If Capital City Surgery Center of Florida believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, Capital City Surgery Center of Florida may initiate contact with them to determine your cost-sharing responsibilities for Capital City Surgery Center of Florida’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If Capital City Surgery Center of Florida determines that you have cost-sharing responsibilities for Capital City Surgery Center of Florida’s bill, in accordance with Capital City Surgery Center of Florida’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. Capital City Surgery Center of Florida’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 Capital City Surgery Center of Florida, 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 Capital City Surgery Center of Florida to be “charity care.” There is no formal application process for obtaining “charity care” at Capital City Surgery Center of Florida. Capital City Surgery Center of Florida’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 Capital City Surgery Center of Florida, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Capital City Surgery Center of Florida. This estimate must be provided to you within seven (7) days of the request being received by Capital City Surgery Center of Florida. 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 Capital City Surgery Center of Florida at (850) 402-4107.
Itemized Bill
Upon request and after discharge from Capital City Surgery Center of Florida we will provide a statement within 7 working days of your request.
Provider Disclosure
Services may be provided in this health care facility by Capital City Surgery Center of Florida 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 Capital City Surgery Center of Florida. You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. Capital City Surgery Center of Florida may contract with providers for pathology and anesthesiology services; these services are billed separately from Capital City Surgery Center of Florida for their services. You may contact these providers through their contact information provided below.
Capital City Surgery Center of Florida Providers
Upon request and after discharge from Capital City Surgery Center of Florida, Capital City Surgery Center of Florida 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