Florida Price Transparency
South Florida Same Day Surgery Center complies with Florida price transparency requirements. The information below provides information and links defined by these requirements.
The Agency for Health Care Administration (AHCA) has developed websites prospective patients can use to learn more about quality and costs for health care in Florida. These websites include Florida Health Finder and Florida Health Price Finder. The AHCA price finder website is based on payment information for the entire state of Florida and does not provide a personalized estimate of charges. A more personalized estimate can be obtained by calling 402-216-5226. The following information is required before using these options:
- Description of services — you will need to provide a description of the medical service you are seeking or the CPT procedure code, which can be obtained from your attending or referring physician.
- Name of your insurance.
- Type of insurance – for example: PPO, HMO, POS, Medicare, Medicaid, self-pay, personal injury.
INSURANCES ACCEPTED
- Medicare
- Medicaid
- Cigna Commercial (PPO, HMO, POS)
- Cigna Medicare Advantage
- Aetna Commercial (PPO, HMO, POS)
- Aetna Medicare Advantage
- Humana Medicare Advantage
- Workers Compensation
- BCBS with Out-of-Network coverage
- United Healthcare with Out-of-Network Coverage
Financial Information
South Florida Surgery Center is committed to providing clear financial information to our patients. Before your scheduled procedure, we will provide an estimate of the surgery center’s fees and your anticipated financial responsibility, including coinsurance, copayments, or deductibles, which must be resolved prior to or on the day of surgery. Please note that failure to address payment issues in advance may result in postponement of your procedure.
The estimate is based on the procedure your physician has scheduled. However, unforeseen circumstances during the procedure may require additional or different treatments or the use of varying supplies or implants, which could impact the final charges. The final cost and your responsibility will depend on the actual services provided and may differ from the original estimate.
In accordance with Florida law, upon written or verbal request, South Florida Surgery Center will provide a good faith estimate of anticipated gross charges for the procedure(s) recommended by your physician. This estimate will be provided within seven (7) business days. If you have insurance, the contracted rates with your insurer will apply and supersede the gross charges estimate.
You may also receive separate bills from other providers involved in your care, such as:
- Your physician or surgeon
- Anesthesia services
- Laboratory testing, if required
- Pathology services for tissue or specimens removed during surgery
- Durable medical equipment
Please direct any questions about these additional services to their respective billing offices.
Bundled Payments
Medicare initiated the Bundled Payments for Care Improvement (BPCI) that ensures facilities enter payment arrangements that include financial and performance outcomes for episodes of care. These outcomes lead to higher quality and lower cost to Medicare. Previously Medicare would make separate payments to providers for each service provided during a single course of treatment leading to fragmented care and outcomes (CMS, 2016). Patients have the right to price transparency and what is included in bundled services or a single fee that accounts for several components to care.
Beneficiary Choice
Patients can always choose which providers or facilities to obtain care. Patients will retain their full Medicare benefits regardless. The redesign is to improve quality of care while lowering the cost of care to Medicare.
Bundled Payment Process
Patients who private pay for services may benefit from bundled payments as it allows for more timely allowance to prepare financially for services. Private pay patients can expect a $500 facility fee that includes imaging, medication and supplies during the procedure in addition to the separate procedure fee. Patients have the choice of what facility they would like to receive treatment from.
Note: The 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
For your convenience, we accept MasterCard, Visa, cash, and personal checks (with a valid photo ID).
Please contact the anticipated healthcare providers for services while in the surgery center regarding a personalized estimate, billing practices and participation with your insurance provider or health maintenance organization (HMO) as the practitioners may not participate with the same health insurers or HMO at the center. Please contact the surgery center for the providers who will bill separately.
Patients receiving care at South Florida Surgery Center may also receive services from healthcare practitioners not directly employed by the center. These practitioners may have their own billing practices and may not participate with the same health insurers or health maintenance organizations (HMOs) as the center. We encourage you to contact the practitioners anticipated to provide your care to request a personalized estimate, inquire about their billing practices, and confirm their participation with your insurance provider or HMO. For assistance identifying these practitioners, please contact our office.
If you have any additional questions or concerns, please South Florida Same Day Surgery Center at 402-216-5226 for more information.