NYS Surprise Bill Act

Scope:

This policy will apply to all patients regardless of payer or service. This policy applies throughout OH, including the hospital and all of its departments and health centers, OH affiliated physician practices (Oneida Medical Services, PLLC and Oneida Medical Practice, PC), the Extended Care Facility and any other department or entity which is part of OH.

十大靠谱网赌平台公司将确保我们遵守纽约州紧急医疗服务和意外账单法中规定的要求.  该法令要求向患者披露健康计划所支付的自付费用, providers and hospitals.

Disclosures may differ dependent on whether it is a Emergency Service or Non-emergency service.  Oneida健康医院必须披露的信息与其附属十大靠谱网赌平台办公室作为提供者/团体诊所可能必须披露的信息之间的披露也可能有所不同.  This policy will serve to assist in distinguishing the required disclosures.

Hospital Website Disclosures:

Oneida Health Hospital will provide disclosure on our external website, yh7v.babytripster.com, as follows: To the extent required by Federal guidelines, access to the hospital’s standard charges for items and services it provides, including Diagnosis Related Groups (DRGs); A list of participating health plans; A statement that states the following:

1. Physician services provided in the hospital are not included in the hospital charges;
2. 在医院提供服务的十大靠谱网赌平台可以也可以不参加与医院相同的健康计划;
3. Encourage the prospective patient to check with the physician arranging for the hospital services to determine the plans with which the physician participates; and
4. As applicable, the name, address, and telephone number of the physician groups that the hospital has contracted with to provide services, including anesthesiology, pathology, or radiology, 以及如何联系这些团体以确定十大靠谱网赌平台参与的健康计划的说明.

Registration / Patient Intake Disclosures:

Oneida Health will provide disclosure to our patients in advance of non-emergent hospital service,  in all of our patient intake/registration areas including, but not limited to, our offsite departments, units and health centers as follows. In addition, 我们将包括这些信息，在任何邮件提供给预定的病人之前，他们的服务.

建议患者或潜在患者咨询安排医院服务的十大靠谱网赌平台以确定名称, practice name, address, and telephone number of any other physician whose services will be arranged by the physician, 以及是否由医院雇佣或签约提供服务的十大靠谱网赌平台提供服务, including anesthesiology, pathology, and/or radiology, are reasonably anticipated to be provided to the patient; and

Provide patients or prospective patients with information about how to determine, in a timely manner, the health plans in which the physicians participate

OH’s Physician Affiliates Disclosures:

At Oneida Health, we have 5 affiliated physician specialty offices that include Ortho, Neuro, Women’s Health, ENT services and Quick Care.  如上所述，这些诊所属于本政策的范围，并将向其患者和潜在患者提供以下信息:

The name, practice name, address, and telephone number for any provider scheduled to perform anesthesiology, laboratory, pathology, radiology, or assistant surgeon services in connection with care to be provided in the physician’s office or referred or coordinated by the physician at the time of referral or coordination; and

For a scheduled admission or outpatient service, provide the patient and the hospital with the name, practice name, address, 以及任何其他十大靠谱网赌平台的电话号码，这些十大靠谱网赌平台的服务将由该十大靠谱网赌平台安排，并在入院前测试时安排, registration, or admission prior to the provision of services; and information about how to determine the plans in which the physician participates.

Health Care Professional Disclosures:

If the Health care professional participates in one or more health plans, they must provide patients and prospective patients the following disclosures:

The plans in which they participate either in writing or on their Web site; and A list of hospitals the health care professional is affiliated with prior to providing non-emergency services, and verbally at the time an appointment is scheduled.

If the Health care professional does not participate with a health plan, they must:

Inform the patient or prospective patient, before the nonemergency services are provided, that the amount the healthcare professional will bill is available upon request; and Upon receipt of this patient request, 以书面形式披露已提供或预计将提供的服务的收费金额或估计金额(或保健中心的收费表)，除非在提供服务时可能出现不可预见的医疗情况.

This disclosure of information will be accomplished at a variety of different times and methods. The information could be presented at the time of scheduling an appointment (offices, health centers, etc), at the time the patient is registered, 由提供服务的辅助科室提供(如果患者绕过“患者访问”)和/或在预定就诊前通过邮件发送.  这将通过向每位患者提供一封“关于在奥奈达医疗中心支付医疗费用的重要信息”(等)来实现, refer to links below).  我们还将向每位患者提供与我们的设施相关的所有适用合同提供者的清单及其计费服务联系信息(请参阅下面的链接)。.

Again, all of this information will be posted and available on our website at yh7v.babytripster.com.

Uninsured/Self-Pay Patient

所有没有保险和自费的病人都有权利要求并获得对任何定期服务的诚实估计, in accordance with the No Surprise Act. 此外，还要求通知存在患者-提供者争议解决程序，以及在法规规定的参数范围内对账单提出争议的权利.

• Right to Receive a Good Faith Estimate of Expected Charges
• Good Faith Estimate for Health Care Items and Services

Other Notable Mandates in the Law:

With respect to Emergency Services, 患者只对网络内的价格负责，不承担比通常的价格分担或共同支付更多的费用, regardless of whether the providers were in-network or out-of-network.

With respect to Other services, 当患者从网络外的提供者那里接受治疗，而网络内没有可用的提供者, or where the provider failed to provide the disclosures required under the law, the patient is only responsible for their in-network price, and may assign their claims to the out-of-network provider, who must seek any additional reimbursement directly from the patient’s health insurer.  设立了一个独立的审查程序来处理医疗保健提供者和医疗计划之间的报销纠纷.  (请注意:此流程不包括导致账单低于600美元的紧急服务账单，该金额可能会有所变化).

Dispute Resolution:

提供者和健康计划之间就医疗服务收费发生争议时, there is an independent review process to deal with the dispute.  However, there is an exclusion for bills for emergency services resulting in charges less than $600.  根据《推荐十大靠谱网赌平台》(FSL)第6条，患者有权将关于支付紧急服务账单和意外账单的争议提交独立的争议解决机构, §606.

Hospital bills are NOT subject to Dispute Resolution. This only applies to providers and patients.

State and Health Plans themselves can pursue dispute resolution.  Oneida Healthcare does not have to notify patients about the dispute resolution process.

References:

New York State Surprise Bill Section 24 of PHL;  Part H of Chapter 60
纽约州意外法案:提议23 NYCRR 200“紧急医疗服务和意外法案的独立争议解决法”
New York State Out-of-Network (OON) Consumer Protection Law (2014-2015 New York State Budget)
Affordable Care Act – 42 U.S.C. §300gg-18(e); 79 Federal Register 50145-50146
Financial Services Law (FSL) Article 6, FSL §606

Forms:

OHC Important Information About Paying for Your Care (01519).pdf
OHC Patient Notification of Contracted Providers-Services OHC (00251) (2).pdf
WHA Patient Notification of Contracted Providers-Services (01516).pdf
WHA Important Information About Paying for Your Care (01518).pdf
OMP Patient Notification of Contracted Providers-Services Oneida Ortho Neurology(01517).pdf
Ortho Important Information About Paying for Your Care Oneida Ortho (01520).pdf
Neuro Important Information About Paying for Your Care Neurology Specialist (01521).pdf
Quick Care Important Information About Paying for Your Care (01523).pdf
Quick Care Patient Notification of Contracted Providers-Services (01522).pdf
ENT Specialists Patient Notification of Contracted Providers-Services (01525).pdf
ENT Important Information About Paying for Your Care (01526).pdf
ED NY Team Health Payer Notice (01527).pdf

Approved by: Revenue Cycle Management Team, 3/31/15