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. 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.
Transparency in Health Care
BC/BS IPG (Implantable Provider Group)
P.O. Box 2443
Dallas, TX 75312-2443
Central Florida Pathologists’ Laboratory
Deland, Fl. 32721-1690
Lake EMS Inc.
Address: 2761 W Old US Hwy 441, Mt Dora, FL 32757
1733 South 1100 East
Salt Lake City, UT 84105
Phone No. 888-412-8087
Fax No. 888-522-0355
120 E. North Blvd. Suite 102
Leesburg, Fl. 34748
Tel. No. 352-460-0292
Orlando Anesthesia Consultants
Address: 10000 W Colonial Drive
Ocoee, FL 34761
QDX Pathology Services
46 Jackson Drive
Cranford, NJ. 07016
Tel. No. 866-909-7284
Fax No. 908-272-1478
Ronald Roth, MD, PA, HistoPathology
1824 Salk Ave.
Tavares, Fl. 32778
The Surgery Center of Mount Dora‘s charitable care policy provides financial relief to patients who receive care and 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 established annually by the Department of Health and Human Services. Submission of supporting documentation is required to validate a patient’s qualifying status.
The patient may be asked to supply all or any of the following: a copy of their last two paystubs; current year Federal 1040 tax return; unemployment benefits; Social Security benefits; Department of Social Services grants and/or food stamps amounts. Additional information may be requested in order to qualify.
As a courtesy to our patients, we will file an insurance claim on behalf of the patient to his/her insurance plan. If an insurance plan requests additional information from the patient, we require prompt response in order to minimize payment delays.
Patients are expected to pay their financial obligations in a timely manner. Denied/ $0 pay claims by the payer may result in the entire contractual amount transferred to the patient for collection.
For all outstanding patient balances, the facility will attempt to reach patients by any method available to us to secure payment including monthly statements and patient phone calls. If the account becomes delinquent, the balance may be placed with an outside collection agency.
The Surgery Center of Mount Dora will verify patient’s health insurance benefits prior to surgery. All co-payments are due at the time of service. Estimated patient responsibility of deductibles and/or co-insurance may be collected prior to/ on the day of surgery. We accept all major credit cards, cash, and personal checks. If patient is not able to pay in full, patient financing and/or payment plans may be available. For patients without insurance or whose procedure is not covered by insurance, discounts may be available.