Financial Assistance Policy
If Longleaf Surgery Center believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, Longleaf Surgery Center may initiate contact with them to determine your cost-sharing responsibilities for Longleaf Surgery Center’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If Longleaf Surgery Center determines that you have cost-sharing responsibilities for Longleaf Surgery Center’s bill, in accordance with Longleaf 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. Longleaf 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 Longleaf 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 Longleaf Surgery Center to be “charity care.” There is no formal application process for obtaining “charity care” at Longleaf Surgery Center. Longleaf 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 Longleaf Surgery Center, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Longleaf Surgery Center. This estimate must be provided to you within seven (7) days of the request being received by Longleaf 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 Longleaf Surgery Center at +1 (727) 372-0600.
Itemized Bill
Upon request and after discharge from Longleaf 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 Longleaf 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 Longleaf Surgery Center. You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. Longleaf Surgery Center may contract with providers for pathology and anesthesiology services; these services are billed separately from Longleaf Surgery Center for their services. You may contact these providers through their contact information provided below.
Longleaf Surgery Center Providers
Infinity DME
7601 N Federal Hwy #140B, Boca Raton, FL 33487
(561) 279-2776
1500 Gateway Blvd., Suite 220, Boynton Beach, FL 33426
(561) 228-1945, ext. 206
SpecialtyCare
3100 West End Ave. Suite 800 Nashville, TN 37203
1-800-348-4565
LabCorp
PO Box 2240 Burlington, NC 27216-2240
1 (800) 845-6167
DJO Global
1430 Decision Street Vista, CA 92081
1 (800) 336-6569
Patient Health Record
Upon request and after discharge from Longleaf Surgery Center, Longleaf 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 +1 (727) 372-0600 or by mail at:
Longleaf Surgery Center
3010 Starkey Blvd, New Port Richey, FL 34655