Billing Information - HSS at NCH
Billing Process
HSS at NCH Ambulatory Surgery Center is committed to making your financial experience as smooth as possible. Our team will contact you prior to your surgery date to review your insurance coverage and financial responsibilities.
Before Your Surgery
Our billing specialists will verify your health insurance coverage, including deductibles and co-payments. We’ll discuss your estimated financial responsibility, so you know what to expect before your procedure.
You can access your billing information through MyChart for convenient review and management of your account.
Payment Options
We offer several payment methods to accommodate your needs:
Accepted on-site at our facility
Personal checks accepted with valid ID
All major credit cards accepted
Special financing options available
A written estimate of your financial responsibility will be provided upon request. Please note that payment is due prior to or on the day of your surgery, so remember to bring your preferred form of payment.
After Your Surgery
Following your procedure, we will bill your insurance company for covered services. You will receive separate bills from:
- The facility (HSS at NCH Ambulatory Surgery Center)
- Your surgeon
- The anesthesiologist
- Pathology services (if applicable)
Any costs not covered by your insurance will be billed directly to you.
Questions? For any billing questions or concerns, please call 239-350-5478.
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is "Balance Billing" (Sometimes Called "Surprise Billing")?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You Are Protected from Balance Billing For:
- Emergency services – If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
- Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
- If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
Your Health Plan Generally Must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
Additional Protections When Balance Billing Isn't Allowed
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
The Agency for Health Care Administration maintains an interactive, searchable pricing website to provide data on health care costs for national, state and county prices.
Information regarding bundle services and procedures is available. The service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services and that actual costs will be based on services actually provided to the patient.
Please do not hesitate to contact our business office with any concerns or questions regarding your coinsurance and/or payment options. You may also contact our billing office to review our Financial Assistance Policy.
For billing questions, please call 239-350-5478.
Payment Plans and Financial Assistance
For payment plans, financial assistance plans, or charity care discounts please call the billing office to see if you qualify at 239-350-5478.
Collection Policy
HSS at NCH Ambulatory Surgery Center’s standard collection policy is to produce and send thee statements for their cost sharing amount. If payment is not received within 90 days of date of service, the balance will be turned over to collections.
Please note that other providers such as anesthesiologist, intraoperative monitoring services, durable medical suppliers and anatomical pathologists may provide services to you at the facility that are not part of the facility’s fees. If any of their services are provided to you while being a patient of this facility, the provider (s) will bill separately for their services rendered. These include:
USAP Anesthesia Partners
851 Trafalgar Ct Suite 200 E
Mailand, FL 32751
Naples Pathology Associates
PO Box 166324
Miami, FL 33116
Quest Diagnostics
Questdiagnostics.com
Insurance Network Verification
Patients and prospective patients should contact each health care practitioner who will provide services in the facility or as an external service to determine the health insurers and health maintenance organization (HMO) with which the Health Care practitioner participates as a network provider or preferred provider.
Good Faith Estimate
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions about your rights regarding surprise billing or Good Faith Estimates, visit www.cms.gov/nosurprises or call 1-800-985-3059.
