Financial Assistance, Price Transparency and Billing Information (395.301)

Services and Fees

Circles of Care is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, Circles of Care provides a list of standard charges. These are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient’s unique needs.

Disclaimer:

I understand that the list of standard charges includes only hospital services and does not contain professional fees for non-Circles of Care physicians or advanced practice providers. It does not contain professional fees for anesthesia, physicians or advanced practice providers.

I understand that a single line-item charge may not represent a complete medical service. In general, multiple charge line items are necessary to represent all components of a service (e.g. procedures, supplies, and drugs).

I understand that the list of standard charges is not intended for media use.

I understand prices are the list price of all hospital charges and not necessarily what my insurance company will pay or what I will owe to the hospital. My actual bill may include one or more of list price charges.

The hospital typically accepts a rate that is less than the list charges. Your insurer will determine what you will owe after they have paid their agreed upon amount.

We know that the billing and payment processes may seem overwhelming at times. Please contact our team at 321-722-5200

Price Transparency

Services may be provided in the hospital by the facility as well as by other health care practitioners who may separately bill the patient.

Healthcare practitioners who provide services in the hospital may or may not participate with the same health insurers or health maintenance organizations as the hospital; and prospective patients should contact the health care practitioner who will provide services in the hospital to determine which health insurers and health maintenance organizations the practitioner participates in as a network provider or preferred provider.

Follow this link to view or print a machine-readable file of all Circles of Care’s Services and Fees.

Sliding Scale

• Sliding Fee Schedule – English
• Sliding Fee Schedule – Spanish

Click here to view our Hospital Price Transparency Readable TXT file

We are committed to excellence in providing quality mental health care while serving those in our area’s needs. Financial Assistance may be available to patients receiving non-elective (emergent) hospital services not covered by any insurance or government program. Verification of income and financial information is required.

• Plain Language Summary of Financial Assistance
• Resumen Simple Poliza de Asistencia Financiera

• Financial Assistance Policy (FAP)
• Poliza de Asistencia Financiera (FAP)

Documents

• Financial Eligibility Application
• Formulario de Elegibidad Solicitud
• Federal Poverty Guidelines
• Fee Discount Appeal Letter

Billing Information

1. Patients and prospective patients have a right to request a personalized estimate from Circles of Care, Inc. To request an estimate or obtain an itemized copy of your bill, please call (321) 722-5200, extension 5904 or 5905 to speak with the Patient Financial Services Department. The Patient Financial Services Department is available Monday – Friday from 8:00am to 4:00pm
2. For AHCA’s pricing website, please follow the link: https://pricing.floridahealthfinder.gov The service bundle information is a non-personalized estimate of costs that may be incurred by the patient for anticipated services and that actual costs will be based on services actually provided to the patient.
3. Surprise billing from outside providers while in a hospital is a fear that many potential patients have. Florida Statute has attempted to provide better price transparency to protect patients and potential patients. The following statements are required to be posted on our website by Florida Statute 395.301(6)(b). However, please be aware and assured that Circles of Care does not allow outside providers to separately bill patients for services rendered in the hospital. The only bill patients will receive is from the Circles of Care, Inc. hospital.
   1. Services may be provided in the hospital by the facility as well as by other health care practitioners who may separately bill the patient.
   2. Health care practitioners who provide services in the hospital may or may not participate with the same health insurers or health maintenance organizations as the hospital; and
   3. Prospective patients should contact the health care practitioner who will provide services in the hospital to determine which health insurers and health maintenance organizations the practitioner participates in as a network provider or preferred provider.
   4. Circles of Care, Inc. may contract with other health care practitioners to provide services within the hospital.

They are:

Mari Aldeghi, ARNP

Trisha Brutus, PA-C

Marlena Ganem, APRN

Debbie Gordon, APRN

Karaline Hoskins, APRN

Boris Kawliche, MD

Marilyn Moss, MD

Merlyn McDonald, APRN

Myriam Ray, APRN

Heather Zealy, APRN

They may be contacted at: Circles of Care, Inc. 400 E. Sheridan Rd Melbourne, FL 32901 Phone: (321) 722-5200