Billing & Financing

Right to Request an Estimate

Patients have the right to request a personalized estimate for non-emergency medical services prior to

receiving care. All estimates provided by the facility are of the costs that may be associated with

anticipated services. Actual charges will be based on the services ultimately provided to the patient.

Personalized estimates are available upon request by the patient or the patient’s legal guardian.

Patients also have the right to:

• Request an itemized statement or bill
• Receive an explanation of charges upon request

Financial Assistance and Payment Plans

Midwest Surgery Center of Kansas City is committed to helping patients meet their financial

responsibilities while maintaining access to high-quality care. The purpose of the facility’s financial

assistance, payment plans, and collections policies is to provide a consistent approach for assisting

patients who are financially responsible for all or a portion of their medical expenses but are unable to

pay the full balance due to financial hardships.

Although patients are encouraged to pay their balances in full, Midwest Surgery Center of Kansas City

offers payment plans for qualifying patients who are unable to make full payment. Payment plans may

be established for outstanding balances, pre-service deposits, procedures, surgeries, or other

non-covered services.

Payment Plan Guidelines

To qualify for a payment plan:

• The outstanding balance must exceed $100.
• A minimum of 50% of the balance is due at the time of service.
• The remaining balance must be paid in three (3) equal monthly installments.

Patients who miss a scheduled payment will be allowed one (1) month to bring the account current. If

the payment is not made within that period, the payment plan will be considered in default, the

remaining balance will become due in full, and the account will no longer be eligible for payment plan

arrangements. Accounts that remain unpaid for more than 120 days may be referred for pre-collection

activity in accordance with the facility’s collection procedures.

Out of Network

Patients considered out-of-network may be eligible for an adjustment to their financial responsibility,

provided such adjustments are permitted under applicable federal and state laws and the terms of the

patient’s health insurance plan. Eligibility for, and the amount of, any out-of-network adjustment will

vary based on the patient’s insurance benefits and coverage. Accounts that become delinquent may no

longer qualify for the adjustment and have it removed.

Section 1557 of the Patient Protection and Affordable Care Act prohibits discrimination on the basis of

race, color, national origin, sex, age, or disability in certain health programs or activities. Section 1557

builds on long-standing and familiar Federal civil rights law: Title VI of the Civil Right Acts of 1964, Title IX

of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Age

Discrimination Act of 1975.