FINANCIAL INFORMATION

Patients will obtain physician/surgeon fees/copays from their surgeon’s office. Please contact us at 863-686-3344.

PAYMENTS

Estimated patient financial responsibility is due prior to your visit. Payment in full is required unless a payment arrangement has been made. Payment can be made in the form of check, money order, cash or credit card. Postdated checks are not accepted.

PAYMENT arrangements

1. Patient account must be in good standing, that has consistently been paid in a timely manner, has not been sent to collections and has not defaulted on a payment plan.
   
   
2. We will accept payment of 50% of the estimated patient responsibility before your visit. The remaining balance will be divided based on agreed-upon monthly payments not to exceed 12 months.
   
   
3. Payment dates can be tailored to your personal needs: weekly, biweekly or monthly.
   
   
4. Payments are set up on automatic withdrawal only by utilizing either a debit or credit card.
   
   
5. Once the payment is posted to your account, a patient statement is generated and mailed.
   
   
6. Payment arrangements are set up based on estimated patient responsibility. If the payment amount needs to be adjusted after your insurance carrier pays in full, you will be contacted by a Central Florida SurgiCenter patient account representative.
   
   
7. Only one payment plan can be in effect at a time. If you have a return visit prior to your payment plan being completed, we can combine your visits into one payment arrangement.

CHARGES

Facility charges will be billed by Central Florida SurgiCenter. Professional fees will be billed separately by your physician and anesthesiologist. If applicable, you will receive a separate bill for surgical assistants, radiologists, pathologists or third-party implant companies.

You should also contact your insurance carrier regarding your cost-sharing responsibilities for both facility charges and professional fees. Click on Financial Q&A for questions to ask your provider.

Some healthcare providers may or may not participate with the same insurance carriers as Central Florida SurgiCenter. We encourage you to contact your insurance carrier if they are in our network before your upcoming visit.

You can access Florida Health Finder to find facility benchmarking, quality measures and statistics regarding healthcare in Florida. This link provides information that is an estimate of costs that may be incurred and actual costs will be based upon the services provided.

TRANSPARANCY IN PRICING INFORMATION

We have provided a link directly to the Florida Health Price Finder for non personalized data on health care costs on National, State and County prices.

Note: Service may be provided in the Surgery center by other health care providers who may separately bill the patient. Such healthcare providers may or may not participate with the same health insurer or HMO’s as the Surgery Center.

You should contact your health care practitioner who will provide services in the surgery center to determine which health insurers and HMO’s they participate in as a network provider or preferred provider.

Patients and prospective patients or their guardians may request an estimate an estimate for charges both from the surgery center and other practitioners who may provide services.

The following is a list of names, addresses and telephone numbers of the health care practitioners we contract with to provide services in the facility.

You may contact them to determine the health insurers and HMO’s with which they participate with as network providers or preferred providers:

As to our Facility

Central Florida Surgery Center, LLC

900 Griffin Road

Lakeland FL.33806

Tel: (863) 686-3344

ANESTHESIA

Lakeview Anesthesia, LLC

P.O.Box 1590

Lutz, FL 33548

Tel: (866) 226-9156

DISCOUNTS AND FINANCIAL ASSISTANCE

Insured patients will receive a discount off billed charges based on the contractual agreement with the insurance carrier.

Uninsured patients will be offered a self-pay rate, which is a percentage off billed charges.

There is no application process required to receive these discounts. Central Florida SurgiCenter financial assistance and charity program is limited to the above discounts and payment plan options.

COLLECTION POLICY

Central Florida SurgiCenter’s standard collection policy is to produce and send two patient statements reflecting the patient’s cost-sharing responsibility. If the statement balance is not paid in a timely manner, a collection notice will be sent. This notice will inform the patient that the unpaid balance will be placed with a collection agency.

CFLSC Insurance Plans

Central Florida SurgiCenter accepts most major commercial insurance, HMO/PPO plans, Medicare, Workers Compensation, and other government sponsored health coverage.

We will bill your insurance company as a courtesy; however, any balance due is your responsibility. Payment will be requested from you if reimbursement from your insurance company is not received within 60 days.

Bring completed insurance forms as well as any medical information. Please check with your insurance company for pre-admission requirements such as second opinions and pre-admission certification. This will facilitate the admitting process.

Uninsured and/or self pay patients will be required to pay for services on or before the admission date unless other arrangements have been made with the Center.

Central Florida Surgi Center recognizes our obligation to remain flexible in financial matters. In the event of the above conditions cannot be met, the center will attempt to make other financial arrangements. These arrangements must be made prior to admission and must be approved by the administrator.

MasterCard and VISA are accepted.

Aetna

Aetna Signature Administrators

Commercial PPO/HMO

Medicare HMO/PPO

Aetna Better Health

Avmed

Medicare Advantge HMO

BayCare Health Plans

Medicare HMO/PPO

CarePlus

Medicare HMO/PPO

Coventry

Commercial PPO/HMO

Healthy Kids

Medicaid HMO

Medicare HMO/PPO

Devoted Health

Medicare HMO/PPO

Division of Blind Services (link unavailable)

First Health

Commercial PPO

Worker's Comp

Blue Cross Blue Shield

Blue Care

Blue Options

Blue Select

Commercial PPO/HMO

Medicare HMO/PPO

Freedom Health

Medicare HMO/PPO

Heritage Summit (link unavailable)

Worker's Comp

Humana

Commercial PPO/HMO

Medicaid HMO

Medicare HMO/PPO

Premier

Humana Tricare

Tricare

Medicade / Medicare

Molina

MarketPlace

Medicaid HMO

Medicare HMO/PPO

Multiplan

Commercial PPO

PHCS

Optimum Healthcare

Medicare HMO/PPO

Polk Healthcare Plan

County Healthcare

Premier Care

Medicaid HMO/PPO

Medicare HMO/PPO

Simply Health Care

Healthy Kids

Medicaid HMO

Medicare HMO/PPO

Sunshine Health

Ambetter

Medicaid HMO

Medicare HMO/PPO

Tri-West

Veterans Choice

PC3

United Healthcare

Commercial PPO/HMO

Medicare HMO/PPO

Medicare Wellmed

Wellcare/ Staywell

Healthy Kids

Medicaid HMO

Medicare HMO/PPO

Q&A

What is an account in good standing?

An account in good standing has consistently been paid in a timely manner, has not been sent to collections and has not defaulted on a payment plan.

How do you bring an account back into good standing if you have defaulted on a payment plan?

You will be required to pay your estimated patient responsibility and any defaulted payment in full before your next visit.

How do you bring an account back into good standing if your account has been sent to collections?

You will be required to pay your estimated patient responsibility and any collection balance in full before your next visit.

What questions should I ask my insurance carrier regarding my upcoming visit?

You should ask:

• Are all providers in-network (the facility, physician, anesthesia, etc.)?
• Does this procedure require an authorization or referral?
• Does this procedure have medical necessity criteria that need to be met?

What is “estimated patient responsibility” and how is it calculated?

“Estimated patient responsibility” is the amount we anticipate you will owe. It is calculated prior to your visit based on the procedure codes scheduled by your physician and your insurance benefits. We evaluate your remaining deductible, out-of-pocket, co-insurance, co-pays and health savings account, if applicable.

Why do I have a different patient responsibility after my visit?

Scheduled procedures may vary from billed procedures. Insurance carriers may apply more or less to patient responsibility based on processed claims.