Fees & Financing
No Surprises Act
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn't be charged more than your plan's copayments, coinsurance and/or deductible.
What is "balance billing" (sometimes called "surprise billing")?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn't in your health plan's network.
"Out-of network" means providers and facilities that haven't signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what you plan pays and the full amount charged for a service. This is called "balance billing." This amount is likely more than in-network costs for the same service and might not count toward your plan's deductible or annual out-of-pocket limit.
"Surprise billing" is an unexpected balance bill. This can happen when you can't control who is involved in your care--like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.
Your're protected from balance billing for:
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan's in-network cost-sharing amoung (such as copayments, coinsurance and deductible). You can't be balance billed for these emergency services. This includes services you may get after you're in stable condition, unless you give written consent and give up your protections not to be balance billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan's in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can't balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other types of services at these in-network facilites, out-of-network providers can't balance bill you, unless you give written consent and give up your protections.
You're never required to give up your protections from balance billing. You also aren't required to get out-of-network care. You can choose a provider or facility in your plan's network.
When balance billing isn't allowed, you also have these protections:
- You're only responsible for paying your share of the cost (like the copayments coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly. Generally, your helath plant must:
- Cover emergency services without requiring you to get approval for services in advance (also known as "prior authorization").
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.
If you think you've been wrongly billed, contact Centers for Medicare & Medicaid Services (CMS) No Surprises Help Desk at 800-985-3059.
Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law.
Our business office team will be glad to submit claims to insurance companies with whom we participate or Medicare for the Aesthetic Plastic Surgery Center charges. Standard outpatient procedures are usually covered by your medical insurance or Medicare. You will receive separate bills from the Aesthetic Plastic Surgery Center, your physician, and your anesthesiologist if one is used. You may also receive a bill for any laboratory, pathology, or diagnostic services that you receive.
Depending on your coverage, you may be asked for partial payment upon admission to the Center. We make every effort to inform you of this amount prior to your admission. When you arrive for surgery, you should be prepared to pay all co-payments and your deductible if it has not been met. Contact your health insurer or HMO for anticipated cost sharing responsibilities.
For your convenience, we accept MasterCard, VISA and American Express credit cards. We also accept cashier's checks and money orders. Please notify the office ahead of time if you plan to use CareCredit.
If we need additional insurance information, or if you need to make a payment at the time of your surgery, one of our business office team members will contact you prior to your procedure. He or she will collect necessary insurance information to assist with your registration process.
If you have not heard from us within 48 hours before your procedure, or if you have any questions regarding any of this information, please call us at 941-484-6836.
Services may be provided in this health care facility by the facility 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 the facility.
You can view The Agency for Healthcare Administration (AHCA) pricing website at: www.pricing.floridahealthfinder.gov Information found at this link is an estimate of costs that may be incurred. Actual costs will be based on the services performed.
Service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services and that actual costs will be based on services actually provided to the patient. Actual costs may exceed the estimate. Patients and prospective patients may request from this facility and other health care providers a more personalized estimate of charges and other information. Patients and prospective patients should contact each health care practitioner anticipated to provide services while in the surgery center regarding a personalized estimate, billing practices and participation with the patient's insurance provider or health maintenance organization (HMO) as the practitioners may not participate with the same health insurers or HMO as the center. Contact information is listed below.
Pathology services used as of September 1, 2018 include:
Global Pathology Aurora Diagnostics 16250 N.W. 59th Ave, Suite 201, Miami Lakes, FL 33014 866-825-4422
Suncoast Pathology 446 S. Tamiami Tr. 2nd Floor, Venice, FL 34285 941-483-3319
Quest Diagnostics 4225 E. Fowler Ave., Tampa, FL 33617 866-697-8378
SaraPath Diagnostics 2001 Webber St., Sarasota, FL 34239 941-362-8900
Radiology services used as of January 1, 2016 include:
Radiology Associates of Venice & Englewood 512-516 Nokomis Ave. S., Venice, FL 34285 941-488-7781
CareCredit®, Patient Financing-Please notify the office when scheduling if you plan to use CareCredit.
It’s something you’ve always wanted to do, but something else was always there to hold you back. Well, not anymore. We offer CareCredit®, a card designed specifically for your health and beauty needs. CareCredit can help you move forward with getting the procedure you’ve always wanted. With convenient monthly payment options, no up-front costs, no prepayment penalties and no annual fees, you can get your procedure sooner. Apply through CareCredit directly at www.carecredit.com.
CareCredit works just like a credit card, but is exclusive for healthcare services. With low monthly payments every time you use it, you can use your card over and over for follow-up appointments or different procedures. This means you don’t have to put your health and beauty needs on hold until you save up enough money. It gives you the power to decide when it’s the right time for you.
Our Financial Assistance Policy is available here, click to view or download a PDF or Word version of the document.
Good Faith Estimates For Cosmetic Procedures and Uninsured or Self-Pay Individuals
You will receive a cost estimate for cosmetic procedures. Payment is due IN FULL 14 days prior to the scheduled procedure date. For cosmetic procedures performed at the Aesthetic Plastic Surgery Center (APSC) the cost estimate is the total cost and includes the doctor's fee, supplies, anesthesia, nursing care, and pre & postoperative visits for 6 months. Any complications requiring surgery are billed separately. There may be additional fees for services not provided at the APSC.
For cosmetic procedures performed at the hospital the cost estimate includes the doctor's fee and pre & postoperative visits for 6 months. There will be additional fees for the hospital and anesthesiologist. If a chest X-ray, EKG, or other tests are required they will be billed in addition to the hospital cost quoted. All additional fees are subject to change without notice.
For uninsured and self-pay individuals a cost estimate will be provided.
If you cancel your procedure within 14 days of the scheduled procedure date for any reason you will be charged a $300.oo cancellation fee. If you cancel your procedure within 48 hours of the scheduled procedure date for any reason you will be subject to a fee of $1,000.00 or more.
Accounts may be turned over to a collection agency if past due 90 days or more. Patients are legally responsible for all collection costs involved with the collection of the account including court costs, reasonable attorney fees, and all other expenses incurred with collection if patient defaults on any unpaid balances.