Financial Assistance Policy

If C-Med Ambulatory Surgery Center believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, C-Med Ambulatory Surgery Center may initiate contact with them to determine your cost-sharing responsibilities for C-Med Ambulatory Surgery Center’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If C-Med Ambulatory Surgery Center determines that you have cost-sharing responsibilities for C-Med Ambulatory Surgery Center’s bill, in accordance with C-Med Ambulatory Surgery Center’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. C-Med Ambulatory Surgery Center’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 C-Med Ambulatory Surgery Center, 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 C-Med Ambulatory Surgery Center to be “charity care.” There is no formal application process for obtaining “charity care” at C-Med Ambulatory Surgery Center. C-Med Ambulatory Surgery Center’s standard collection policy is to produce and send one or more bills to patients for their cost sharing amount.

 

Financial Hardship Application
Click HERE for the financial hardship application

 

Good Faith Estimate

Upon your request, and before the provision of non-emergency care at C-Med Ambulatory Surgery Center, you can receive a good faith estimate of anticipated charges for the treatment of your condition at C-Med Ambulatory Surgery Center. This estimate must be provided to you within seven (7) days of the request being received by C-Med Ambulatory Surgery Center 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 C-Med Ambulatory Surgery Center at 727-797-7463.

 

Itemized Bill

Upon request and after discharge from C-Med Ambulatory Surgery Center we will provide a statement within 7 working days of your request, barring any unusual circumstances.

 

Provider Disclosure

Services may be provided in this health care facility by C-Med Ambulatory Surgery Center 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 C-Med Ambulatory Surgery Center.  You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. C-Med Ambulatory Surgery Center may contract with providers for pathology and anesthesiology services; these services are billed separately from C-Med Ambulatory Surgery Center for their services.  You may contact these providers through their contact information provided below.

 

C-Med Ambulatory Surgery Center’s Providers

Kodiak Anesthesiology

187 97th Ave NE

St Petersburg 33702

727-724-5653

 

We may be required to send tissue for analysis by a pathology lab contracted with your health plan. Your insurer’s provider network information may include the pathology lab in the insurer’s network of providers. You may want to check with your insurer.  Or, you can contact the laboratory directly about whether they participate in your health plan.

 

Physicians