Understanding Your Bill

What You Need to Know

The hospital billing process may seem complicated, but you can feel more in control by knowing exactly what your bill covers. For example, if you stay overnight, you can expect to see charges for your room, meals, 24-hour nursing care and medicines. The bill will also show charges for any special services, such as X-rays and lab tests. You’ll receive bills for doctors, surgeons and specialists separately from the hospital.

If you have Medicare, you may have to fill out an MSP (Medicare Secondary Payer) form. This ensures that Medicare only pays for services not covered by other insurance you may have. If you have secondary insurance, this usually covers Medicare deductibles. If you don’t have secondary insurance, you need to pay these amounts yourself.

Also be sure to read your quarterly MSNs (Medicare Summary Notices) to review:

• the amount your doctor(s) charged
• the amount Medicare approved and paid
• the amount you owe
• your current deductible status

If you have questions, call the customer service number listed on your statement.

If you use a commercial insurance provider, then the hospital forwards your claim based on the information you provide at registration. About a month after you leave the hospital, you’ll get an explanation of benefits (EOB) statement from your insurance provider. This isn’t a bill. 

EOBs show:

• the amount billed by your doctor or hospital
• how much of that cost is covered by your insurance
• how much you owe

Review this and all other bill-related documents carefully. If you have questions, contact your doctor or the customer service number listed on the statement.

If you’re planning to pay your bills without help from Medicare or a commercial insurance provider, then you’ll get bills directly from the hospital. When the first bill arrives, call the hospital’s financial services department to set up a payment plan. 

If you do not have insurance, you may contact Patient Financial Services to set up payment plans or inquire about the various financial assistance programs that may be available to you.

Applications for financial assistance/sliding fee scale are available at the following locations in the hospital: the Admitting Department, ER Registration and the Cashier’s office. For more information, please call Patient Financial Services at (855) 807-7894.

Have you ever received a surprise medical bill after seeing a health care professional or receiving a medical service in a hospital or outpatient facility?

As of April 1, 2015, under New York State’s Emergency Medical Services and Surprise Bills Law, you have the right to information that will help you stop receiving surprise medical bills.

When you receive emergency medical services: You are responsible for paying only your usual health insurance plan in-network costs and/or co-payment amounts, even if the emergency care was given by a doctor who does not participate with your health insurance plan.

When you receive non-emergency medical services: You have the right to know whether the doctor who provides these services participates in your health insurance plan. You also have the right to request an estimate of the costs of the services.

• Doctors involved in your care may not participate in your health insurance plan—even if the hospital or outpatient facility does participate.
• Services provided by a hospital or other facility are billed separately than services billed by a doctor.

What to ask your doctor before you schedule non-emergency medical care:

• Does your doctor participate with your health insurance plan?
• Does the hospital or outpatient facility where you will receive medical care participate in your health insurance plan?
• Will there be any other doctors scheduled to be involved in providing services related to your care or referred by your doctor?
• What is the name and contact information for each of the other doctors involved in your care?
• You will need to contact each of the doctors to find out if they participate in your health insurance plan.
• If the doctor does not participate, ask this doctor to provide an estimated cost for the services that will be billed.

Ask your doctor or health care professional for all the information you are entitled to receive.

Keeping Track

One of the key ways to feel well-informed and less overwhelmed about the hospital billing process is to stay organized. Keep all of your statements and bills together, and review each one as it arrives.

Need Help?

If you don’t understand something on your bill, or if you’re having trouble paying your bills, let us know. A patient representative can work with you.