Patient Rights Under Florida Transparency Act of 2016.
PATIENT PRICE ESTIMATE REQUEST INFORMATION:
In the case of financial hardship there may be ways to reduce a patient’s financial responsibility for services rendered by the surgery center. Please contact our facility’s business office at (813-908-2020) for further information on our policies.
All patients who are scheduled for a procedure receive a Financial Advance Notice form during their preoperative visit. This form is an estimating of what we expect your insurance to pay as well as any out of pocket amounts you would owe.
As a courtesy to our patients, we will file an insurance claim on behalf of the patient to his/her insurance plan. A patient is expected to respond to his/her insurance plan’s request for information timely, as needed, in order to minimize processing delays with the claim.
Patients are expected to pay their financial obligations in a timely manner including the estimated portion by the day services are received, and any remaining portion upon finalization of the claim by the payer. Unpaid claims by the payer may result in the account’s outstanding balance being fully transferred to the patient for collection.
If needed, the center will attempt to reach a patient by any method available to us to secure payment on the outstanding balance utilizing internal and external resources. Beyond us contacting your insurance carrier, you should also contact your insurer or health maintenance organization regarding your cost-sharing responsibilities for having a procedure at our facility- Newsom Surgery Center of Sebring/Tampa Surgery Center.
The patient will be informed of his/her patient responsibility in the form of a patient statement generated on a monthly basis.
If a patient has additional financial responsibilities after the final insurance claim has been processed (other than what was collected pre procedure), it is our policy to send one or more bills to the patient.
If a patient informs us that he/she is not able to fully pay his/her responsibility, Care Credit is available and allows monthly payments to be made.
If the account is not paid by the due date on the patient statement and after the third monthly statement has been mailed, we will attempt a courtesy call to the patient in order to collect payment in full.
If payment in full is not made within 24 hours, the collector will forward the account to the Business Office Director for review and approval to be referred to an outside collection agency.
Special Note: If a patient has a previous bad debt or outstanding balance from a prior visit, the account must be paid in full prior to any future appointments.
Each patient is expected to pay his/her estimated financial liability on or before the day of service. Payment plans are not offered by the facility. The surgery center does offer financial assistance through Care Credit. Please consult with our surgery center’s business office at (813-908-2020) for further information. Visit Care Credit online and apply at www.carecredit.com/apply/.
If a patient is unable to pay their cost share for his/her procedure in full on or before services are provided because he/she believes he/she is medically indigent, or are not covered by any health insurance or health maintenance organization (HMO), upon request, Facility, in its sole discretion, may offer the patient or prospective patient a discount on the amount due and/or offer a payment plan.
Any such discount is considered by Facility to be charity care.
There is not a formal application process for obtaining charity care at Facility.
The patient’s attending physician, and other health care providers, such as the anesthesiologist, durable medical supplier, pathology, and/or the laboratory service provider(s) are not a part of the Facility’s fees. If any of these providers delivered services to the patient during their short stay at the Facility, each of the provider(s) will bill separately for their services rendered. Such health care providers may or may not participate with the same health insurers or health maintenance organizations as the facility.
Payment Bundle Resources
Information on payments made to the facility for defined bundles of services and procedures is available at http://pricing.floridahealthfinder.gov/. The service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services, and actual costs will be based on services actually provided to the patient. The patient can request a personalized estimate from the center at any time before or after the procedure is performed. Patients should contact the health care practitioners anticipated to provide services to the patient while in the center regarding a personalized estimate, billing practices and participation with patient’s insurance provider or HMO as the practitioners may not participate with the same insurers or HMO as the center.
Services are provided in this health care facility by the facility as well as by other health care providers who may separately bill the patient and who may or may not participate with the same health insurers or health maintenance organizations as the facility. Again, we encourage you to contact your insurer or health maintenance organization regarding your cost-sharing responsibilities for having a procedure at our facility- Newsom Surgery Center of Sebring/Tampa Surgery Center.
Patients and prospective patients may request from this facility and other health care providers a more personalized estimate of charges and other information. Patients and prospective patients should contact each health care practitioner who will provide services in this surgery center to determine the health insurers and health maintenance organizations with which the health care practitioner participates as a network provider or preferred provider.
Contracted Service Providers
The following providers render services to patients at Newsom Surgery Center of Sebring/Tampa Surgery Center and the patients should contact them directly if they need further information.
Surgeons-Newsom Eye and Laser Center: T. Hunter Newsom, M.D. B. David Garruto, M.D. Vinita Srivastava, M.D. Kendra DeAngelis, M.D. Shamim Haji, M.D.
4211 US Hwy 27 N
Sebring, FL 33870
13904 N. Dale Mabry Hwy
Tampa, FL 33618
113 S. Armenia Avenue
Tampa, FL 33609
Anesthesia- Quality Anesthesia Care 521 Cummings St.
Sarasota, FL 34242
Jay Horowitz, CRNA Timothy P. Schmidt, CRNA
Ramona Alea, CRNA
Patients may access the State of Florida’s Agency for Healthcare Administration website at this link for information about this facility and others: www.floridahealthfinder.gov