Transparency in Healthcare
Click on the headings below to learn more about Jupiter OSC's Financial Services, Transparency in Healthcare Legislation, Insurance Policies and Plans.
Financial Services
Jupiter Outpatient Surgery Center will verify your health insurance benefits prior to surgery and bill your carrier following your procedure. Estimated patient responsibility of co-pay portions, deductibles, and/or out of pocket fees are expected on the day of surgery.
We accept cash, credit cards, and personal checks. We also are able to offer financing of your portion of the bill through Care Credit, an organization established for this purpose.
If you are unable to pay your portion of the bill, we may be able to set up a payment plan. Discounts or cash pay prices may be offered if you do not have insurance or if your procedure is not covered by your plan.
Charity care is offered on a limited basis and you must qualify by completing the Financial Assistance/Charity Application which you can contact us to request.
State of Florida Transparency in Health Care Legislation
Services may be provided in this health care facility by the facility as well as 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. Patients and prospective patients should contact each health care practitioner who will provide services in the ASC to determine the health insurers and health maintenance organizations with which the health care practitioner participates as a network provider or preferred provider.
The following providers are contracted with JOSC to provide services for patients:
Bethesda Anesthesia Associates
P.O. Box 452498
Sunrise, FL 33345-2498
Phone: 800-296-2611, option 1
BCBS Evolent (Implantable Provider Group)
2520 Northwinds Pkwy, Suite 300
Alpharetta, GA 30009
Phone: 866-295-1260
Gastro Health
9500 S. Dadeland Blvd #200
Miami, FL. 33156
Phone: 1-888-851-0105/305-468-4194
Palm Beach Pathology
2013 Ponce De Leon Ave.
West Palm Beach, FL 33407
Phone: 800-582-3657
Jupiter Medical Center
1210 S. Old Dixie Highway
Jupiter, FL 33458
Phone: 561-744-4440
Additional information regarding health care quality measures and statistics provided by the State of Florida Agency for Health Care Administration can be found at www.Floridahealthfinder.gov.
Price Estimation for Service Bundles
The Agency for Health Care Administration provides information on payments made to facilities for defined service bundles and payments on their pricing website located at https://pricing.floridahealthfinder.gov/#!
This service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services. Actual costs will be based upon services actually provided to the patient.
Download the full State of Florida Transparency in Health Care Legislation document for a listing of physicians who perform procedures at this facility along with their phone number. Please contact them for an estimate for their services that may be billed separately from the surgery center bill.
Download the full State of Florida Transparency in Health Care Legislation
Insurance Policy
One of our patient account representatives will contact you prior to your procedure. They will collect necessary insurance coverage information to expedite the registration process for you. If you have not heard from them within 48 hours of your procedure, PLEASE CALL US AT (561)741-1705 and request someone to assist you in providing this information.
We will file your insurance for you for the coverage of the routine equipment and supplies, preprocedural services, routine drugs and anesthetics administered while in the Center, procedural room time and recovery charges.
Standard outpatient procedures are generally covered by your medical insurance. You may be asked for a partial payment upon admission to the center, dependent upon your insurance coverage. We make every effort to advise you of this amount prior to your admission. Full payment for the deductible and cop-pay, if applicable, is required upon admission.
- Medicaid patients must have a current, valid Medicaid card with them at time of admission
- Cosmetic procedures require 100% of the fee to be paid at the time of admission
- Visa, MasterCard, American Express, Discover and CareCredit are accepted
- We also accept personal checks, cash, cashier's checks and money orders
You will be billed separately for services from your physician, anesthesiologist, pathologist and any other laboratory or radiology service received.
If you have any questions about any of the preceding information, please do not hesitate to call us at (561)741-1705.
Insurance Plans
In-Network Insurance Plans Accepted:
- Aetna
- Aetna Golden Choice
- Aetna Golden Medicare Plan
- America's Health Choice
- APA Partners
- Blue Cross Blue Shield of Florida - All Plans
- Care Plus Health Plans, Inc.
- ChoiceCare Network
- Choice Managed Care
- Cigna - HMO & PPO
- ECN Employers Network
- Galaxy Health Network
- Health Network One (Care Access)
- Heritage Summit HealthCare of Florida
- Humana - All Plans, including Medicare Advantage
- Medicaid
- Medicare
- MedLink Healthcare Networks
- Multiplan
- Railroad Medicare
- State of Florida Workers Compensation
- United Healthcare - All Plans, including Americhoice
- Vista Health Plans - Referral Required, includes HMO
Out of Network Insurance Plans Accepted:
Most PPO and POS Plans
Tricare - Require Authorization
Insurance Plans NOT Accepted:
Medicare Replacement Plans (with exception to Aetna and BCBS)
HMOs that are not listed under Accepted Plans
Questions About Our Insurance Plans:
If you do not see your insurance plan listed, or if you have any questions regarding the accepted insurance plans please call our Business Office Manager at (561)741-1705.
No Surprises Act
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn't be charged more than your plan's copayments, coinsurange, and/or deductible.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays, and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.
You’re protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Additionally, Florida law protects patients with coverage through a Health Maintenance Organization (“HMO”) from balance billing for covered services, including emergency services, when the services are provided by an out-of-network provider.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other types of services at these in-network facilities, out-of-network providers can’t
balance bill you unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.
Additionally, Florida law also protects patients with coverage through Preferred Provider Organization (“PPO”) or an Exclusive Provider Organization (“EPO”) from balance billing for covered services provided at hospitals, urgent care centers or ambulatory care centers for (1) emergency services and (2) non-emergency services provided at an in-network facility by an out-of-network provider if the patient did not have the opportunity to choose an in-network provider. This protection only requires patients to pay their in-network cost sharing amounts.
When balance billing isn’t allowed, you also have these protections:
- You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
- Generally, your health plan must:
- Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.
If you think you’ve been wrongly billed:
Contact The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises/ consumers for more information about your rights under federal law.
The Florida Department of Financial Services, Division of Consumer Services at 1-877-693 – 5236 (1-877-MY-FL-CFO).
The federal phone number for information and complaints is: 1-800-985-3059.
Download PDF - Your Rights and Protections Against Surprise Medical Bills