FINANCIAL INFORMATION

Patients will obtain physician/surgeon fees/copays from their surgeon’s office. Our CFLSC phone number is 863-646-3344. Our email address is deborah.sams@cflsc.com.

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 Lakeland Surgical & Diagnostic Center 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.

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. Lakeland Surgical 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

Amerigroup

Argus Dental and Vision

AvMed

Beech Street

Blue Cross/Blue Shield Medicare Advantage

Blue Cross/Blue Shield Medicare HMO/PPO

Blue Cross/Blue Shield Traditional

CarePlus

Champion National Security/Commercial

Champus Humana HMO/PPO

Champ VA

CIGNA

Coventry All Products

Division of Blind Services

Evolution Choice Network/Commercial/PPO

First Health PPO

Freedom Medicaid/Commercial/Products

Golden Rule HMO

Health Advantage PPO

Health Cost Solution

Health Net Federal Services

Humana Choice/HMO/Managed Medicare

Medicaid

Medicare

Medicare Railroad

Meritain Health

Molina Medicaid

Molina Medicare

Multiplan PPO

Optimum Medicare

Premier Eyecare/Medicaid Managed Care

Prestige Medicaid

Private Health Care System/PPO

Simply/Better Health

Southcare PPO

Staywell Health

Sunshine Medicare

Sunshine Medicaid Managed

Sunshine Healthy Kids

United Healthcare/all products

VA Authorized special

WellCare Medicare/Medicare Managed

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.