Promenades Surgery Center

Financial Assistance, Good Faith Estimate, Itemized Billing

PURPOSE:

To ensure patients are informed of the financial assistance and good faith estimate and itemized billing policy in accordance with Federal and Florida State law.

POLICY:

It is the policy of Promenades Surgery Center, (hereafter referred to as the “Facility”), to collect all copayments, coinsurances and deductibles at or before the time of service. Promenades Surgery Center will inform patients that they may request a Good Faith estimate of charges for a scheduled procedure.

The Facility will admit patients based on the need for services provided by the Facility and will bill patients only for the services and care provided. All patients will be requested to pay for services received.

The Facility will inform the patient or prospective patient that he or she may or may not pay less for the services being provided at another facility or in another healthcare setting. Additionally, the patient will be informed that the attending physician who scheduled the patient's procedure(s) at the facility may or may not be on the medical staff of other such facilities.

Services may be 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 care insurers or health maintenance organizations as the facility.

Due to the nature of our services, Promenades Surgery Center does not routinely provide discounts for uninsured patients.  However, in unique cases involving medically necessary services to be delivered to an indigent patient, the management may consider the specific needs of a patient and grant a discount accordingly on a case by case basis individually. Any such discount is considered by Promenades Surgery Center to be “charity care”. Promenades Surgery Center's standard collection policy is to produce and send one or more bills to patients for their cost sharing amount.

The Facility will provide itemized billing upon request from the patient within seven (7) business days.

PROCEDURE:

1.     Inform the patient or responsible party about the payment policies and the procedure for resolving billing issues upon entry into the system. Inform the patient that services may be provided in this facility by this Facility as well as by other health care providers that may bill separately.

2.     During the initial scheduling process, provide patients, upon request, a written good faith estimate. The estimate must be provided within one business day after scheduling (when the service is scheduled at least three business days in advance) or no later than three business days after scheduling (when the service is scheduled at least 10 business days in advance). For uninsured or self-pay patients, it must be provided within three business days after the consumer who has not yet scheduled requests a good faith estimate. As with any medical procedure, if unforeseen circumstances should arise during the procedure it may be necessary for the physician to perform additional or different procedures and /or to use more/less expensive supply or implants. The use of implants and /or the difference in procedures may cause the estimate to vary. However, it is understood that final gross charges and patient responsibility will depend on actual services provided and may or may not exceed the original estimate.

3.     The Good Faith estimate in writing for the total expected cost of any non-emergency services which will include the surgeon's fee, the facility fee and any ancillary fee ( ie. Pathology, Laboratory, Anesthesia). If charges are at least $400.00 more than the Good Faith estimate, the patient can dispute the bill by calling the billing liaison at 94l-627-5155. The patient will be informed it is the policy of the Promenades Surgery Center that balance billing* ( * the difference between what was billed to the insurance company and what the insurance company has paid in addition to the co-insurance, co-pay and/or deductible ) is not allowed regardless of participation status with the patient's insurance.

4.     When a patient has decided to undergo treatment, verify the patient's insurance benefits. Notify the patient if a payment is required prior to surgery, and if patient has questions, inform patient to contact their insurance company regarding their coverage and cost-sharing responsibilities i.e. deductibles and co-pays.

5.     Prior to or on the day of surgery, before services are provided, it is the Facility policy to collect in full all deductibles, co-insurance and copayments as determined by the patient's individual insurance company. If the patient is not able to fully pay his/her estimated deductible, co-insurance or copayment at the time of service, Care Credit is available and allows monthly payments to be made. For the application process, go to CareCredit.com.

If the patient has no insurance coverage, alternative payment arrangements will be reviewed with the patient.

6.     Medicare is accepted for certain services. Medicare patients are billed after payment from Medicare and secondary insurance if there is one for the balance of their accounts which is due 30 days from date of bill.

7.     Upon request and after discharge from the facility, the facility will provide an itemized statement within seven (7) business days of patient's request.

8. Upon request and after discharge, the facility shall make available the patient record that may be necessary for verification of the accuracy of patient's statement. The patient record will be provided within ten (10) working days of patient's request. Pursuant to AHCA Statute s.395.3025, F.S. if a copy of a patient record is requested, the facility may charge copy fees.

9.     A statement of account will be sent every month for three months. After 90 days a final statement will be sent allowing 10 days to pay. If no payment is received after the 10 days have passed, the account may then be placed with an attorney or collection agency to pursue such unpaid amounts. If accounts are placed with an attorney/ collection agency, the costs charged by the attorney/ collection agency will be passed on to the patient to pay, and the patient's credit score may be negatively impacted.

Links to Healthcare Related Data

Pursuant to AHCA Statue: s.405.05, F. S. Please find here a link to data, quality measures and statistics that are disseminated by AHCA.

www.Floridahealthfinder.gov

www.cms.gov/nosurprises 

Providers for Promenades Surgery Center: