Pricing Estimates and Information
What is pricing transparency? Pricing Transparency describes a set of healthcare industry initiatives geared towards providing meaningful pricing information to patients having procedures in hospitals and ambulatory surgery centers. The Center for Endoscopy is committed to presenting pricing information on its website as well as providing information about financial assistance, payment plans and collection procedures. We will also provide a list of any out of any potential out of network providers billing separately, and patients rights to request more personalized estimates of charges.
What services are included in my bill estimate?
If you are viewing estimates provided on this website, the pricing includes estimated out patient services, supplies, nursing care and equipment use. You may call to request a more personalized estimate of charges and other information and we will provide that to you within seven days of your request.
What services are excluded from my bill estimate?
Your Gastroenterologist's professional fee or other professionals providing you with anesthesia and pathology services will bill you separately. These providers will bill you seperately and may or may not participate with the same health insurers or health maintenance organizations as the facility. You may call these health care providers for a more personalized estimate of charges and to find out if they are in network with your insurance plan. You may visit the staff section of this webpage to find your physician and a link to their office with contact information. The anesthesia services at our center are provided by Suncoast Anesthesia Partners, 4754 East SR 64, Bradenton, FL 34208 and they can be reached at 888-337-3509. The pathology services are performed by Florida Digestive Health Specialists, 10920 Technology Terrace, Lakewood Ranch, FL 34275 and can be reached at 941-757-4820.
How often is the pricing estimate data refreshed?
It is our intention to update the data used on our website annually.
What does "Uninsured" mean?
It means that you have to pay for your services and that you do not have coverage for the surgical services by a third party like Medicare, Medicaid, Workers Compensation or an insurance company. "Self Pay is another term commonly used to describe Uninsured patients.
Can I rely on the pricing estimates posted on this website if I have insurance?
The amounts listed are estimates of what an Uninsured Patient would have to pay. If you have insurance or some form of medical coverage, your out of pocket typically can include a deductible, coinsurance, co-payment or even non-covered services. The contracted terms negotiated by your insurance company will dictate the prices for your services. For a more accurate estimate, we will need to verify your specific plan benefits for the procedure you're having done. Please give us a call for this estimate.
When I call for a pricing estimate, what information do I need to have available?
Before you call, it is a good idea to contact your physician's office to get the best description possible of the services that you need. Then, if you have insurance, contact your insurance company and make sure that the services required are "covered services" under your specific plan. If they are not "covered", then you would be considered "uninsured" for these services. Please also provide the procedure type, physician name and insurance information including ID number, group name and number, policy holder name and insurance company phone number located on the back of the card. If you are not the policy holder you may need to provide the date of birth and ss number of the guarentor in order for us to verify benefits with the insurance carrier.
Can I get an exact pricing quote?
We are unable to provide an exact quote but will do our best to provide you with a pricing range based on our historical pricing for comparable services. Price quotes are not guaranteed since the findings can vary and determine whether a screening is now considered a diagnostic procedure requiring potential biopsies or other diagnostic procedures.
What is expected of patients in terms of payment?
For insured patients we will collect any copayment, coinsurance and/or deductibles at the time of arrival. After your insurance company pays us, we will send you information about any amount you may still owe. For uninsured patients, we expect payment at time of service for the estimated price of your services. A payment plan may be approved under certain circumstances in which case we will collect half up front and the remainder over the next three months. We accept major credit cards, checks, money orders and cash.
Do you have a Charity policy?
We do not have a charity policy but do have a financial hardship policy for uninsured patients who meet the criteria for government assistance as listed on www. benefit.gov. The current requirements are income less than 133% of the federal poverty guidelines based on household size. A financial Hardship Declaration form must be completed and submitted with documentation of income. Documentation may include the most recent federal tax return, 12 months of bank statements or paystubs or unemployment statements for everyone in the householod over 18 years of age. If the patient qualifies we will reduce our rates to the current Medicare allowable rates and collect 50% of the amount at the time of the procedure with the remainder on a monthly payment plan. The financial hardship declaration form is located on this website in the new patient forms section. Underinsured patients who qualify for financial hardship will be responsible for the contracted allowable form their helath plan but may take advantage of the payment plan as outlined above. Please call our center at 941-552-3480 if you have any questions or concerns.
How does the insurance billing process work?
We outsource our billing to a Central Billing Office that will send your claim to your insurance company. After they pay us, the billing company will send you a statement with and balance due that was not paid upon arrival at our facility. It is important to remember that you are bound by the terms of your insurance policy and if you do not follow them there is a chance they may not pay for all or part of your care. For any questions or concerns relating to your bill or for an itemized statement please call our billing company: Florida Digestive Health Specialists, 10920 Technology Terrace, Lakewoord Ranch, FL 34275 at 941-757-4820