Paying for Care

Hospital Services Charges

Generally, charges fall into two categories:

• A basic daily rate which can include your room, meals, and nursing treatment. In addition to hospital charges, patients may be billed by other professionals who participated in providing care; and
• Charges for services ordered by your physician (or other permitted provider) which can include additional bills from those (some who you may not have seen in person) who helped with your treatment, such as radiology, pharmacy, emergency room, laboratory, anesthesia, surgeon, and other physicians.

Hospital charges do not include fees from your private physician and other providers. Should you have any questions regarding their bills, please contact them directly.

Clinic Services Charges

Similarly, generally charges fall into two categories: (i) a bill for treatment provided and (ii) a professional bill for the provider services.

Billing and Claims

EHS’s Billing Department will submit a claim for payment to your health insurer. Once your claim is submitted, your health insurer should notify you of its processing and payment decisions via an Explanation of Benefits (EOB), which summarizes charges incurred and identifies the payment made to EHS as well as your responsibility (i.e., Deductible, Co-Pay, and/or Co-insurance). Depending on your health plan, you may be responsible for part or all of these charges. If your health coverage does not cover your expenses, EHS can work with you on arranging payment including manageable payment plans and assisting with enrollment in government assistance programs.

Surprise Bills

NYS law protects you from unknowingly receiving care from out-of-network providers and facing “surprise” medical bills. It covers surprise medical bills in general and those related to, among other things, emergency services (including inpatient care following emergency treatment), when treated by a non-participating (out-of-network) doctor at our hospital.

Please take a moment to review Your Rights and Protections Against Surprise Medical Bills provided by EHS.

For additional information, please visit also the NYS Dept. of Finance’s Website for further information on surprise bills.

EHS is a participating provider in many health plan networks. You can find a list of the plans in which we participate here.

EHS is an organization whose mission is to provide treatment to those in need regardless of their ability to pay or their source of payment. Thus, EHS has established guidelines for levels of financial assistance dependent upon the financial situation (e.g., income and family size). No one will be denied services based on inability to pay.

If your health coverage does not cover your medical expenses, EHS can work with you on arranging payment plans. Staff is available to review your individual financial situation to determine if you qualify for financial assistance, either in the form of government assistance or an individual payment plan or EHS Charity Care.

If you qualify for EHS Charity Care, some charges may apply a “flat-fee” or a percentage of the facility’s applicable Medicaid Rate for inpatient and/or outpatient service types, or to a percentage of charges. The final discounted amount will depend on the type of service rendered (see ‘Financial Assistance Addendum A – Charity Care Grid’ for specific amounts by service types below). Professional bills from our St. John’s Medical Services, P.C. may apply a “flat-fee” and/or percentage of charges according to the applicable charity group level. All other professional services are excluded and financial hardship should be addressed directly with the billing entity.

It is important to let EHS know as soon as possible that you may have trouble paying your bill. Below is some helpful information about financial assistance at EHS:

• Financial Assistance Policy
• Charity Care Program
• Financial Assistance Addendum A – Charity Care Grid
• Financial Assistance Addendum B – Process & Application
• Asistencia Financiera Apendice B – Proceso & Aplicacion