Transparency in Healthcare

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

http://pricing.floridahealthfinder.gov/

*St Marks Surgical Center is required to let patients know to contact health care practitioners that may provide services to a patient while in the center regarding a personalized estimate.

*Anesthesiologists and Laboratory Testing are not part of St Marks fees.

St. Mark’s Surgical Center Financial Assistance and Collections Policy

• Individuals must meet one of the following criteria to be eligible for financial assistance:

o Any patient who does not qualify for Medicaid has limited funds but is capable and willing to settle the account for a lesser amount.

o Any minor parental responsibility cannot be established.

o Any self-paid patient who is indigent, transient and with no medical coverage available.

o Any patient not qualified for Medicaid, with limited funds, minimal or no insurance coverage, and is incapable of payment.

o Any patient who has exhausted his/her insurance benefits and demonstrates no -further ability to pay for services rendered.

o Any account returned to us by our collection agencies and is designated by the collection agency as being potentially eligible for: financial assistance.

o Any account in which an outside party (i.e., social worker, attorney, or caregiver) calls for the patient to inform us of financial difficulties.

o Any patient with a coinsurance, copay, or deductible greater than $500 by his or her insurance company, is not eligible for Medicaid, has limited funds, but is capable and willing to settle the account for a lesser amount; or

• Eligibility for financial assistance is based on family size, annual individual or family income and the current Federal Pove1ty Level ("FPL") Guidelines established by U.S. Department of Health and Human Services.

• Financial assistance will be available to alI eligible persons without discrimination on the grounds of race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, political affiliation or physical handicap. Services will not be denied to any person covered by a program such as Medicare or Medicaid.

• Applicants requesting financial assistance shall be required to furnish such information as may be requested by the Center to substantiate eligibility. Deductibles, estimates of copays and coinsurance amounts or non-covered services should be paid on or before the day of surgery. Payment arrangements can be made for patients who are unable to pay in full by the day of surgery. Payment plans will not extend past 90 days.