Financial Assistance Policy

If Charlotte Surgery Center believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, Charlotte Surgery Center may initiate contact with them to determine your cost-sharing responsibilities for Charlotte Surgery Center’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If Charlotte Surgery Center determines that you have cost-sharing responsibilities for Charlotte Surgery Center’s bill, in accordance with Charlotte 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. Charlotte 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 Charlotte 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 Charlotte Surgery Center to be “charity care.” There is no formal application process for obtaining “charity care” at Charlotte Surgery Center. Charlotte 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 Charlotte Surgery Center, you can receive a good faith estimate of anticipated charges for the treatment of your condition at Charlotte Surgery Center. This estimate must be provided to you within seven (7) days of the request being received by Charlotte 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 Charlotte Surgery Center at (941) 625-3636. 

Itemized Bill

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

Charlotte Surgery Center Providers

Anesthesia and Pain Management Associates of S.W. Florida, LLC
18350 Murdock Circle  Suite 102
Port Charlotte, Florida  33948
(941) 206-7251

Bayshore Pathology Consultants, P.A.
J. Augusto Ross, M.D., FCAP, Medical Director
18308 Murdock Circle, Suite 105
Port Charlotte, Florida  33948
(941) 313-9009

Patient Health Record

Upon request and after discharge from Charlotte Surgery Center, Charlotte 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 (941) 625-3636 or by mail at:
Charlotte Surgery Center
23970 Suncoast Blvd Port Charlotte, Florida 33980