Financial Assistance Policy

If Pediatric Surgery Centers believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, Pediatric Surgery Centers may initiate contact with them to determine your cost-sharing responsibilities for Pediatric Surgery Centers’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If Pediatric Surgery Centers determines that you have cost-sharing responsibilities for Pediatric Surgery Centers’s bill, in accordance with Pediatric Surgery Centers’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. Pediatric Surgery Centers’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 Pediatric Surgery Centers, 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 Pediatric Surgery Centers to be “charity care.” There is no formal application process for obtaining “charity care” at Pediatric Surgery Centers. Pediatric Surgery Centers’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 Pediatric Surgery Centers, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Pediatric Surgery Centers. This estimate must be provided to you within seven (7) days of the request being received by Pediatric Surgery Centers. 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 Pediatric Surgery Centers at 1-813-490-6100. 

Itemized Bill

Upon request and after discharge from Pediatric Surgery Centers we will provide a statement within 7 working days of your request.

Provider Disclosure

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

Pediatric Surgery Centers Providers

Quest Diagnostics

GI Pathology

Upon request and after discharge from Pediatric Surgery Centers, Pediatric Surgery Centers 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

Patient Complaint or Grievance

To report a complaint or grievance, you can contact the facility Administrator by phone at 1-813-490-6100 or by mail at:
Pediatric Surgery Centers
10080 Balaye Run Drive