If SurgCenter Pinellas believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, SurgCenter Pinellas may initiate contact with them to determine your cost-sharing responsibilities for SurgCenter Pinellas’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If SurgCenter Pinellas determines that you have cost-sharing responsibilities for SurgCenter Pinellas’s bill, in accordance with SurgCenter Pinellas’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. SurgCenter Pinellas’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 SurgCenter Pinellas, 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 SurgCenter Pinellas to be “charity care.” There is no formal application process for obtaining “charity care” at SurgCenter Pinellas. SurgCenter Pinellas’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 SurgCenter Pinellas, you can receive a good faith estimate of anticipated charges for the treatment of your condition at SurgCenter Pinellas. This estimate must be provided to you within seven (7) days of the request being received by SurgCenter Pinellas. 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 SurgCenter Pinellas at 727-408-5310.
Itemized Bill
Upon request and after discharge from SurgCenter Pinellas we will provide a statement within 7 working days of your request.
Provider Disclosure
Services may be provided in this health care facility by SurgCenter Pinellas 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 SurgCenter Pinellas. You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. SurgCenter Pinellas may contract with providers for pathology and anesthesiology services; these services are billed separately from SurgCenter Pinellas for their services. You may contact these providers through their contact information provided below.
SurgCenter Pinellas Providers
BayCare Outreach Laboratory Services
Morton Plant Hospital – Adler Institute of Lab Medicine
300 Pinellas Street Clearwater, Florida 33756
Phone: 855-269-3777
DR Anesthesia – ANESTHESIA BILLING
Bolder Healthcare Solutions
201 Montgomery Avenue Sarasota, FL 34243
Phone: 877-360-1566
Phone: 941-360-1566
Fax: 941-358-9818
IPG
2520 Northwinds Parkway, suite 300 Alpharetta, GA 30009
Phone: 866-753-0046
Patient Health Record
Upon request and after discharge from SurgCenter Pinellas, SurgCenter Pinellas 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.
To report a complaint or grievance, you can contact the facility Administrator by phone at 727-408-5310 or by mail at:
SurgCenter Pinellas
12416 66th St N Largo, Florida 33733