Financial Assistance Policy
If Tavares Surgery Center believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, Tavares Surgery Center may initiate contact with them to determine your cost-sharing responsibilities for Tavares Surgery Center’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If Tavares Surgery Center determines that you have cost-sharing responsibilities for Tavares Surgery Center’s bill, in accordance with Tavares 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. Tavares 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 Tavares 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 Tavares Surgery Center to be “charity care.” There is no formal application process for obtaining “charity care” at Tavares Surgery Center. Tavares Surgery Center’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 Tavares Surgery Center, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Tavares Surgery Center. This estimate must be provided to you within seven (7) days of the request being received by Tavares 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 Tavares Surgery Center at (352) 508-5401.
Itemized Bill
Upon request and after discharge from Tavares Surgery Center we will provide a statement within 7 working days of your request.
Provider Disclosure
Services may be provided in this health care facility by Tavares 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 Tavares Surgery Center. You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. Tavares Surgery Center may contract with providers for pathology and anesthesiology services; these services are billed separately from Tavares Surgery Center for their services. You may contact these providers through their contact information provided below.
Tavares Surgery Center Providers
Pathology
EndoChoice Inc.
11405 Old Roswell Rd
Alpharetta, GA 30009
Phone: 888-682-3636
Mid-Florida Pathology
120 East North Blvd., Suite 102
Leesburg, FL 34748
Phone: 352-460-0292
Lake Gastroenterology Associates - Pathology
1858 Mayo Drive
Tavares, FL 32778
Phone: 352-383-5200
Pathology Laboratories
822 Perkins Street
Leesburg, FL 34748
Phone: 352-315-4111
Keller & Goodman, M.D., P.A.
1879 Nightingale Lane, Suite C-2
Tavares, FL 32778
Phone: 352-742-7776
Anesthesia
Rest Assured Anesthesia LLC
1878 Mayo Drive
Tavares, FL 32778
352-508-5812
Patient Health Record
Upon request and after discharge from Tavares Surgery Center, Tavares Surgery Center 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 (352) 508-5401 or by mail at:
Tavares Surgery Center
1878 Mayo Dr, Tavares, FL 32778