Paying for Your Care
No protected health information will be shared unless with an insurance company or a third party to obtain prior approval for treatment, to determine whether your plan will cover the treatment, or to obtain payment.
In addition, your personal information will be kept confidential via our secure server.
Any necessary refund of payment would be at the directive of the Patient Accounting Office and would be mailed.
For more information on protecting your healthcare information, click here.
Overview of Admissions Process
The first stop for every patient, both inpatients and outpatients, is the Admissions Department. There are several ways you might check in to the hospital, and they all start at the admissions desk:
You might need emergency treatment, in which case you check in with Emergency Department registration on your arrival at the hospital.
Your primary care physician might have ordered pre-admission testing for you. If so, you simply need a brief stop at Admissions.
During a visit to your physician’s office, s/he may determine that you should be admitted to the hospital. Your physician will call and make arrangements. When you arrive here, you simply need to stop at the Admissions desk to check in.
Some insurance companies require that they be contacted prior to or within 24 hours of medical services being rendered (i.e. hospital admission, emergency services, outpatient procedures such as MRIs, physical and occupation therapy, and outpatient surgery). It is your responsibility to notify your insurance company to obtain prior authorization.
Overview of Insurance Billing
One insurance policy is not like the next. If you are covered by health insurance, one of several possibilities will apply:
• Schuyler Hospital accepts your insurance and the service(s) you seek are covered by your policy.
• Schuyler Hosptial accepts your insurance, but some or all of the service(s) you seek are not covered by your policy.
• Schuyler Hospital does not accept your insurance.
We suggest that you discuss coverage with your employer or your private insurance carrier before you seek treatment, both to make certain you are insured and to learn how much of your treatment is liable to be covered by your policy. Schuyler Hospital will bill your insurance carrier directly in those instances where complete billing information has been received. Your insurance coverage is a contract between you and your insurance company and, while we will assist you in expediting your claim, you are ultimately responsible for your account. Any amount not paid by your insurance is your responsibility. We accept cash, personal checks and most major credit cards (American Express, Discover, Visa, & MasterCard). If your insurance policy requires a co-pay, that payment is required upon registration.
One of the aspects of hospital billing that may seem confusing is that you will receive separate billing statements from all of the doctors who assisted in your care: not only your referring physician but other doctors who may have served as consultants on your case. If, during your hospital stay, you were visited by your health care provider or a consulting physician requested by your health care provider, had surgery and received anesthesia, had x-rays which were interpreted by a radiologist, had laboratory tests requiring interpretation by a pathologist, or visited our emergency department, you will receive a separate bill for these services. You may not even have met these doctors in person, but they assisted in your treatment in some capacity. The bills will not necessarily arrive at the same time because the varying departments may be on different processing schedules. These fees are payable directly to the physician/facility issuing the bill; which may or my not be Schuyler Hospital.
We are here:
• To help you understand your billing statement
• To establish a payment plan for a billing statement
• To process a payment on a billing statement
• To update or change the insurance we have on file for you
• To assist you in applying for financial assistance
• To help appeal an adverse decision made by your insurance company
The patient representative will verify your insurance and notify you of any problems which may arise with your insurance coverage. This individual is available to help you make any necessary arrangements regarding payment of your hospital bill as well as answer any questions regarding your insurance coverage and our Financial Assistance Program.
Financial Assistance Program
Schuyler Hospital will reduce or eliminate patient financial responsibility for necessary and appropriate treatment and prevention in situations where the individual requiring treatment qualifies under financial hardship guidelines. Determination of financial hardship is based upon the income and assets available directly to the patient (applicant), or indirectly available through a parent or legal guardian. Schuyler Hospital uses the most current Federal Poverty Income Guidelines as a basis for these determinations. Each applicant for assistance must complete a written application and provide any information that is reasonably necessary to verify financial information. You can apply for financial assistance.
Click here for online financial assistance guidelines and application
Click here for Financial Aid brochure
Cayuga Health System is committed to providing excellent care regardless of an individual's ability to pay. If you are considering financial assistance to help cover the costs of your care, you may be eligible for free or low cost, State or Federally funded insurance programs like Medicaid. A financial counselor can refer you to someone who can help you apply for these programs. Schuyler’s FAP covers all medically necessary care provided by those outlined in our Provider List. Schuyler Hospital, Cayuga Medical Center, and Cayuga Medical Associates participate in Cayuga Health System's FAP. One application will qualify you for financial assistance at any of the participating facilities.
Please contact our Patient Service Representatives at (607) 535-8639 ext. 2321 or 2356, Monday through Friday between the hours of 8:00 a.m. – 4:30 p.m., to arrange a payment option or apply for financial assistance.
Frequently Asked Questions
I believe my insurance provider should have paid my bill, but they haven’t. What should I do?
Here are the next steps to take:
1. Contact your insurance company to verify that they have received and processed the claim.
2. Review your insurance policy to determine if the service is covered. If you are unable to determine this, call your insurance company to see if the procedure is covered. Their personnel will have the most accurate and up-to-date information about your policy and your claim.
3. Call the Patient Service Representative at (607) 535-8639 ext. 2321 or 2356 to make sure we have the most up-to-date insurance information on file for you.
Will my insurance cover my visit?
Your insurance policy specifies whether or not services we offer will be covered. If you are not sure if a service is covered we suggest you contact your insurance company. Their telephone number should be on your policy and your insurance identification card.
My insurance has changed. What should I do?
In order for your claims to be paid promptly, we need your most up-to-date insurance information so that we bill the correct insurance company. Please bring your current insurance card to all appointments so we can verify your most recent insurance information. If your insurance has changed, please advise the receptionist when you check in for services. You may also call (607) 535-8639 ext. 2321 or 2356 to update your insurance information. Keeping us current will help prevent any delays in processing your insurance claims.
I have insurance. Why did I get a bill?
As a courtesy to you, we bill your insurance company directly for services rendered. The charges become your responsibility if your insurance company does not pay them. If you receive a bill, the most likely explanation is either that your insurance policy does not cover the services you received or we do not have your most up-to-date insurance information so we were not able to bill your insurance company.
How did Schuyler Hospital determine how much I owed?
We as healthcare providers do not determine a patient’s co-payment or deductible amounts. Healthcare providers have contracts with insurance companies and the insurers pay us predetermined amounts for specific services provided. The amount the insurance company will pay is decided by the insurance plan and if that amount does not cover the balance of the bill, the remainder becomes the responsibility of the patient.
Can I pay all or part of my statement with credit?
Certainly. You may simply write your credit card information in the space provided on the front of your statement or call a Patient Service Representative at (607) 535-8639 ext. 2321 or 2356 for assistance.
Why did I get a bill for a balance I already paid?
If a payment was received after the statement date, it will appear again on your next statement.
How do I change the mailing address on my statement?
You may fill out the change of address section of the statement when you send in your payment.
Will my insurance pay for the charges listed on my statement?
Your statement tells you which charges your insurance company did and did not pay. The balance on the statement (“patient balance”) represents the amount left after the insurance company has paid its share. We request payment in full for the patient balance within 30 days of receipt of the statement. If you need to make payment arrangements, you can do so by calling the Patient Service Representative at (607) 535-8639 ext. 2321 or 2356.
What forms of payment do you take?
In addition to cash and personal checks, we accept Discover, MasterCard, VISA, and American Express. You can mail your payment to:
220 Steuben Street
Montour Falls, NY 14865
If I get a bill from a physician for services provided while I was in the hospital, can I send my payment to Schuyler Hospital?
Some physicians are housed in independent practices which have their own billing and collection services. In order for your payment to be recorded and accurately and promptly, payment should be sent directly to the address listed on your bill, not to the hospital.
My insurance company based their payment on Usual, Customary, and Reasonable (UCR) rates, and they did not cover all my costs. Are your rates unusually high?
To the contrary, on average Schuyler Hospital is one of the lowest-cost providers in the region. We’ve worked hard to keep our costs down because we are fiscally responsible and responsive to our customers. Our charges are “usual, customary, and reasonable” for this region. Our charges are very competitive to those of surrounding area hospitals.
Whom do I contact to discuss a discount?
In order to be fiscally responsible and to conserve resources for our financial assistance program, we do not have a discount program as such. However, we do maintain our financial assistance program to help those who have the willingness to pay but not the resources to do so. Our charges are very competitive and payment plans are available.
Definitions of Important Terms
Advanced Beneficiary Notice (ABN)
An Advanced Beneficiary Notice is a form advising you that tests performed by your doctor may not be covered by Medicare. The purpose of the Advanced Beneficiary Notice is to let you know in advance that these services may not be covered and to advise you that you will be responsible for payment of these charges.
Insurers assign a set cost to each medical procedure. Any amount above that cost is considered the responsibility of the patient. Therefore, the “approved amount” is the amount of the hospital's charge that an insurance payer will recognize in calculating benefits. (Under Medicare, this is also called the "Medicare Allowable Charge".)
This rule is called upon to decide which parent’s plan is to be considered the primary plan for dependent children. According to the Birthday Rule, the primary plan will be the plan of the parent whose date of birth (month and day) falls earlier in the calendar year.
For example, if the father's birth date is March 4 and the mother's birth date is January 22, the mother's plan would be primary. If both parents have the same birth date, the primary health plan will be the one that has been in effect for the longer period of time.
The Birthday Rule is endorsed by the National Association of Insurance Commissioners (NAIC).
In some insurance policies, the insured person and the insurer share the cost of services. The insurer pays a certain percentage and the insured person pays the rest. This system is one way of lowering the cost of the insurance policy. The co-insurance is the percent of the approved charge that the insured person pays.
In some insurance policies, the insured person pays a specified flat fee per visit or per unit of service (e.g., $50 for emergency services), with the insurer paying the balance. The co-payment is the flat fee that the insured person pays.
An insurance deductible is the minimum amount the patient must pay out of pocket before the insurance company will pay anything toward charges. Usually the deductible is not a one-time fee but is reactivated yearly.
Medicare Medical Savings Account
Some people are eligible for a Medicare health plan option made up of two parts: one part is a Medicare MSA (Medical Savings Account) Health Policy with a high deductible. The other part is a special savings account, called a Medicare MSA (Medical Savings Account.) The funds in the Medical Savings Account are traditionally used for such things as deductible payments, preventive care not otherwise covered, etc.
Original Medicare Plan
This is the traditional pay-per-visit arrangement that divides coverage into “Part A” and “Part B” services. The amount of your coverage depends on whether you have coverage under Medicare Part A, Medicare Part B, or both. Typically, Medicare Part A pays for your inpatient hospital expenses and Medicare Part B pays for your outpatient health care expenses.
Private Fee-for-Service Plan (PFFS plan)
A PFFS plan is a Medicare Advantage health plan offered by a state-licensed provider who contracts with Medicare and Medicaid to provide Medicare benefits plus any extra benefits it chooses to provide. Some Medicare Advantage plans require patients to choose their healthcare providers from a prescribed network; in most cases, persons insured by a PFFS plan may use any health provider who accepts Medicare, rather than choosing from a specified network.
A referral is a recommendation from your primary care doctor to see a certain specialist or receive certain services. Referrals are sometimes required before an insurance company will pay for treatment. Some specialists will only see patients who have obtained a referral.
Urgent Need Care
Urgent Need Care addresses unexpected illness or injury that needs immediate medical attention but is not life threatening. Such care is billed under the heading of emergency services.
Office hours are Monday through Friday 8:00 a.m. - 4:30 p.m.