Financial Assistance

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NewYork-Presbyterian Hudson Valley Hospital recognizes that there are times when patients in need of care will have difficulty paying for the services provided. NewYork-Presbyterian Hudson Valley Hospital’s financial assistance program provides discounts to qualifying individuals based on your income. In addition, we can help you apply for free or low-cost insurance if you qualify. Just contact our Financial Counselor, Monday through Friday 8:30 AM-4:30 PM, at 914-734-3518 or go to the Financial Counselor located in the Admitting Department for free, confidential assistance. You may also contact the billing department at 914-734-3858, Monday through Friday 8:30 AM-4:30 PM.

Who qualifies for a discount?

Financial Assistance is available for patients with limited incomes and no health insurance. If you cannot pay your balance due after insurance, you may also qualify for financial assistance.

Everyone in New York State who needs emergency services can receive care and get a discount if they meet the income limits.

In addition, if they meet the income limits, everyone who lives in the hospital’s service areas can get a discount on non-emergency, medically necessary services at NewYork-Presbyterian Hudson Valley Hospital. You cannot be denied medically necessary care because you need financial assistance.

You may apply for a discount regardless of immigration status.

What are the income limits?

The amount of the discount varies based on your income and the size of your family. Income limits are established according to the Federal Poverty Guidelines. If you have no health insurance, these are the income limits for 100% discount:

Family Size Annual Family Income Monthly Family Income Weekly Family Income
1 Up to $24,120 Up to $2,010 Up to $464
2 Up to $32,480 Up to $2,707 Up to $625
3 Up to $40,840 Up to $3,403 Up to $785
4 Up to $49,200 Up to $4,100 Up to $946
5 Up to $57,560 Up to $4,797 Up to $1,107
6 Up to $65,920 Up to $5,493 Up to $1,268

* Based on the 2017 Federal Poverty Guidelines (200%)

If you are outside of these limits, you may still qualify for a discounted rate. Please submit your application for review.

What if I do not meet the income limits?

If you cannot pay your bill, NewYork-Presbyterian Hudson Valley Hospital offers an interest free payment plan. The amount you pay depends on the amount of your income. Our goal is not to exceed payments beyond a 12 month period.

Can someone explain the discount? Can someone help me apply?

Yes, free, confidential help is available. Call the Financial Counselor at 914-734-3518.

If you do not speak English, someone will help you in your own language.

The Financial Counselor can tell you if you qualify for free or low-cost insurance, such as Medicaid, Child Health Plus and Family Health Plus. If the Financial Counselor finds that you don’t qualify for low-cost insurance, they will help you apply for a discount.

The Counselor will help you fill out all the forms and tell you what documents you need to bring.

What do I need to apply for a discount?

  • Photo ID (license, passport, green card)
  • Proof of residence (a bill indicating his/her address)
  • Proof of current income from any source

If you cannot provide any of these, you may still be able to apply for financial assistance. Please contact us to see how we may help you.

What services are covered?

All medically necessary services provided by NewYork-Presbyterian Hudson Valley Hospital are covered by the discount. This includes outpatient services, emergency care, and inpatient admissions.

Charges from private doctors who provide services in the hospital are not covered by the hospital policy. You should talk to private doctors to see if they offer a discount or payment plan.

How much do I have to pay?

Our Financial Counselor will give you the details about your specific discount(s) once your application is processed.

For elective services, a deposit is required. Please contact the financial counselor for a brief screening. She will assess your situation and based on your income, establish a fair deposit.

How do I get the discount?

You have to fill out the application forms. As soon as we have proof of your income, we can process your application for a discount according to your income level.

You can apply for a discount before you have an appointment, when you come to the hospital to get care, or when the bill comes in the mail.

Send the completed form to NewYork-Presbyterian Hudson Valley Hospital, Financial Counselor, 1980 Crompond Road, Cortlandt Manor, NY 10567 or bring it to the Financial Counselor, located in the Admitting Department. You have up to 90 days after receiving services to submit the application.

If you have questions about the form, please call the Financial Counselor at 914-734-3518.

How will I know if I was approved for the discount?

NewYork-Presbyterian Hudson Valley Hospital will send you a letter within 30 days after completion and submission of documentation, telling you if you have been approved and the level of discount received.

What if I receive a bill while I’m waiting to hear if I can get a discount?

You cannot be required to pay a hospital bill while your application for a discount is being considered. However, your application must be on file or bills will continue to be sent to you. If your application is turned down, the hospital must tell you why in writing and must provide you with a way to appeal this decision to a higher level within the hospital.

What if I have a problem I cannot resolve with the hospital?

You may call the New York State Department of Health complaint hotline at 1-800-804-5447.


Charity Care Policy

Policy and Purpose:

New York State Public Health Law (Section 2807-k-9-a) and the Internal Revenue Codes (Section 501(r)) require hospitals to provide free or reduced price services for emergency or other medically necessary care to patients who are determined to be unable to pay for their care in whole or in part, based on their financial status.

NewYork-Presbyterian Hudson Valley Hospital (NYPHVH) recognizes its responsibility to provide charity care (hereafter Charity Care) for those who may be uninsured or underinsured, and have received emergency or other medically necessary services at the hospital. The Hospital is committed to the comprehensive assessment of individual patient need and to providing Charity Care when warranted, regardless of age, gender, national origin, socio-economic or immigrant status, sexual orientation or religious affiliation.

Applicability:

  1. This Policy applies to emergency or other medically necessary inpatient and/or outpatient services rendered to an individual who qualifies for assistance under this policy by the Hospital and its employees.
  2. This Policy applies to emergency services rendered to residents of New York State (including EMTALA transfers) and non-emergency, medically necessary services provided to any qualified resident of the Hospital’s primary service area. (See exhibit A attached). Medical services are defined as those services covered under the New York State Medicaid program.
  3. In addition to covering the uninsured who may qualify, this policy covers those individuals who qualify and face extraordinary medical costs, including copayments, deductibles, or coinsurance, and/or who have exhausted their health insurance benefits (including, but not limited to, health savings accounts).
  4. This Policy does not apply to any services provided by any other provider, e.g., physicians or other service providers (who bill independently for their services). Patients should expect to receive separate bills from physicians and other service providers; those bills from such physicians and other service providers are not subject to this Policy.
  5. Charity Care will be considered upon submission of a completed application form accompanied by required documentation. In certain limited circumstances specified herein, Charity Care may be provided to patients based on presumptive calculated income scores from credit or specialty reporting agencies.
  6. Charity Care will be provided after patient has been screened for eligibility for Medicaid or other insurance programs, when reasonable or appropriate.
  7. Exceptions to this Policy can be made by approval of a designated Hospital official. Disputes concerning medical necessity will be settled by the Hospital Utilization Review Department in accordance with applicable Hospital policies and procedures.

Procedure:

  1. Upon request, patient is given New York-Presbyterian Hudson Valley Hospital application for financial assistance. Assistance is available in addition to the self pay discount.
  2. Uninsured or self pay patients are given a discount at the time of service. The amount of the discount is the amount generally billed to a patient with insurance. This amount is considered charity care for our uninsured patients.
  3. Uninsured patients’ accounts will be reviewed for possible insurance coverage and other self pay options. Patient will also be evaluated to see if they qualify for Medicaid. Assistance will be given to any patient who may qualify for Medicaid as requested.
    1. If a patient is denied by Medicaid, the guarantor will be requested to supply the financial counselor with the denial letter along with the completed financial assistance application.
    2. If the patient is not applying for Medicaid, the patient has 90 days from discharge to request financial assistance application.
    3. In the event of extenuating circumstances the 90 day application time frame may be extended with the approval of the supervisor or manager of patient accounts.
    4. The guarantor has 20 working days to complete the application. The guarantor must supply 3 months worth of documents to support the current income. In the event of extenuating circumstances, the period for submission may be extended.
    5. While the guarantor is in the process of filing for financial assistance, the account will not be sent to collections if the guarantor is cooperating with the filing requirements.
  4. Upon receipt of application, the financial counselor reviews the required information along with the application and submits for approval.
    1. If there is any false information, financial counselor can immediately deny the application.
    2. If there is incomplete information, patient is contacted to supply the information. Patient will be given 10 additional days to supply the information. If not supplied, application is denied due to lack of supporting information.
    3. Financial counselor reviews the financial statement submitted by the patient and compares it to the guidelines. Financial counselor will recommend assistance based on these guidelines.
    4. All information is entered into the MAPs system.
    5. Financial counselor will note all accounts as necessary including documenting the mailing of, receipt of, issues with and approval of the application. All applications will be filed.
  5. If the patient’s yearly income is equal or less than the NewYork-Presbyterian Hudson Valley Hospital guidelines, the applicant is eligible to receive 100% free/ charity care. Guidelines are based on FPL for that year and do consider income, family size and resources.
  6. If the applicant’s income is greater than the New York-Presbyterian Hudson Valley Hospital guidelines for category A, but equal to or less than category B, the patient will be eligible for partial aid.
  7. Applications and documentation will be reviewed by the Director of Patient Accounting. Discretion will be used in reviewing applications based on income and outstanding bills. Application can be approved where income is outside of the guidelines based on compelling documentation and ability to pay. Applications may also be approved without all supporting documentation at the discretion of Director of Patient Accounting.
  8. Upon approval or denial of the financial assistance application, the financial counselor will:
    1. Send a letter to the patient with the appropriate status of the account, listing amount of the discount and amount due.
    2. Apply the approved discount to the accounts approved or denied.
    3. Set up a payment plan with the patient. The payment plan will not exceed more than 10% of the patient’s income.
    4. File all paperwork.
    5. Approval will not cause any refunds of prior payments by patient or guarantor.
  9. Payment arrangements are made by the financial counselor or billing representative regarding balances on the bill. If arrangements are not met, patient may be sent to collections for no more than the agreed amount rate. (See policy 07-8421-59)
  10. If patient makes no contact with the hospital regarding the need for financial aid, patient will not be considered for financial assistance and collection efforts will continue per policy 07-8421-06. All efforts to contact the patient will be made by billing staff to get patient to comply with request for forms.
  11. Patients treated in the Emergency Room who indicate an inability to pay due to financial hardship will be given a financial assistance application by registration or the Financial Counselor’s card at the time of services. Once the request has been completed or contact has been made, the Financial Counselor will review and determine eligibility for charity or discount.
  12. Guidelines will be updated yearly according to the Federal Poverty Levels set by the Department of Health and Human Services.
  13. Applications will be honored for all current hospital accounts. This does not include the physician fees for services performed. Should the patient have continued services, application must be updated at least every year. Financial assistance will be honored for 1 year from approval date for all services. Applications will be kept on file for review as needed. Patient must complete application timely in order to be considered for aid.
  14. Notice of Financial Assistance and applications will be posted in all patient intake areas and on all patient bills as well as the hospital’s website.
  15. Staff in all areas will be educated as to policy and whom to contact for information regarding policy.
  16. Policy shall be applicable to any resident of New York State. It is open to others at the discretion of the Director of Patient Accounting and Vice President of Finance. Patients will also qualify for charity in the following scenarios:
    1. Homeless: 100% charity, no self pay discount (8651).
    2. Out of state Medicaid: Non-par 100% charity (8651), no self pay discount, no Medicaid allowance.
    3. Patients with Insurance billed to insurance and 100% goes to deductible/coinsurance. Approved amount that insurance will have paid is considered charity. An application should be filed for these cases.
    4. Certain Nursing Home cases: HBO patients—patient and nursing home charity case—100% charity agreed to.
    5. Medicaid/Medicaid HMO: No rate code from state—100% charity.
    6. Patient’s failure to respond to insurance re COB, WC related etc.: charity on discounted rate if there is an application on file.
    7. Pre-existing condition = no insurance=charity 100%.
    8. Bankrupt with insurance: charity on approved amount.
    9. Bankrupt without insurance: charity on full amount.
    10. Deceased (no estate) with insurance: charity on approved amount.
    11. Deceased (no estate) without insurance: charity on full amount.
    12. Lapse in Medicaid/Medicaid HMO=100% charity (presumptive).
    13. Uncollectable returns from agency: Now have Medicaid or Medicaid HMO = presumptive (re-class).
    14. Patients with emergency Medicaid only: seen in other areas, not related to condition approved: 100% charity.
  17. Patient who has met their lifetime maximum are considered a self pay. Go through the process and if not paid or if patient is deceased with no estate, amount is considered charity.
  18. The hospital may make inquiries to and obtain reports from third parties, such as credit agencies, to determine whether a patient may be presumptively eligible (presumptive eligibility) for charity care under the following limited conditions:
    1. The patient has been discharged from the hospital.
    2. The patient lacks insurance coverage or the coverage has been exhausted.
    3. A balance exists and remains outstanding for the patients account.
    4. The patient has received at least one bill and the time period for paying that bill has expired.
    5. The patient has not applied or completed an application for Financial Assistance.
    6. Credit reports shall not be used to deny application for Financial Assistance.
  19. The hospital will not report patient’s account status to such third parties.

The Hospital’s collection practices and procedures are outlined in a separate Collection Policy consistent with the requirements of New York State Public Health Law (Section 2807-k-9-a) and the Internal Revenue Service regulations (Section 501 (r))of the Internal Revenue Service Code.

See attachment B for Guidelines for 2017.

Responsibility

Patient Financial Services

Policy Dates

Issued: May, 2007

Revised: April, 2017

Reviewed and Revised: April, 2009; February, 2010; July, 2011;February,2013; February,2014; April, 2015; October 2016; April, 2017

Exhibits Revised: April, 2009; February, 2010; July, 2011;February,2013; February,2014; April, 2015; October 2016; April, 2017

Approvals: Board of Trustees


Exhibit A

Primary Service Area

For the NewYork-Presbyterian Hudson Valley Hospital, the primary service area consists of the following counties: Westchester, Bronx, Orange, Putnam, and Rockland.


Attachment B

2017 Financial Assistance Guideline
NewYork-Presbyterian Hudson Valley Hospital

2017 Financial Assistance Guideline
Click Here To Enlarge

2017 Federal Poverty Levels
Charity Care 08-8421.04