Patient Financial Services

Have a billing question? Call the Billing Advocacy Office at 941-917-1540, or email billing-inquiries@smh.com.

Sarasota Memorial is committed to transparency and providing our patients with the information they need to make health care decisions. Our Patient Financial Services department provides patients and third-party insurance carriers with timely and accurate billings. We also ensure that each patient understands his or her financial responsibility for medical services, and help with financial aid options when needed. We offer the following services:

• You have rights and protections against surprise medical bills - When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. For more information, click here. 
   
• Billing directly to insurance providers – Prior to billing patients, we bill your insurance company, including but not limited to governmental plans, commercial health insurance, PIP auto insurance, third-party liability insurance, Medicare/Medicaid replacement plans, and any secondary insurance; based upon the information you provided to us, in accordance with applicable regulations and insurance company guidelines. At the same time, we send you billing statements so you are aware of any insurance activity. The statement will show that the balance is pending with insurance. See a full list of insurance we accept.


• Billing statements in plain language – Your monthly billing statements show the most current balance you owe until all payments are made by the insurance company or by you.


• World-class customer service and financial counseling – We are happy to answer your billing questions, help with payment issues, assist with financial aid programs, or arrange for an interpreter.


• Patients can request a personalized written estimate and other information from Sarasota Memorial. For information regarding price quotes for services, please contact 941-917-1447 or email PriceQuoteLine@smh.com. 


• Our Patient Assistance Programs adress the financial needs of uninsured patients. Click here for more information and for our Financial Assistance (Spanish version) and Charity Care (Spanish version) Policies. 

A Smooth Billing Process
At Sarasota Memorial, we are committed to making the billing process as patient-friendly as possible. Here are some ways you can help the process go smoothly:

• Please give us your complete health insurance information when you check in for your appointment.


• Please let us know if your personal or insurance information has changed since your last visit.


• Understand and follow the requirements of your health plan, including benefits,proper authorization for services, referrals or claim forms, and coordination of benefits forms.


• Understand that many insurance plans require patients to pay a copayment or deductible amount at the time of registration, service or discharge.


• Please respond promptly to requests from your insurance provider. If your insurance provider has not paid us after a reasonable time (usually 60 days after billing)and has not responded to our attempts to resolve payment on your behalf, the amount owed may become your responsibility.


• If you have a balance due on a bill, please make timely payments. Please do not wait for your insurance company to pay pending balances.


• If you have an insurance plan that is not contracted with Sarasota Memorial or if you do not have insurance, we will ask you to meet with a financial counselor prior to scheduling your appointment. He or she will prepare an estimated cost of services and will request a deposit covering half of those expenses. If you are unable to pay the deposit, we can determine whether you are eligible for government or Sarasota Memorial financial assistance programs.

Pre-Arrival Services
After you or your doctor tells us about a service or procedure you need, our Registration staff will contact you for demographic and insurance information. Providing the correct information allows us to process your insurance claim quickly and accurately. Please have your insurance card with you when visiting Sarasota Memorial.

Newborn Babies
Newborn babies are usually eligible for coverage under your hospitalization policy, if they are added to your policy within 30 days of birth. It is your responsibility to contact your employer and your insurance carrier to enroll your child. If you are covered by Medicaid or Medicaid-related insurance, you must add your newborn to your Medicaid case.

Referrals and Authorizations
Most insurance companies require that your primary care physician refer you to receive specialty care. Each plan is different, and it is your responsibility to know the requirements of your plan and obtain any necessary referrals. You may be responsible for payment or your appointment may have to be rescheduled if you do not get the necessary approvals.

Many insurance plans also require prior authorization for services. If your insurance company does not approve your care, we will notify you in advance and you will be responsible for payment, should you choose to proceed with services.

Collection Procedures
Sarasota Memorial staff will ask patients to pay estimated co-pays, co-insurance and deductibles prior to or at the time of your health care services. After your services, Sarasota Memorial will file a claim for insurance coverage in accordance with applicable regulations or insurance company guidelines. Once the claim has been processed by your insurance company, Sarasota Memorial will send you two billing statements. If the billing statements are not settled, Sarasota Memorial will refer the account to an external, contracted business office to follow up. The external business office can assist you in establishing a payment plan. If payment is not received by the business office, the account balance will be sent to a collection agency.  The collection agency also can help you establish a payment plan. Establishment and continued payment of agreed-upon payment terms will avoid any outstanding amounts being reported by the collection agency to a credit bureau. 

For more information, please contact our Billing Advocacy Center at (941) 917-1540 or (800) 764-2455, weekdays, 8:00 a.m. - 5:00 p.m., and our representatives will assist you. 

Commitment to Transparency: Information on Hospital Prices & Quality

Sarasota Memorial is committed to providing transparent information to help patients make informed decisions about their care. 

To obtain a personalized price quote for any service or procedure, please call 941-917-1447 or email PriceQuoteLine@smh.com.  Sarasota Memorial financial counselors are available to work with patients before they receive services to answer questions, explain out-of-pocket costs, insurance and billing options, and offer financial assistance and a financial plan that fits within the patient’s budget.   Patients with insurance can also contact their health plan for information.

Additional Information:
The state of Florida offers the Florida Health Finder website (http://www.floridahealthfinder.gov/index.html), which provides hospital quality and performance information. According to the website’s hospital comparison tool, Sarasota Memorial has the lowest charges of all hospitals in Sarasota County. 

The state also offers a site for data on health care costs and pricing. The pricing website (https://pricing.floridahealthfinder.gov/#!) provides information on payments made to facilities for defined service bundles and procedures. The 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 on services actually provided to the patient; please contact Sarasota Memorial to obtain an estimated cost of services.

The federal government requires all hospitals to make public a list of their standard charges via the Internet, through a format such as the Charge Description Master (CDM), as well as a list of standard charges for each diagnosis-related group (DRG). The CDM— a database of all billable items and services  — and the list of diagnosis-related group charges are provided on Sarasota Memorial’s website for information only. These are not effective tools to help accurately estimate or determine what patients will pay for care. Charges in the CDM and the diagnosis-related group list do not reflect actual payments from patients, insurance companies and other payors for health care services. Actual reimbursement to Sarasota Memorial is affected by a number of factors, including (but not limited to) health plan rates, Medicare and Medicaid rates, and prompt payment discounts. The cost of care also may vary from patient to patient for the same service depending on any complications or different treatments provided because of the patient’s health. Whether a procedure was performed on an inpatient or outpatient basis also influences actual reimbursement.  

Sarasota Memorial’s Transparency File is available here.

Certain physicians providing care at Sarasota Memorial may bill separately from the hospital. Sarasota Memorial’s CDM does not include those physicians’ fees. (See “Additional Billing Information” below.) 

The most accurate way for patients to determine their out-of-pocket cost for a service or procedure is to request a personalized estimate from Sarasota Memorial; please call 941-917-1447 or email PriceQuoteLine@smh.com. 

Additional Billing Information

Click here for Health Insurances we accept. 

In addition, during their stay, Sarasota Memorial Hospital patients will receive care from Sarasota Memorial Hospital and its affiliated healthcare providers. Because of this, patients could receive bills from multiple providers for the services rendered. These affiliated health care providers might or might not participate in the same insurance plans as Sarasota Memorial Hospital. We encourage patients to contact their physicians or their insurance company to determine provider health plan participation and to ask for information about possible non-SMH costs.