Financial Assistance Policy
If SurgCenter of Greater Jacksonville believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, SurgCenter of Greater Jacksonville may initiate contact with them to determine your cost-sharing responsibilities for SurgCenter of Greater Jacksonville’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If SurgCenter of Greater Jacksonville determines that you have cost-sharing responsibilities for SurgCenter of Greater Jacksonville’s bill, in accordance with SurgCenter of Greater Jacksonville’s financial assistance policies, you will be required to pay your cost-sharing responsibilities in full on or before the date that Services are provided. SurgCenter of Greater Jacksonville’s financial assistance policies are that if you are unable to pay your cost-sharing responsibilities in full on or before the date that Services are provided, because you believe you are medically indigent or you are not covered by any health insurance or HMO, then upon request SurgCenter of Greater Jacksonville, in its sole discretion, may offer you a discount on the amount due and/or offer a payment plan. Any such discount is considered by SurgCenter of Greater Jacksonville to be “charity care.” There is no formal application process for obtaining “charity care” at SurgCenter of Greater Jacksonville. SurgCenter of Greater Jacksonville’s standard collection policy is to produce and send one or more bills to patients for their cost sharing amount.
Good Faith Estimate
Upon your request, and before the provision of non-emergency care at SurgCenter of Greater Jacksonville, you can receive a good faith estimate of anticipated charges for the treatment of your condition at SurgCenter of Greater Jacksonville. This estimate must be provided to you within seven (7) days of the request being received by SurgCenter of Greater Jacksonville. 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 SurgCenter of Greater Jacksonville at (904) 586-8540.
Itemized Bill
Upon request and after discharge from SurgCenter of Greater Jacksonville we will provide a statement within 7 working days of your request.
Provider Disclosure
Services may be provided in this health care facility by SurgCenter of Greater Jacksonville 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 SurgCenter of Greater Jacksonville. You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. SurgCenter of Greater Jacksonville may contract with providers for pathology and anesthesiology services; these services are billed separately from SurgCenter of Greater Jacksonville for their services. You may contact these providers through their contact information provided below.
SurgCenter of Greater Jacksonville Providers
Anesthesiology :
Allegiant Anesthesia, LLC.
577 Mulberrt St., Suite 110
Macon, Ga. 31201
(888) 728-0228, ext. 1
https://www.allegiantanesthesia.org/
Pathology:
Quest Diagnostics :
(866) 697-8378
https://www.questdiagnostics.com/
DME :
NextStage Medical
https://nextstagemedical.com/
Upon request and after discharge from SurgCenter of Greater Jacksonville, SurgCenter of Greater Jacksonville will make available the patient record that may be necessary for verification of the accuracy of your patient statement within 10 working days of your request.
Link to Healthcare Related Data
Pursuant to AHCA Statute: s.405.05,F.S. please find here a link to data, quality measures, and statistics that are disseminated by AHCA.
Patient Complaint or Grievance
To report a complaint or grievance, you can contact the facility Administrator by phone at (904) 586-8540 or by mail at:
SurgCenter of Greater Jacksonville
9143 Philips Hwy Ste 500, Jacksonville, FL 32256