Financial Assistance Policy

If Surgicath LLC believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, Surgicath LLC may initiate contact with them to determine your cost-sharing responsibilities for Surgicath LLC’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If Surgicath LLC determines that you have cost-sharing responsibilities for Surgicath LLC’s bill, in accordance with Surgicath LLC’s financial assistance policies, you will be required to pay your cost-sharing responsibilities in full on or before the date that Services are provided. Surgicath LLC’s financial assistance policies are that if you are unable to pay your cost-sharing responsibilities in full on or before the date that Services are provided, because you believe you are medically indigent or you are not covered by any health insurance or HMO, then upon request Surgicath LLC, in its sole discretion, may offer you a discount on the amount due and/or offer a payment plan. Any such discount is considered by Surgicath LLC to be “charity care.” There is no formal application process for obtaining “charity care” at Surgicath LLC. Surgicath LLC’s standard collection policy is to produce and send one or more bills to patients for their cost sharing amount.

Good Faith Estimate

Upon your request, and before the provision of non-emergency care at Surgicath LLC, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Surgicath LLC. This estimate must be provided to you within seven (7) days of the request being received by Surgicath LLC. You should contact your insurer or health maintenance organization regarding your cost-sharing responsibilities. You may request and obtain a Good Faith Estimate by calling Surgicath LLC at 561-790-8630.

Itemized Bill

Upon request and after discharge from Surgicath LLC we will provide a statement within 7 working days of your request.

Provider Disclosure

Services may be provided in this health care facility by Surgicath LLC 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 Surgicath LLC. You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. Surgicath LLC may contract with providers for pathology and anesthesiology services; these services are billed separately from Surgicath LLC for their services. You may contact these providers through their contact information provided below.

Surgicath LLC Providers

St. Lucie Anesthesia 877-684-9114

Quest Diagnostics 866-697-8378

Ameripath 800-395-7284

LabCorp 800-877-7831

Patient Health Record

Upon request and after discharge from Surgicath LLC, Surgicath LLC will make available the patient record that may be necessary for verification of the accuracy of your patient statement within 10 working days of your request.

Link to Healthcare Related Data

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

www.Floridahealthfinder.gov