Patient Information

Your Rights and Protections Against Surprise Medical Bills

When you receive services at an in-network hospital or ambulatory surgical center, certain physicians and other healthcare professionals involved in your care may be out of network. Federal law protects patients from certain unexpected or “surprise” medical bills in these circumstances.

You are protected from balance billing for:

Emergency Services

If you receive emergency services from an out-of-network provider or facility, the most the provider or facility may generally bill you is your health plan’s in-network cost-sharing amount, such as a copayment, coinsurance, or deductible. You cannot be balance billed for these emergency services. This protection includes services you may receive after you are in stable condition unless you give written consent and give up certain protections.

Certain Services at an In-Network Hospital or Ambulatory Surgical Center

When you receive services at an in-network hospital or ambulatory surgical center, certain providers involved in your care may be out of network. In these cases, the most those providers may generally bill you is your health plan’s in-network cost-sharing amount.

You cannot be balance billed for certain services, including emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, and intensivist services. These providers generally may not ask you to give up your protections against balance billing.

If other out-of-network services are scheduled, an out-of-network provider may be permitted to ask you to give written consent to receive those services and give up certain balance-billing protections. You are never required to give up your protections, and you are not required to receive care from an out-of-network provider when an in-network provider is available.

When Balance Billing Is Prohibited

When balance billing is prohibited:

• You are responsible only for your applicable in-network cost-sharing amount.
• Your health plan generally must cover the applicable services without requiring prior authorization solely because the provider was out of network.
• Your health plan generally must base your cost-sharing amount on what it would pay an in-network provider or facility.
• Amounts you pay must generally count toward your in-network deductible and out-of-pocket limit.

This notice does not determine whether Vascardio Ambulatory Surgical Center or a particular physician or other provider is in network with your health plan. Patients should contact their health plan directly to verify network participation and coverage before receiving scheduled services.

Questions or Complaints

If you believe you have been wrongly billed or your rights have been violated, contact:

For questions concerning a bill from Vascardio Ambulatory Surgical Center, contact:

Visit www.cms.gov/nosurprises for additional information about your rights under federal law.

Your Right to Receive a Good Faith Estimate

Under federal law, healthcare providers and healthcare facilities must provide patients who do not have health insurance, or who are not using health insurance to pay for their care, with an estimate of the expected charges for scheduled, nonemergency healthcare items and services.

If you are uninsured or do not intend to submit a claim to your health plan:

• You have the right to receive a Good Faith Estimate explaining the expected cost of your scheduled care.
• If you schedule an item or service at least three business days in advance, make sure your healthcare provider or facility gives you a Good Faith Estimate in writing within the timeframe required by federal law.
• You may also request a Good Faith Estimate before scheduling an item or service.
• The estimate should include the expected charges for the primary item or service and other items or services reasonably expected to be provided as part of the same scheduled period of care.
• A Good Faith Estimate is an estimate and may not include unexpected services that become necessary during treatment.

If the final bill from a provider or facility is at least $400 more than that provider’s or facility’s Good Faith Estimate, you may have the right to dispute the bill through the federal patient-provider dispute resolution process.

Save a copy or photograph of your Good Faith Estimate and the bills you receive.

For questions or to request a Good Faith Estimate, contact:

For additional information about Good Faith Estimates and the federal dispute-resolution process, visit www.cms.gov/nosurprises or call the No Surprises Help Desk at 1-800-985-3059.

Notice of Nondiscrimination and Language Assistance

Vascardio Ambulatory Surgical Center complies with applicable federal civil rights laws and does not discriminate, exclude, or treat individuals differently because of race, color, national origin, age, disability, sex, religion, or any other status protected by applicable law.

Vascardio Ambulatory Surgical Center provides appropriate auxiliary aids and services to individuals with disabilities when necessary to support effective communication. Services may include qualified interpreters and information provided in accessible formats.

Free language-assistance services are available to individuals whose primary language is not English. Patients may request a qualified interpreter or translated information. Patients should not be required to provide their own interpreter.

To request language assistance, disability-related assistance, or another communication accommodation, please contact:

If you believe that Vascardio Ambulatory Surgical Center has failed to provide these services or has discriminated against you, you may submit a grievance directly to the facility.

You may also file a civil rights complaint with:

Accessibility Statement

Vascardio Ambulatory Surgical Center is committed to making its website and patient information accessible to individuals with disabilities.

If you experience difficulty accessing information on this website or need information provided in an alternative format, please contact us at (786) 500-8272. When contacting us, please describe the information or service you were attempting to access and the type of assistance or alternative format you need.