Financial Assistance Policy
If AdventHealth Surgery Center Davenport believes that you have health insurance and/or HMO coverage(s) that may cover some or all of the Services, AdventHealth Surgery Center Davenport may initiate contact with them to determine your cost-sharing responsibilities for AdventHealth Surgery Center Davenport’s bill. You may contact them directly as well for additional information concerning your cost-sharing responsibilities. If AdventHealth Surgery Center Davenport determines that you have cost-sharing responsibilities for AdventHealth Surgery Center Davenport’s bill, in accordance with AdventHealth Surgery Center Davenport’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. AdventHealth Surgery Center Davenport’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 AdventHealth Surgery Center Davenport, 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 AdventHealth Surgery Center Davenport to be “charity care.” There is no formal application process for obtaining “charity care” at AdventHealth Surgery Center Davenport. AdventHealth Surgery Center Davenport’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 AdventHealth Surgery Center Davenport, you can receive a good faith estimate of anticipated charges for the treatment of your condition at AdventHealth Surgery Center Davenport. This estimate must be provided to you within seven (7) days of the request being received by AdventHealth Surgery Center Davenport. 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 AdventHealth Surgery Center Davenport at (863) 419-2812.
Itemized Bill
Upon request and after discharge from AdventHealth Surgery Center Davenport we will provide a statement within 7 working days of your request.
Provider Disclosure
Services may be provided in this health care facility by AdventHealth Surgery Center Davenport 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 AdventHealth Surgery Center Davenport. You may request a more personalized estimate of charges from these other health care providers by contacting the health care providers directly. AdventHealth Surgery Center Davenport may contract with providers for pathology and anesthesiology services; these services are billed separately from AdventHealth Surgery Center Davenport for their services. You may contact these providers through their contact information provided below.
AdventHealth Surgery Center Davenport Providers
Envision Health Greater Florida Anesthesia
5380 Tech Data Drive
Clearwater, FL 33760
844-607-5824
9350 Bay Plaza Blvd, Suite 120-127
Tampa FL 33619
352-308-8903
3003 West Dr Martin Luther King Junior Blvd
Tampa, FL 33607
800-324-7853
5755 Hoover Blvd
Tampa, FL 33634
813-884-2849
Patient Health Record
Upon request and after discharge from AdventHealth Surgery Center Davenport, AdventHealth Surgery Center Davenport 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 (863) 419-2812 or by mail at:
AdventHealth Surgery Center Davenport
107 Park Place Boulevard Davenport, Florida 33837