No Surprise Billing

Information to Help You Avoid Surprise Medical Bills

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

Beginning April, 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 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.

  • It is possible that 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.

When you receive emergency medical services:

You are responsible to pay only your usual health insurance plan in-network costs and/or copayment amounts, even if the emergency care was given by a doctor who does not participate with your health insurance plan.

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

  • Does your doctor participate with your health insurance plan7
  • Does the hospital or outpatient facility where you will receive medical care participate in your health insurance plan7
  • Will there be any other doctors scheduled to be involved in providing services related to your care or referred by your doctor7
  • 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.

Resources to help you avoid surprise medical bills:

  • Visit https://www.northwell.edu/no-surprise-billing for
    • Health plans accepted by the hospitals and a hospital-specific cost estimator tool for in-network care
    • Find A Doctor tool to fmd your doctor's profi le to see the plans your doctor accepts
  • 1-888-321-DOCS (3627) to find a doctor
  • 1-877-483-2213 to obtain hospital-specific costs for out-of-network services
  • North Shore-liJ Financial Assistance Office l -800-995-5727 or visit NorthShoreUJ.com/assistance

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

"Emergency Medical Services and Surprise Bills" law is effective April 1, 2015, and amends the New York Insurance Law, Public Health Law, and Financial Services LAw. Details of the bill and your patient rights are available at www.assembly.state.ny.edu Search for bill #A09205