Patient Rights Under Florida Transparency Act Of 2016
Services Provided by ASC Surgery Center, a state-licensed health care facility.
The Central Florida Eye Institute Ambulatory Surgical Center provides patient care when Dr. Croley schedules a procedure for you. The facility has a fee that covers the following items: Nursing, technician and related services; use of the facility; testing for certain lab tests performed at the surgery center just as glucose (blood sugar), pregnancy, and hemoglobin; medications administered before, during and after your surgery while in the facility; surgical supplies used by the physician and staff; equipment used in the facility; surgical dressings; implants except those specifically classified as premium implants that require additional patient payment; certain types of drugs are also separately charged.
Services may be provided in this facility by the facility as well as by the health care provider who will separately bill the patient. In some instances, those separate health care providers may or may not participate with the same health insurers or health maintenance organizations (HMOs) as this facility. Patients and prospective patients should contact their health insurer or HMO to determine if the ASC and providers listed above are considered a network provider or preferred provider.
Another health care provider who will bill you separately for services includes your physician performing the procedure, an anesthesia provider who delivers anesthesia services to you at the facility and a pathology provider and laboratory which will analyze tissue your physician may require to be sent to the laboratory to diagnose your condition. You can contact the facility’s surgical coordinator about whether these other providers participate in your health plan.
The anesthesia providers are;
Name of anesthesia provider group: Scott Tanner, CRNA (effective 9-1-13)
Mailing address: 3133 SW 32 Avenue, Ocala, FL 34474
Telephone number: 1-352-237-8400
We may be required to send tissue for analysis by a pathology lab contracted with your health plan. Your insurer’s provider network information may include the pathology lab in the insurer’s network of providers. You may want to check with your insurer. Or, you can contact the laboratory directly about whether they participate in your health plan.
The pathology labs we send tissue to for analysis include:
Name of pathology lab: Labcorp
Mailing address: P.O.Box 2240 Burlington, NC 27216
Telephone number: 1-800-845-6167
Name of pathology lab: Quest
Mailing address: P.O.Box 740698 Cincinnati, OH 45274
Telephone number: 1-866-697-8378
Estimate of Charges
Patient or prospective patients may request from this facility and other health care providers an estimate of charges prior to receiving services. We will respond to you within seven days of your request.
Our estimate will be based upon the procedure your physician tells us that he or she plans to perform and the insurance information that you provide to us. We normally will contact your insurer to learn of your insurance policy coverage and benefits for the procedure and will then base our estimate upon what the insurer tells us about the benefits you have available for the procedure. The procedure your physician actually performs may differ from the initial one planned based upon your medical condition at the time of the procedure. Since we cannot forecast the change, the estimate will be based upon the planned procedure as scheduled by your physician.
You may pay less or more for this procedure or service at another facility or in another health care setting.
Health-Related Data and Pricing
Health-related data, including quality measures and statistics for defined procedures, can be found on the Agency for Healthcare Administration website at https://www.floridahealthfinder.gov The service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services and that actual cost will be based on services actually provided to the patient.
The average pricing for bundled procedures can also be found on the Agency for Healthcare Administration website: https://pricing.floridahealthfinder.gov.
Financial Assistance Arrangements
We only schedule procedures at this facility by physicians who are on the medical staff at the facility. Payment is expected prior to the surgery unless other arrangements have been made with our billing office. We do not offer financial assistance to patients; payment arrangements will be considered on a case-by-case basis. The surgery center does not provide charity care.
Prior to your scheduled procedure, we will contact you with the results of the verification of your insurance benefits to advise of your insurance deductible, coinsurance, and co-payment amounts that will be due from you prior to your surgery. We expect the amount estimate due to be paid prior to the surgery.
If we received a denial of payment from your insurer or Health Maintenance Organization, we will work to resolve the denial and may need assistance from you to do so. If we receive payment from your insurer or HMO that is less than originally estimated, we will notify you of additional payment due. Payment will be expected within 30 days of notification of the balance due. Failure to pay the balance due will result in further collections activity which may include your account being turned over to a collections agency.