Financial Assistance Policy

If CFAGI Surgery Center believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, CFAGI Surgery Center may initiate contact with them to determine your cost-sharing responsibilities for CFAGI Surgery Center’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If CFAGI Surgery Center determines that you have cost-sharing responsibilities for CFAGI Surgery Center’s bill, in accordance with CFAGI 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. CFAGI 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 CFAGI 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 CFAGI Surgery Center to be “charity care.” There is no formal application process for obtaining “charity care” at CFAGI Surgery Center. CFAGI 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 CFAGI Surgery Center, you can receive a good faith estimate of anticipated charges for the treatment of your condition at CFAGI Surgery Center. This estimate must be provided to you within seven (7) days of the request being received by CFAGI 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 CFAGI Surgery Center at (407) 644-4222. 

Itemized Bill

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

CFAGI Surgery Center Providers

Pathology Labs
LabCorp:
PO Box 2240, Burlington, NC 27216-2240
(800) 845-6167

Anesthesia Provider
MNH GI Anesthesia and Pain Management:
740 Concourse Pkwy South, Suite 100, Maitland, FL 32751
(407) 644-4222

Our Providers

• Raouf Hilal, MD
• Douglas Sprung, MD, FACG, FACP
• Andria Mushahwar, MD
• Joseph Quagliata, MD
• Paul S. Panzarella, MD

Upon request and after discharge from CFAGI Surgery Center, CFAGI 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.

www.Floridahealthfinder.gov

Patient Complaint or Grievance

To report a complaint or grievance, you can contact the facility Administrator by phone at (407) 644-4222 or by mail at:
CFAGI Surgery Center
740 Concourse Pkwy South, Suite 100, Maitland, FL 32751