Financial Estimate for Your Procedure

At Florida Heart & Vascular Surgery Center we believe that transparency in healthcare pricing is essential for our patients. Understanding the potential costs of your procedure helps you make informed decisions about your care. We are committed to providing clear and accurate financial estimates in compliance with CMS and AHCA requirements.

What Is a Financial Estimate?

A financial estimate is a breakdown of the expected costs for your upcoming procedure at our center. This estimate includes the following categories of charges:

• Facility Fees: The cost for using our surgical facility, including staff, equipment, and supplies.

• Surgeon Fees: The fee charged by your surgeon for performing the procedure.

• Anesthesia Fees: The cost for anesthesia services, if applicable.

• Other Services: Any additional services, such as lab work, diagnostic imaging, or other treatments related to your procedure.

Please note that this is only an estimate. The final cost may vary depending on the specific services you receive during your procedure, changes in your treatment plan, or any unforeseen circumstances or complications.

Requesting a Financial Estimate

You can request a financial estimate for your upcoming procedure by contacting our billing office at 863-937-7232 or contact@flheartvascular.com. Please provide the following information to help us create an accurate estimate:

• Your name and contact information

• The specific procedure or service you are scheduling

• Your insurance information (if applicable)

• Any secondary or supplemental insurance details

• Whether your procedure requires anesthesia or other specialized services

Our financial counselors will work with you to verify your insurance coverage and provide an estimate based on your plan’s deductible, co-insurance, and out-of-pocket maximums.

Price Transparency Tool

As part of our commitment to transparency, we offer a Price Transparency Tool on our website. This tool allows you to view estimated costs for common procedures performed at our center. To use the tool:

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Understanding Your Financial Estimate

Your financial estimate will include the following components:

• Facility Fee: This fee covers the costs associated with the operation of our ambulatory surgery center, including nursing staff, surgical equipment, and other overhead expenses.

• Physician/Surgeon Fee: Your surgeon’s fee is separate from the facility fee and will be included in the estimate if applicable. If you are seeing an out-of-network provider, please be aware of potential additional costs.

• Anesthesia Fee: If your procedure requires anesthesia, this fee will be included in your estimate. Anesthesia services may be provided by an independent anesthesia provider, who will bill separately.

• Additional Services: If your procedure requires additional services, such as lab tests or diagnostic imaging, these will be listed in your estimate.

Please remember that this is an estimate and that the actual charges may vary based on the specific services rendered during your procedure.

Insurance and Financial Assistance

If you have insurance, we will work with your insurance provider to determine your coverage and help you understand what portion of the procedure will be covered by your plan. Your financial estimate will reflect:

• Your insurance’s negotiated rate with our facility.

• Your deductible, co-pay, or co-insurance amounts.

• Any out-of-pocket expenses you may be responsible for, based on your insurance coverage.

If you do not have insurance or if you are facing high out-of-pocket costs, we offer several options:

• Self-Pay Discounts: For patients without insurance, we offer discounted pricing based on a bundled payment for procedures. Please contact our financial office for details.

• Financial Assistance: For those experiencing financial hardship, you may qualify for our Charity Care Program or a payment plan. Our financial counselors can guide you through the process.

No Surprise Billing

In compliance with the No Surprises Act, you will not receive a surprise bill for emergency services or out-of-network care that you did not choose. If you receive services from an out-of-network provider at our center, we will ensure that you are informed of any potential out-of-pocket costs before the procedure.

Changes to the Estimate

The financial estimate is based on the information available prior to your procedure. It may change if:

• Additional services or treatments are required during the procedure.

• There are changes in your insurance coverage or benefits between the time the estimate is provided and your procedure date.

• Complications arise that require additional care or treatment.

If any changes occur, we will update your estimate and discuss the new financial obligations with you as soon as possible.

Contact Us for Financial Assistance

Our financial counselors are available to help you understand your financial estimate and answer any questions you may have about your procedure costs. If you need assistance, please contact our billing office at 863-937-7232 or email us at contact@flheartvascular.com.

We are committed to providing the highest level of care at a cost that is transparent and manageable for you.

Frequently Asked Questions

1. How accurate is my financial estimate?
While we strive to provide accurate estimates, actual costs may vary based on the specific services rendered, insurance coverage, and any changes to the treatment plan.

2. Will I be billed separately for anesthesia?
Yes, anesthesia services are typically billed separately. The anesthesia provider may be an independent contractor, but we will include an estimated anesthesia fee in your financial estimate.

3. How do I know if my procedure is covered by insurance?
Our financial counselors will verify your insurance benefits before your procedure and help you understand what portion of the procedure is covered by your plan.

4. What happens if I can’t afford the estimated cost?
We offer self-pay discounts, payment plans, and financial assistance for those who qualify. Please contact our financial office for more information.

CMS and AHCA Compliance

This Financial Estimate policy is designed to meet the requirements of CMS and AHCA by ensuring transparency, providing clear financial estimates, and protecting patients from surprise billing. In compliance with the No Surprises Act, we ensure that patients are fully informed of their potential financial obligations before receiving care, promoting a fair and transparent billing process.

CMS: The policy provides accurate and understandable financial estimates, as required by CMS regulations, and ensures that patients with Medicare or Medicaid receive the necessary information about their coverage and out-of-pocket costs.

AHCA: The financial estimate complies with AHCA standards by offering clear, upfront pricing for services and procedures, ensuring that patients in Florida have access to the information they need to make informed decisions about their healthcare.