, and so I left the house and went straight to the village, who already received me with the news that they knew nothing and that there would be no No bed was available, but, due to my partner's position in the situation, they freed up a bed for me, even so, with my water broken, no medication was given to me. After a long wait, I was seen by 2 doctors who explained that I could get an infection that would pose risks to my life and that my baby would have to be born anyway, even so, I went to an observation room to wait for a bed and no medication. When it was the next day, 09/18/2023, they started taking medication due to the discharge that was coming out of me, which by the way hurt my entire arm due to the inexperience of the nursing team. When it was afternoon, they took me to the emergency room and found that the umbilical cord was out (cord prolapse). The doctors immediately sent me to the surgical suite, but when I got there, I was surprised by the information that I I didn't want to invest in my baby's survival, since I would never say that and that was not said by me or my partner, in that moment of tension I had to take a stand saying that I wanted a cesarean section and I would like to invest in my baby and I wanted the same to be true for uterine birth, given that 3 years ago I had a natural birth at 22 weeks and my baby was stillborn, I wanted to have a different experience! They performed an emergency cesarean section, my baby was born and went to the neonatal ICU, I went to bed to recover and receive medication. I underwent tests and they medicated me saying that I had an infection in the uterus, but then the torture show began, I felt very ill with the strong medications, I was barely willing to see my baby in the ICU, every time the team was asked to None of them were attended to by the doctor, the nursing team often didn't come, I even registered a police report while still in a hospital bed in the situation I was in, all the treatment coming from the nursing staff was grotesque and inhumane, they even hurt me at the time of doing an ultrasound on my stomach, when the nurse went to take off my pants and shaved my pants on my scar which was swollen with a seroma. After being discharged and spending a few days, on one of the days that I went to visit my baby in the ICU, I was feeling ill with a seroma in the cesarean section scar and I could barely move, we kept moving back and forth in search of care and nothing. meet! On 09/28/23 I received the news that my baby had died in the neonatal ICU, the responsible doctors only issued the death certificate and did not want to give us a verbal and personal explanation, all the doctors hid it, it was very painful to have to Facing this chaos at the most difficult time of my life, even when they reported the death of my baby they were completely rude and inhumane, I am disgusted with this hospital, I will never set foot in it again and I will not recommend it to anyone! But justice will be done!

Terrible care in this hospital, I was hospitalized on May 19, I They channeled me to medicate me and left a piece of what appears to be a needle inside my right wrist where they put the channel. I am already in the city where I live. They do not want to take responsibility, even though I have to undergo surgery due to their negligence, I have to lose days of work, I have to lose time and the trauma that all this is causing me, they want me to travel to Acapulco again, generating MORE EXPENSES and more stress about the situation, so that according to them they can take care of me!!!

Terrible, terrible 😡 service We went to the emergency room for my son who was having seizures and to treat him they asked us for a deposit of 5000. Afterwards, they didn't even do a checkup as it is, they just put the oximeter on him and took his temperature and the doctor on duty told me that I had to go to the pediatrician but that he was going to charge me 1500 in addition to the 5000 deposit Because he is a specialist and that is aside, it also took about 40 minutes for the pediatrician to arrive and he didn't check my son, he just asked the doctor how my son was doing. He asked me what medication he was taking and he just stared at his cell phone for about an hour, In the end they just adjusted the medication and didn't even know what the medication was. We just went to give away 6500 We arrived around 11 pm and left. At 2 in the morning only with the medication adjustment. Appalling

Terrible service, they do not know how to weigh a baby nor were there doctors, the one who treated my baby was not a doctor, she gave us a prescription with another name from a male doctor and she was a woman, very poor care and very expensive for the poor care they provide.

My cousin went to this hospital to have this removed since it went through her finger. Doctor Carmona Estrada Mayra attended my cousin and told her that anesthesia was not needed, plus she was really busy. My cousin sat through all that pain of having it pulled out with no pain reliever. That doctor had also told her that even if she opened up her finger that she wouldn’t put no anesthesia on it. After all that pain my cousin went to another hospital because there was a broken piece of the object still left in her finger. This Doctor needs to go because she couldn’t even perform this normal task to help out her patient.

Bad experience at this hospital with doctors not being honest and staff is rude. Their not helpful at all and there just out for your money. They have no true concern about your family member. They lie about how the patient is doing and if anything they make them worst to your expense. It was truly heartbreaking to realize how bad this hospital is. Don’t take your family members here. Find a different place.Funny thing is that I wrote a detail review of everything that happened and for some reason it’s not on here. Point is don’t trust them with your love ones. Question what there doing and why. Research to see if they even need certain things they ask you for and what the purpose of it is.

A lot of patience in the external consultation Archive and in the consultations themselves, sometimes the doctors do not arrive or they assign others who should not and you have to make an appointment again in the Archive. But they are no longer scheduling APPOINTMENTS for 2023 because they don't have a 2023 Agenda. Well that's what they say...

I was seen super quickly at the doctor..When it was time to do the dressing..I was waiting for 45 minutes..Shift change..No one to be seen, just me and one other person..I thought it was disrespectful..And I had to pay plus an hour of parking..

The structure of the hospital looked great after the renovation. Access and exit very well organized. But in the emergency embarkation and disembarkation part, it was abandoned. I stopped to disembark a friend there. Very close to the zebra area. She moved slowly. It was then that an Uber, with a damaged Kwid, stopped close to the left side of my car, almost hitting my mirror. I stared at him. So I rolled down the window to explain that he couldn't go through there. The citizen still wanted to criticize me, saying that he was in a wheelchair, he went wherever he wanted and that I was completely lost. I think you should paint that zebra area better, as it's a little faded. As far as I know, you can't go over it. It would also be interesting to get someone to instruct these Ubers that are completely lost, because if he had damaged my car, he would charge the hospital!

The hospital in general is good, so far I have received good care in consultations and exams, but today in the ENT the attendants at 217 are to be congratulated for their incompetence. I've been waiting more than 1 hour to be answered, as I couldn't find a location for the website, I came here on Google, I will reformulate this evaluation after receiving an answer and make my next query here.

We have been waiting for two hours to be seen in the emergency room by Unimed. My son is classified as “blue”. This is considered not serious. All, I repeat: all the people who have arrived so far have been attended to before him. Does this mean: we arrive, register and wait for new patients to come in and go before them??? That's right? Knowing that we will always wait a long time, because another color gets in front of it. ABSURD.

I went to the obstetric emergency because I'm 13 weeks and there was bleeding. Another pregnant woman and I waited for 2 hours of service, we went to ask and the girl said that it was protocol according to the assessment, finally I arrived at 7:35 and was seen at 9:41 pm and the chairs were empty and they weren't even attending!

Rgy

I accompanied my husband for knee surgery, we were very well looked after in all sectors, the nurses were extremely attentive, the rooms were very well equipped. We were satisfied.

I have always received very good care at Hospital Estrela, I am immensely grateful!

TERRIBLE ATTENDANCE! I was admitted due to a fall, with acute pain in my leg and the professional who was pushing my wheelchair pressed my foot, the leg that couldn't handle the pain, against the wall and without even apologizing, left. He returned with medication, applied it without any guidance or explanation and left. The doctor barely assessed it, he just said that I didn't have a fracture and sent me away without even referring me to a specialist and requesting tests such as MRI. And I still had to put up with a rude professional when I asked to leave. I went in with acute pain and came out worse.

Being in the medical field for 40 years world wide Absolutely the Best Hospital overall I have ever visited! Facilities A+ Staff A+ Communication A+ Value A+

Excellent. Both our daughters were born here and care was absolutely great. Thanks. :)

Excellent in every measure. Was admitted for an emergency surgery and they diagnosed other ailments that needed emergency care. All the staff at the hospital are the best trained and competent I've seen. I owe my life to them.

A good hospital with a VERY SERIOUS issue! There is no information on food for patients and companions with restrictions! The Marieta restaurant offers ABSOLUTELY NOTHING without gluten and milk. The person spending the whole day there is hungry, because not even the PURCHASED coffee has a nutritional sheet with information! We are talking about a hospitaaaaal! How does a celiac patient spend the day in a place like this?

Bad experience! We arrived with my 78-year-old mother in the emergency room. Super slow service. When we arrive at the doctor, he informs us that we can leave because there is no room, no box or even an armchair to receive medication. Avoid this place!

Terrible, zero service, an absurd delay in the emergency room, I waited 50 minutes until I lost patience and left. I do not recommend!!!

I'm amazed by the outstanding service we're receiving here, from the entire staff and doctors at every stage. Despite its simplicity, hygiene is a top priority everywhere, and both doctors and nurses have displayed not only humility but also a profound understanding of their fields. They have been readily available to explain all the details that might be important for our peace of mind, with patience and zero condescendence. The interior design of the entrance is exceptional and is worth a quick visit, even if you're not here to use the hospital facilities.

I'm amazed by the outstanding service we're receiving here, from the entire staff and doctors at every stage. Despite its simplicity, hygiene is a top priority everywhere, and both doctors and nurses have displayed not only humility but also a profound understanding of their fields. They have been readily available to explain all the details that might be important for our peace of mind, with patience and zero condescendence. The interior design of the entrance is exceptional and is worth a quick visit, even if you're not here to use the hospital facilities.

One of the best hospitals even been in, from the reception to the surgery room. Very well organized, punctual, super clean rooms, respectful staff, and great doctors. They have well preserved the mission of Santa Catarina, since 548 A.D.

Great and fast service. English speaking Doctor and nurses were available. Recommendation for Expats.

The hospital is good, but in my opinion it can improve more. There are doctors and others not so nice and thoughtful. The reception is good, some people (receptionists) are polite, friendly ... The same in relation to the security guards. There should be more integration, communication among the coworkers. As I told you it could be better, even in its standard procedure, being more effective,

Excellent service and support regarding many domains. We had a undergo and the whole staff was extremely supportive (from the first approach, passing by intensive care and ending on maternity domain). Its definitely one of the best hospitals in Sao Paulo.

Caring

Never again! I took my girlfriend to this hospital because she was having strong abdominal pains on 07/02/21. The two doctors were recent graduates v. inexperienced. One of them actually told me that Coca-Cola was a good drink for hidration!!! Today we spent most of our day worrying that we may have contracted Covid seen as one in every 5 staff members were either not wearing a mask or wearing them inappropriately. We had complained to the night manager, who didn't care less! To pay for the treatment they tell you to go to talk to a manager in his glass office. This guy not only charged us 5000 Reais which is an obscene amount, but had zero empathy or people skills. And to think that the doctor actually wanted her to stay overnight, probably to be able to bill me ten times as much!!! This hospital has some serious issues.

Everything was excellent, from the operating team (special thanks to the amazing doctor Alexandre Santa Cruz, the best orthopedic surgeon there is!!!) until the nursing staff (impeccable and extremely professional, available and kind), the cleaning service (very effective) to the food!!!! (I never ate so well in a hospital!!!). The medical and customer care are so good that you enjoy being there and feel extremely safe and protected until you are ready to return home! Congratulations to all parties!!! I fully recommend this hospital!

I found cordiality and care all the time in my hospitalization

Took us 3 hours to get treated with a basic appointment (ear infection) and sort out the insurance stuff, very slow

Hospital is not well equipped to attend cold symptoms at the emergency. You will have to wait for the arrival of an specialist at 10 AM so that he can look inside your ear canal with an otoscope. Even my throat was looked with a cellphone light. A disappointment. See images of equipments that should be part of the emergency below at the national manual of emergency.

I broke my finger on 11/19/23 and went to the HSVP emergency on 11/20/23, I went in and was seen, the fracture was confirmed by the RX and the doctor, he directed me to another doctor and asked to come in the next morning, With a broken finger, the doctor told me to buy a wrist glove that holds the finger at the pharmacy. The next doctor asked me to do an MRI and it was also found that the ligaments were broken! OK! But until now the finger is doing nothing...lol and just asking me to go there, and look, like UPA, health center or even on the island of Marajó, where I lived for years, I went through this situation of being attended to entering through the emergency door and solving the problem of a simple broken finger in installments..."Break your arm with an open fracture? Come by tomorrow!" ...or... "Have you broken your head?, come by tomorrow!" ...it's not a joke because I've already been through this and received immediate care! I'm going to another hospital today, 11/26/23 because the finger is still purple and swollen and very painful!

Very clean and structured hospital, but there is a chance that the doctor who attends to you makes a mistake and the delay is certain! We had such an experience that the doctor did not see the bacterial plaque in my relative's throat, which was very visible... which made it worse and the other doctor confirmed the mistake. There is a lack of quality management, but the structure and service are effective. It takes a few days unnecessarily and that's hell! Good for gentlemen, they at least have patience because they also don't have much commitment lol. There is a King of Mate and parking.

Came in with Zika and they weren't surprised

Got first-rate care, had a great experience and a positive outcome! Kudos to the Nurses, Doctors/Surgeons/Anasthesioligists, Physical Therapists, Dieticians/ Food Service, Fellows, Interns and Students.Special shout-out to my postoperative caregiver- Karina Valentine. She kept me going through the most challenging part of my surgical journey- enduring procedures to facilitate the OUT in outpatient. Lest we forget the unsung heroes that keep the hospital so hygienically safe and superior- I must now sing my praises to the custodial technicians: 🎶We could eat off of the floors But we don’t have to They give plates and forks Don’t spill dessert (I got strawberry shortcake 🍰)

Duke has reached a new low in Health Care. I'd give them stars in the minus categories if I could. My son had eye surgery and every time we went for an appointment we waited over 2 hours to be seen. I can tell you I read 150 pages of a book on one visit. We actually saw people leave without being seen because they had waited so long. My son objected to the long wait one day and was told by the surgeon that he was ruining her day. Because of the wait he asked to talk to the manager or an administrator. While waiting the police came made him leave because they said he raised his voice. He was not allowed to talk to the administrator and was escorted out. This is not the first problem we have had with Duke. My son was in the emergency room waiting for the specialist on call when the Emergency Doctor came in and told him that the specialist on call was already home and refused to come in to see him. We were told he should go to the specialist's off the next day. We did that and he was seen for less than 10 minutes and told to go back to another doctor. Seems the specialist could have cut through the chase and just told us that to begin with. My impression is that almost every one in the hospital system is very impressed with themselves and seems to think it below them to interface and deal with patient who have some real problems. I can, in no way, recommend any Duke Service. I could continue with examples but it would sound repetitive. I practiced Nursing for 45 years and never came up against any care that is this poor in quality. Giving them -5.

There is good and bad. I recently gave birth at Duke University Hospital and I want to say that my experience with Doctor Clifford, and nurses Lexi, Brenna, Tabitha, Josephine among others was phenomenal. I was blown away by the care and compassion I received so I will say it was a four star experience. However, I have one major complaint about the experience and feel it's important enough to try to voice it. The postnatal recovery rooms are terrible. They are the size of walk in closets and if you have a support person such as your husband staying with you, they have to sleep on what is essentially an airplane chair. My husband could not do it, and it made the end of my experience at Duke hard because I needed him there with me. I felt like me and my baby were locked in a cell and I was going crazy by the time I was discharged. Thank god I was discharged early. There were many people coming in and out of my closet those last few days and nights, and it was definitely too many people. After receiving an emergency C section, I felt I was improperly educated on the repercussions. I had no idea I would have trouble producing milk after my blood loss in surgery and I was not informed about any of the medication I was prescribed. Again, it would have helped if my husband could have been there because maybe I actually was given information but was too out of it for it to sink in.

They have a terrible Surgeon, is name is José Antonio Soriano, he was my surgeon and the results of the operation were disastrous, he only cares about money , and not about his patients. I filed a complaint at the hospital and the didn’t do nothing

Terrible experience. I tested positive for COVID three days ago, and began Paxlovid and fever reducers immediately. After three days, I am still having symptoms and testing positive. I called the ambulance to bring me to the hospital. My oxygen was 81 (after a dexamethasone injection and tablet today). The paramedic gave me oxygen right away in the ambulance. The doctor was useless. He refused to prescribe remdesivir. In nonhospitalized patients with mild to moderate COVID-19 who are at high risk of progressing to severe disease, remdesivir should be started within 7 days of symptom onset and administered for 3 days. The doctors name was Dr. Diego Lecona. I showed proof of my asthma and low oxygen saturation from prior attacks. He did nothing to help me and didn’t give me the medicine. All he did was charge me over $300 for a useless consult. Never again

Unfortunately I became quite I’ll on a recent trip to Mexico City. The physician on call for the hotel direct me to this hospital. My care in ER was efficient, caring and appropriate. Lilliana and Mezil in Er were so caring and great communicators. I was admitted and again impressed with the care of the team. Very professional and respectful. When called received prompt response. My physician, Dr Jessica was knowledgeable, great personality and did follow thru with communication upon my return home. Highly recommend and hope in US we can rid our staff of the EMR demands that take them away from the bedside. Perhaps then we can be as attentive as the team in this hospital. Thank you to the nurses, housekeeping and residents as well!

This hospital is part of the inherited Mexico, with a staff with the excellence that experience provides, but fatigue periodically takes its toll, so as a patient, everyone will talk about how the fair went. The staff makes an effort for the shortcomings they work with and for such a diverse population. More hospital centers like this are needed for this city. Abroad, dozens and even a few hundred spend hours and even days waiting for care for family members, either for medical appointments and studies, as well as those who are hospitalized for days in these facilities. There are those who already go with a folding bench, others rent chairs, umbrellas and some institutions offer a tent for those who come from afar to accompany a family member during their hospitalization period.

Excellent

Exceente

A big thank you to the staff of Galenia hospital!!! During our stay this month, my friend became suddenly ill and had to be hospitalized. Being from the US, I must say that it was a bit nerve wracking to have to seek medical help in a foreign country. However, our experience was entirely positive!!! To the concierge staff - Eric and Alfredo - I wish to extend tremendous gratitude!!! Your translation services as well as your kindness and hospitality were both indispensable and greatly appreciated!!!! I also wish to extend my gratitude to Dr. Allejandro (I don't remember your last name); not only were you genuinely gracious, you discovered the problem quickly and got my friend back on her feet in no time at all!!! Again, thank you Hospital Galenia for such a good experience!!! You took great care of my friend and went above and beyond in showing us courtesy and consideration!!!

BEWARE IF YOU ARE A TOURIST! My father was hospitalized on a family trip to Cancun. He was transported to this hospital and needed emergency surgery This hospital FAILED him. They wouldn’t even give him so much as saline or an antibiotic without payment in FULL. WE WERE CHARGED $4,000 FOR. He went 8 HOURS sitting on an emergency room bed when he should have been in surgery. THEY DEMANDED 50,000 DOLLARS PAID IN FULL BEFORE STARTING ANY CARE AND THAT WAS JUST FOR THE SURGERY. WE OFFERED TO PAY 25,000 SO THEY COULD START AND THEY REFUSED. WE OFFERED TO PAY THE REST THE NEXT DAY AND THEY REFUSED. WE TRANSFERRED MY FATHER TO THE OTHER HOSPITAL BECAUSE WE THOUGHT HE WAS GOING TO DIE. WE FELT USELESS WHILE THEY HAD ALL THE POWER TO DO SOMETHING THEY CHOSE TO DO NOTHING!!!!! THEY ARE SCAMMERS AND NOTHING MORE. ITS A MIRACLE MY FATHER SURVIVED AND ONLY BY THE HELP OF GOD WAS MY FATHER ABLE TO COME BACK HOME WITH US. JUST TO TOP IT OFF WHEN WE WERE PAST THE TRAUMA THAT THESE PEOPLE PUT US THROUGH THEY HAD THE AUDACITY TO BILL IS THE OXYGEN THAT WAS ADMINISTERED DURING THE AMBULANCE RIDE!! 2000 DOLLARS!!!!!!!! THEY WOULD RATHER WATCH YOUR FAMILY MEMBER DIE, I WILL NEVER FORGET THEIR DISGUSTING SMUG FACES

It feels very comfortable being there. Olivia is the best. She arranges everything for you when you are from outside the country of Mexico. You show up and all is prepared. Her personality is very welcoming and friendly. I love not having to worry about the stress of paper work especially since i don't know Spanish well. All her subordinates speak English as well and are all very nice. Galenia might be costly however the peace of mind you get not being stresses out with paperwork helps a lot. I don't even need to Contact my insurance. They do everything for you. Best service. The receptionist at imaging are a bit slow and don't know any English. But the staff attending to you in the radiation area are super friendly and helpful. I see many people complain about the price. This is a private hospital and will be costly. It is the same in my own country. Private hospitals cost a lot but if you have insurance and you are not from Mexico, then I highly recommend using their tourism concierge. They are a great help and speak English. They are all very nice and helpful. I have had the pleasure of meeting and being assisted by Olivia (who is the best), Ellen, Ricardo and another guy i cant remember his name. Not sure if it is Daniel or something with a D. That was over 2 years ago i met him. They arranged everything with my insurance prior to going there. I just showed up and Olivia walked me through everything. I was in and out as quick as possible. No long waiting. Use the concierge service they have. It really helps you from stressing about paperwork and payments. My journey at Galenia started September 2021 and I continue into 2023......