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Financial Information

Financial Information

Financial Assistance

I. Financial Assistance

a. Contact the Business Office to schedule a financial assistance appointment.

i. Insurance Coverage Determination:

1. Yes, insurance coverage is available:

a. Business Office will complete benefit check.
b. Business Office will advise patient how to contact their plan and obtain estimated patient responsibility.
c. See Item III for patient responsibility payment plan.

2. No, there is no insurance coverage available:

a. Complete a financial assessment form with the Business Office.

i. If patient qualifies for charity care:

1. Enrollment assistance offered for Medicaid or Health Insurance Exchange, if applicable.
2. See Item V for Charity Care Policy.

ii. If patient does not qualify for charity care:

1. Advise of full patient responsibility.
2. See Item III for payment plan.

II. Application Process – All applicability of allowable financial arrangements are based on a standardized financial assessment form to be completed by the patient with assistance from the Business Office.

a. Contact the Business Office to arrange a financial assessment.
b. The Business Office will evaluate and provide options based on information obtained during the financial assessment. See Item I.

III. Payment Plans – Payment options exist for patients’ financial responsibility that may be negotiated based on the financial assessment form.

a. If insured, upon request, deductible, co-pays, and co-insurance payment plans can be discussed, as applicable, based on the outcome of your financial assessment.
b. If uninsured, and not qualified for charity care, payment plan options will be presented.
c. If qualified for charity care, this process is not applicable.

IV. Discounts – There are no standard discounts. Individual payment plans may include cost reductions.

V. Charity Care Policy – When an uninsured patient falls below certain income levels, which is identified through the financial assessment, services provided are considered charity care and recorded as such. No charges are billed to the patient.

a. A financial assessment must be completed with the Business Office.
b. The Business Office will advise patient if charity care criteria have been met.
c. Enrollment assistance offered for Medicaid or Health Insurance Exchange, if applicable.

VI. Collections Procedure – Payments can be made through various tender. Due dates are discussed during payment plan arrangements. Significantly delinquent accounts will be reviewed for potential placement with a third-party agency.


  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. You or your insurance company may receive a separate bill in addition to the hospital’s bill for any of the following services you may receive while at the hospital: your attending physician (including your attending psychiatrist), consults or second opinions ordered by your attending physician, internal medicine physician, anesthesiologist, and ambulance services.
  5. Estimated Charges are available upon request.
    To request an individualized estimate of charges, itemized copy of your bill or medical records to very your bill please call 866-671-3130 and request to speak to the Business Office Monday through Friday 8:30 a.m. – 5:00 p.m.
    Patients and prospective patients have a right to request a personalized estimate.
  6. This is the link to the AHCA pricing website. 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 actual costs will be based on services actually provided to the patient.


Insurance Companies currently contracted

Aetna – www.aetna.com

Ambetter- www.ambetterhealth.com

American Behavioral – www.americanbehavioral.com

Amerigroup- www.amerigroup.com

Blue Cross Blue Shield – www.bcbs.com

Beacon – www.beaconhealthoptions.com

Cigna – www.cigna.com

CompCare – www.compcaremedicalgroup.com

Concordia- www.concordiaplans.org

Humana – www.humana.com

Magellan – www.magellanhealth.com

Medicare – www.medicare.gov

MehraVista – www.mehravistahealth.com

MHNet – www.mhnet.com

MultiPlan – www.multiplan.com

Psychcare – www.beaconhealthoptions.com

TriCare East – www.humanamilitary.com

TriWest – www.triwest.com

United Healthcare (United Behavioral Health) – www.optum.com

The Vines Hospital Medical Staff (352) 671-3130

Trina Hope Webb, M.D., Psychiatrist

Sunil l Koneru, M.D., Psychiatrist

Mason Ayobello, M.D., Psychiatrist

Sanjeev Singh, MD, Psychiatrist

Georgina Bembry, ARNP

Colleen Character, Ph.D., Psychologist


Moore Medical Group Phone: 407-732-7957

Eric Moore, M.D.

Elizabeth Collie, ARNP, Moore Medical Group

Cathy Vergara, ARNP, Moore Medical Group

Nasser Lavaud, ARNP, Moore Medical Group