Financial Assistance Policy
If Select Physicians Surgery Center believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, Select Physicians Surgery Center may initiate contact with them to determine your cost-sharing responsibilities for Select Physicians Surgery Center’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If Select Physicians Surgery Center determines that you have cost-sharing responsibilities for Select Physicians Surgery Center’s bill, in accordance with Select Physicians 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. Select Physicians 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 Select Physicians 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 Select Physicians Surgery Center to be “charity care.” There is no formal application process for obtaining “charity care” at Select Physicians Surgery Center. Select Physicians 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 Select Physicians Surgery Center, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Select Physicians Surgery Center. This estimate must be provided to you within seven (7) days of the request being received by Select Physicians 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 Select Physicians Surgery Center at 813-321-1616.
Itemized Bill
Upon request and after discharge from Select Physicians 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 Select Physicians 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 Select Physicians Surgery Center. You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. Select Physicians Surgery Center may contract with providers for pathology and anesthesiology services; these services are billed separately from Select Physicians Surgery Center for their services. You may contact these providers through their contact information provided below.
Select Physicians Surgery Center Providers
Team Health, Gulf-to-Bay Anesthesia Group
400 N. Ashley Drive, Suite 1625
Tampa, FL 33602
(813) 868-7499
AccuPath Laboratories
5938 Frond Way
Apollo Beach, FL 33572
(813) 641-0466
BayCare Laboratories
8020 Woodland Center Blvd
Tampa, FL 33614
(800) 324-7853
Implantable Provider Group (IPG)
11605 Haynes Bridge Road, Suite 200
Alpharetta, GA 30009
(770) 753-0046
Reliance Pathology
5755 Hoover Blvd
Tampa, FL 33634
(813) 490-7206
Upon request and after discharge from Select Physicians Surgery Center, Select Physicians 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 1-813-321-1618 or by mail at:
Select Physicians Surgery Center
3440 W. Dr. Martin Luther King Jr Blvd, Suite 103, Tampa, FL 33607