Lecanto Surgery Center

Payment Policy

Lecanto Surgery Center: We bill most insurance carriers directly. However, primary responsibility for the account is yours. Payment is due at the time of service, unless other financial arrangements are made. This includes deductibles, copays, and/or co-insurance. If you are an established patient with a delinquent balance you will be asked for payment at the time of service.

Medicare Patients: Lecanto Surgery Center does participate with Medicare. As a Medicare patient we will file your Medicare/Medicare Replacement policyon your behalf. In addition, patients are responsible for the Medicare annual deductible and any copay amounts. (Usually 20% of the Medicare allowable after Medicare deductible is met.)

Commercial Insurance Patients: Lecanto Surgery Center will file your insurance for youas a courtesy. Although an insurance claim may be filed; this office cannot accept responsibility for collecting your insurance claim or for negotiating a settlement on a disputed claim. You are responsible for payment of your account within the limits of our payment policy. Not all BlueCross/BlueShield, Tricare, Private Insurance policies are considered “In-Network” therefore, if coverage cannot be determined prior to the procedure it is the responsibility of the patient (or responsible party) for payment for ALL services provided by LECANTO SURGERY CENTER at the usual and customary amount. Verification of coverage is NOT a guarantee of payment.

Self-Pay Patients:You are expected to take responsibilityfor all monies due when services are rendered. Financial Agreement can be made prior to your surgery date, with administrative approval.

Co-pays and/or Deductibles:Are the responsibility of the patient (or responsible party). You are accountable for all monies due when services are rendered. Payment can be made by either cash, check, or credit card. A Notice of Financial Responsibility will be made available in advance of your procedure.

FinancialAgreement:An Agreement of Financial Arrangement is available upon request, with proper authorization, proof of financial hardship, and administrative approval.

Collection Policy:Payment is due no later the 30 days after your account has been considered your responsibility. This includes, copays, deductibles and any denied insurance claims. Your failure to pay will place your account in “Past Due” status. After two (2) past due statements your account will be sent for collection review. Upon physician approval; three (3) statement and failure to pay notices, your account will be sent to collections for the purpose of collecting the unpaid debt.

Insurance Information:Providing current and accurate insurance cards/information is your responsibility. As a courtesy, we will bill your primary insurance carrier. It is essential that correct insurance information be provided. If your insurance changes, please present your new insurance information as soon as possible or at your next visit. Charges owed due to errors, claim rejections, and/or non-response by the insurance company is the responsibility of the patient. Any procedure and/or supply for procedure(s) provided by LECANTO SURGERY CENTER that is not covered by insurance is the responsibility of the patient. Your health plan may refuse payment of a claim for some of the following reasons: 1) This is a pre-existing illness that is not covered by your plan, 2) You have not met your full calendar year deductible, 3) The type of medical service required is not covered by your plan, 4) The health plan was not in effect at the time of service.For any of these reasons the account will revert toa self-payaccount. Please understand that financial responsibility for medical services is between you and your health insurance organization. While we are pleased to be of service by filing your medical insurance for you, we are not responsible for any limitations in coverage that may be included in your plan. If your health plan denies the claim for any of these or other reasons, our office cannot be responsible for this bill. It is your responsibility as the patient to pay any denied amounts in full. If, by mistake, your health plan remits payment to you, please send it to us along with all paperwork sent to you at the time. Until we receive any payments made on your behalf, you remain responsible. Verification of eligibility and coverage placed on your behalf to your insurance company IS NOT a guarantee of payment. If your insurance requires a referral and/or authorization from your primary care provider (PCP) to receive treatment at an Ambulatory Surgery Center, it is your responsibility to obtain this authorization.

Additional Charges:Lecanto Surgery Center charges are for the use of the facility only. As applicable, services may be provided by the facility as well as by other health care providers, (anesthesia providers, durable medical equipment suppliers, anatomical pathologists), who may separately bill and who may or may not participate with the same health insurers or health maintenance organizations as the facility.

Remember, your insurance is an agreement between you and your insurance company.

OM03