Financial Assistance

Good Faith Estimate

Upon your request, and before the provision of non-emergency care at Transformations Surgery Center, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Transformations Surgery Center. This estimate will be provided to you within seven (7) days of the request being received by the center. 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 our center at 813-563-1144. 

Information on payments made to the facility for defined service bundles and procedures, you can visit the Agency for

 

Healthcare Administration’s pricing website at

http://pricing.floridahealthfinder.gov

 

The service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services, and actual costs will be based on services actually provided to the patient.

Collection Policy

As a courtesy to our patients, we will file an insurance claim on behalf of the patient to his/her insurance plan. A patient is expected to respond to his/her insurance plan’s request for information timely, as needed, in order to minimize processing delays with the claim.

Patients are expected to pay their financial obligations in a timely manner including the estimated portion by the day services are received, and any remaining portion upon finalization of the claim by the payer. Unpaid claims by the payer may result in the account’s outstanding balance being fully transferred to the patient for collection.

If needed, the center will attempt to reach a patient by any method available to us to secure payment on the outstanding balance utilizing internal and external resources. Beyond us contacting your insurance carrier, you should also contact your insurer or health maintenance organization regarding your cost-sharing responsibilities for having a procedure at our facility.

 

Financial Assistance

Our financial assistance program offers a variety of ways to reduce a patient’s financial responsibility for services rendered by the surgery center. Our program structures a balance between offering the patient a reduced financial liability while still complying with insurance contract obligations and Federal and state regulations. Please contact our facility’s business office at 813-563-1144 for further information on our policies as reflected below. Surgeons, anesthesiologists, and other service providers (such as pathologists or laboratories) bill for their services separately from the surgery center and may offer their own financial assistance program—please contact them for further information regarding their services.

Application Process

You may request the facility to provide details for any of the elements within the financial assistance program. Certain policies have an application process requiring the patient to submit additional financial and household information to determine qualification of the available assistance.

Payment Plans

Each patient is expected to pay his/her estimated financial liability on or before the day of service. In the event a patient is unable to pay the estimated liability in full, our surgery center may offer a short-term repayment schedule after a minimum down payment is made. For an extended repayment schedule, a patient may need to secure financing with an outside source. Please consult with our surgery center’s business office at 813-563-1144 for further information.

Uninsured Discounts

Patients who are not eligible to receive services paid for by insurance or other third-party payment sources may be eligible to receive an uninsured discount from our facility. This discount does not apply for cosmetic surgery services as defined by our facility. The discount is a set percentage off of charges and is subject to change. If a patient’s services are subsequently found to be covered by insurance or other third-party payment source, the uninsured discount may be disallowed.

 

Charity Care

 

The center maintains a charity discount policy which provides financial relief to patients who receive medically necessary care and who do not qualify for state or Federal assistance and are unable to pay the estimated or remaining financial responsibility in part or in full. A patient must meet the policy’s household income qualifications which are based on Federal Poverty Level Guidelines (revised annually). Submission of supporting documentation is required to validate a patient’s qualifying status.

 

Out of Network

 

A patient receiving treatment at our surgery center under insurance with which our facility is out of network may be eligible to receive an adjustment to their assigned out of network patient liability, assuming our facility is not prohibited from offering Out of Network adjustments under state/Federal laws or your insurance company’s provisions. If not prohibited, the application of any out of network discount is subject to vary based on a patient’s benefit coverage. Accounts which become delinquent may have the adjustment disallowed.

 

Other Providers

 

Services are 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. Again, we encourage you to contact your insurer or health maintenance organization regarding your cost-sharing responsibilities for having a procedure at our facility.

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 who will provide services in this surgery center to determine the health insurers and health maintenance organizations with which the health care practitioner participates as a network provider or preferred provider.

Contracted Service Providers

The following providers render services to patients at Transformations Surgery Center and the patients should contact them directly if they need further information.

Surgeons:

 

Larry Fishman, MD

  • Florida Surgery Consultants

         35111 US 19 North Suite 301

         Palm Harbor, FL 34684

        Phone: (888) 411-6824

Jonathan Hall, MD

  • Florida Surgery Consultants

         35111 US 19 North Suite 301

         Palm Harbor, FL 34684

         Phone: (888) 411-6824

Richard Katz, MD

  • Florida Surgery Consultants

         35111 US 19 North Suite 301

         Palm Harbor, FL 34684

         Phone: (888) 411-6824

  • The Katz Orthopaedic Institute

         14153 Yosemite Drive, Suite 103

         Hudson, FL 34667

         Phone: (727) 869-2663

Aaron Mates, MD

  • Florida Joint Care Institute

         2165 Little Rd

         Trinity, FL 34655

         Phone: (727) 372-6637

Raj Ambay, MD

  • Ambay Plastic Surgery

         2441 Oak Myrtle Lane Suite 102

         Wesley Chapel, FL 33544

         Phone: (813) 406-4448

  • 360 Dermatology

         2441 Oak Myrtle Lane Suite 101

         Wesley Chapel, FL 33544

         Phone: (813) 406-4835

  • Florida Surgery Consultants

         35111 US 19 North Suite 301

         Palm Harbor, FL 34684

         Phone: (888) 411-6824

Aparna Ambay, MD

  • 360 Dermatology

         2441 Oak Myrtle Lane Suite 101

         Wesley Chapel, FL 33544

         Phone: (813) 406-4835

 

 

Anesthesia:

Magnolia Anesthesia Consultants

301 South Magnolia Ave 

Tampa, FL 33606

Phone: (813) 362-3718

Fax: (813) 258-2104

Olympia Anesthesia, LLC

16618 Villalenda De Avila 

Tampa, FL 33613

Radiology:

Elite Radiology Service

7842 Land O' Lakes Blvd Suite 119

Land O' Lakes, FL 34638

Phone: (941) 376-0739

Neuromonitoring Services:

US IOM Neuromonitoring Services

111 Boland Suite 211

Fort Worth, Texas 76107

Phone: (214) 315-6432

 

Pathology:

This surgery center submits species to different pathology providers so please inquire with the facility as to which pathology will be used. Some pathology providers may engage specialized pathologists to assist in examining the patients specimen.

 

Patients may access the State of Florida’s Agency for Healthcare Administration website at this link for information about this facility and others: www.floridahealthfinder.gov