Financial Assistance Policy

If Winter Haven Ambulatory Surgical Center believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, Winter Haven Ambulatory Surgical Center may initiate contact with them to determine your cost-sharing responsibilities for Winter Haven Ambulatory Surgical Center’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If Winter Haven Ambulatory Surgical Center determines that you have cost-sharing responsibilities for Winter Haven Ambulatory Surgical Center’s bill, in accordance with Winter Haven Ambulatory Surgical 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. Winter Haven Ambulatory Surgical 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 Winter Haven Ambulatory Surgical 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 Winter Haven Ambulatory Surgical Center to be “charity care.” There is no formal application process for obtaining “charity care” at Winter Haven Ambulatory Surgical Center. Winter Haven Ambulatory Surgical 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 Winter Haven Ambulatory Surgical Center, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Winter Haven Ambulatory Surgical Center. This estimate must be provided to you within seven (7) days of the request being received by Winter Haven Ambulatory Surgical 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 Winter Haven Ambulatory Surgical Center at 863-291-4000. 

Itemized Bill

Upon request and after discharge from Winter Haven Ambulatory Surgical 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 Winter Haven Ambulatory Surgical 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 Winter Haven Ambulatory Surgical Center.  You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. Winter Haven Ambulatory Surgical Center may contract with providers for pathology and anesthesiology services; these services are billed separately from Winter Haven Ambulatory Surgical Center for their services.  You may contact these providers through their contact information provided below.

Winter Haven Ambulatory Surgical Center Providers

Anesthesia Associates of Florida
PO Box 3190
Indianapolis, IN 46206-3190
855-381-0342

Micropath Laboratories
1125 Bartow Rd #101
Lakeland, FL 33891
863-683-7171 

Patient Health Record

Upon request and after discharge from Winter Haven Ambulatory Surgical Center, Winter Haven Ambulatory Surgical 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.

www.Floridahealthfinder.gov