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. Self-pay patients have the right to receive a "good faith" estimate before a planned hospital stay. To learn more, visit cms.gov/nosurprises.

When the first bill arrives, call the hospital’s financial services department to set up a payment plan. Communicate with the financial services department as soon as possible. If you don’t set up a payment plan, or if you stop making payments, then your account may be placed with a collection agency. The hospital wants to work with you, so reach out with any questions or concerns you have.

At Northwell Health (Northwell), we are committed to providing the best care possible for all of our patients and to increasing access to high-quality clinical care in the communities we serve. We understand that, as a patient, you may feel stressed to receive a hospital bill. That is why we have created a robust financial assistance policy at our hospitals and hospital-based clinics. You may qualify for help if you are unable to pay all or part of your bills for emergency or other medically necessary care.

We have a large staff of trained financial counselors ready to assist you if you believe you need financial assistance. We encourage you to use the contact information listed below to contact Northwell and ask to speak to a financial counselor to see if you qualify. Northwell financial counselors may also be able to help you obtain health care insurance available to you.

Eligible services

You may be eligible for financial assistance for emergency medical care and other medically necessary services provided and billed by Northwell Health’s hospitals. These services include physician services in these hospitals provided by physicians who are employed by Northwell Health. A sliding fee discount is also available for medically necessary services provided to uninsured patients in a Northwell hospital clinic.

If you are a New York state resident, you may qualify for financial assistance or the sliding fee discount if you submit an application and if we determine that you are eligible. You may be eligible if you have no health insurance, or if you are otherwise unable to pay. If you do have health insurance, you may still be eligible if you have out-of-pocket expenses that you are not able to pay. Factors that will determine your eligibility for financial assistance are discussed below.

How to apply for financial assistance

Submit a complete financial assistance application with all required documentation online, via mail, or by working with one of Northwell Health’s financial counselors over the phone. You can get an application in any of the following ways:

• online at the Northwell Health website: https://www.northwell.edu/billing-and-insurance/financialassistance-
• programs-policies/financial-assistance-program
• at each Northwell Health hospital facility’s main registration desk or emergency room desk, or at the
• applicable clinic
• by contacting Northwell at the contact listed below and asking to speak with a financial counselor

If you are a hospital patient, we encourage you to apply for financial assistance as soon as possible and within 90 days from the date on your first post-discharge billing statement. Note, however, that you can submit a financial-assistance application at any time after you are treated at the hospital.

If you are a new patient at a hospital clinic, we encourage you to submit your application before your first appointment, or to bring the materials necessary to submit an application to your first appointment.

If you submit an incomplete application, we will notify you and give you an opportunity to provide any missing information or documentation.

Determination of eligibility

Eligibility for financial assistance is based on family income and, in some cases, on other information you provide. If after reviewing your application, Northwell determines that your income is at 500% of Federal Poverty Guidelines (FPG) or below, you will be eligible for a discount on your bill for eligible services. Greater discounts are provided for lower levels of income. In 2024, the maximum income levels for eligibility at 500% of FPG are shown below:

*These guidelines are from 2024 but will be updated every year.

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.