Patient Information

SurgiCare of Boca accepts Medicare, Medicaid, Champus, Workers Compensation, and ALL forms of Commercial Insurance.  Specifically, SurgiCare of Boca has written contracts/agreements with the following major manager care insurers/networks:

Health Plans & Insurance Carriers Accepted

Aetna

https://www.aetna.com/

  • Aetna Signature Administrators
  • Commercial PPO/ HMO
  • International PPO
  • Medicare HMO/PPO

AvMed

https://www.avmed.org/

  • Commercial HMO
  • Medicare HMO/PPO

Careplus

https://www.careplushealthplans.com/

  • Medicare HMO/PPO

Cigna

https://www.cigna.com/

  • Commercial PPO/HMO

Humana

https://www.humana.com/

  • Commercial PPO/HMO
  • Medicaid HMO
  • Medicare HMO/PPO

Humana Tricare

https://www.humanamilitary.com/

  • Tricare

Coventry (Vista)

http://coventryhealthcare.com/

  • Commercial PPO/HMO
  • Healthy Kids
  • Medicaid HMO
  • Medicare HMO/PPO

Florida Blue (BCBS)

https://www.floridablue.com/

  • Blue Care
  • Blue Options
  • Blue Select
  • Commercial PPO/HMO
  • Medicare HMO/PPO

Florida Blue (Health Options)

https://www.floridablue.com/

  • HMO

Simply Health Care Plans

https://www.simplyhealthcareplans.com/

  • Clear Health Alliance
  • Healthy Kids
  • Medicaid HMO
  • Medicare HMO/PPO

Sunshine Health Care Plans

https://www.sunshinehealth.com/

  • Ambetter
  • Medicaid HMO
  • Medicare HMO/PPO

The bills a patient will receive for surgery and the cost of the surgery will depend primarily on the following items. You will likely receive separate bills for each.

  1. SurgiCare of Boca’s fee for the type of procedure. This fee includes nursing care, medications, standard supplies, and use of the operating and recovery rooms.
  2. The surgeon’s fee for performing the surgery
  3. The anesthesiologist’s fee for providing anesthesia for the procedure, if applicable

Depending on the procedure performed, patients also may receive bills for laboratory or x-ray tests prior to the procedure or bills from other care providers such as pathologist, durable medical equipment, radiologist and/or surgical assistants.

Payment

We require payment of your deductible, co-payment, and co-insurance at the time of admission. We accept cash, checks, debit and all major credit cards. For procedures that are not covered by insurance and for patients who do not have medical insurance, we require full payment (100%) at the time of admission. Please call our office prior to your surgery date if special payment arrangements are necessary.

Insurance

Many same-day surgical procedures are covered by standard medical insurance and we participate with many insurance plans. However, you should call your insurance company prior to your surgery date to verify that we participate with your plan and to understand the coverage for your procedure. We will submit claims to most major insurance plans.

Questions

If you have any questions about financial arrangements or billing, call us at (201) 855-8336

Our financial assistance program offers a variety of ways to reduce a patient’s financial responsibility for services rendered by the surgery center. Our program structures a balance between offering the patient a reduced financial liability while still complying with insurance contract obligations and Federal and state regulations. Please contact our facility’s business office for further information on our policies as reflected below. Surgeons, anesthesiologists, and other service providers (such as pathologists or laboratories) bill for their services separately from the surgery center and may offer their own financial assistance program—please contact them for further information regarding their services.

Application Process

You may request the facility to provide details for any of the elements within the financial assistance program. Certain policies have an application process requiring the patient to submit additional financial and household information to determine qualification of the available assistance.

Payment Plans

Each patient is expected to pay his/her estimated financial liability on or before the day of service. In the event a patient is unable to pay the estimated liability in full, our surgery center may offer a short term repayment schedule after a minimum down payment is made. For an extended repayment schedule, a patient may need to secure financing with an outside source. Please consult with our surgery center’s business office for further information. Please call (201) 855-8336.

Uninsured Discounts

Patients who are not eligible to receive services paid for by insurance or other third party payment sources may be eligible to receive an uninsured discount from our facility. This discount does not apply for cosmetic surgery services as defined by our facility. The discount is a set percentage off of charges and is subject to change. If a patient’s services are subsequently found to be covered by insurance or other third party payment source, the uninsured discount may be disallowed.

Charity Care

The center maintains a charity discount policy which provides financial relief to patients who receive medically necessary care and who do not qualify for state or Federal assistance and are unable to pay the estimated or remaining financial responsibility in part or in full. A patient must meet the policy’s household income qualifications which are based on Federal Poverty Level Guidelines (revised annually). Submission of supporting documentation is required to validate a patient’s qualifying status.

Out Of Network

A patient receiving treatment at our surgery center under insurance with which our facility is out of network may be eligible to receive an adjustment to their assigned out of network patient liability, assuming our facility is not prohibited from offering Out of Network adjustments under state/Federal laws or your insurance company’s provisions. If not prohibited, the application of any out of network discount is subject to vary based on a patient’s benefit coverage. Accounts which become delinquent may have the adjustment disallowed.

Collection Procedures

As a courtesy to our patients, we will file an insurance claim on behalf of the patient to his/her insurance plan. A patient is expected to respond to his/her insurance plan’s request for information timely, as needed, in order to minimize processing delays with the claim.

Patients are expected to pay their financial obligations in a timely manner including the estimated portion by the day services are received, and any remaining portion upon finalization of the claim by the payer. Unpaid claims by the payer may result in the account’s outstanding balance being fully transferred to the patient for collection.

If needed, the center will attempt to reach a patient by any method available to us to secure payment on the outstanding balance utilizing internal and external resources. If the account becomes delinquent, it may be placed with an attorney or agency for collection in which their fees and expenses may be the obligation of the patient.

Other Providers

Services may be provided in this health care facility by the facility 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 the facility.

Patients and prospective patients may request from this facility and other health care providers a more personalized estimate of charges and other information, such as billing practices. Patients and prospective patients should contact each health care practitioner who will provide services in this surgery center to determine the health insurers and health maintenance organizations with which the health care practitioner participates as a network provider or preferred provider.

Contracted Service Providers

The following providers render services to patients of this surgery center.

Orthopaedics:

  • Curtis Beauregard, MD
  • Manish Gupta, MD
  • Scott Katzman, MD
  • Curtis Kephart, MD
  • Michael Krantzow, MD
  • Malcolm Christopher MacLaren, MD
  • Alan Saperstein, MD

Pain Management:

  • Harold Gregory Bach, MD

Podiatry:

  • Kevin Palmer, DPM

Anesthesiology

St. Lucie Anesthesia Associates
501 Glades Road
Boca Raton, FL 33432
800-248-1639

Pathology

This surgery center submits specimens to different pathology providers so please inquire with the facility as to which pathology provider will be used. Some pathology providers may engage specialized pathologists to assist in examining the patient’s specimen.

Laboratory

This surgery center submits specimens to different laboratories so please inquire with the facility as to which one will be used. Some laboratories may engage other labs to assist in analyzing the patient’s specimen.

Estimates

Center will provide and estimate upon request of the patein, prospective patien, or legal guardian for nonemergency medical services.

For a non-personalized estimate of costs, go to this website: www.floridahealthfinder.gov.  Actual costs may be different.  Please contact us for a personalized estimate.  201-855-8336.

Patient Safety Resources

Above all else, we are committed to the care and improvement of human life. In recognition of this commitment, we strive to deliver high quality, cost effective healthcare in the communities we serve. To accomplish this we would like to know what we are doing right or what needs improvement. We depend on our patients and their families to keep us informed.

If you have a complaint involving our surgery center and wish to speak to someone directly, please call during regular business hours and ask to speak to the Administrator at (561)544-5501 or write to:

SurgiCare of Boca Raton

Attn: Administrator

1905 Clint Moore Road, Suite 300

Boca Raton, FL 33496

Filing a complaint will not adversely affect your care or access to care. If you have a complaint against this facility, you may directly contact:

Agency for Health Care Administration

Complaint Administration Unit

2727 Mahan Drive, Bldg. 1

Tallahassee, FL 32308

(888) 419-3456

http://ahca.myflorida.com/contact/index.shtml

If you have a complaint against a health care professional, you may contact:

Florida Department of Health

Consumer Services Unit

4052 Bald Cypress Way, Bin C75

Tallahassee, FL 32399-3260

(850) 245-4339

http://www.floridahealth.gov/

All Medicare beneficiaries may also file a complaint or grievance with the Medicare Beneficiary Ombudsman. Call (800) 633-4227 or visit the webpage at https://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html

Our surgery center is accredited by the following organization; you may also contact them directly with any concerns/complaints:

Accreditation Association for Ambulatory Health Care, Inc.

5250 Old Orchard Road, Suite 200

Skokie, Illinois 60077

(847) 853-6060

http://www.aaahc.org/contact-us/