Adirondack Medical Center, a member of Adirondack Health, will provide you with information to contact an enroller to see if you qualify for any of the low or no-cost insurances available. By going through this process you will receive a 30% discount 30 days from your date of service. Once you have completed the enrollment process, you may be eligible for further discounts, and in some cases forgiveness of 100% of your Adirondack Health medical bills.
If you have completed the facilitated enrollment process and you do not qualify for any of the low or no-cost insurances available, Adirondack Health will use the financial information you provide to determine if you meet our financial assistance program criteria. This program is based on Federal Poverty Guidelines, and allows from 20% to 100% discounting on services billed by Adirondack Health.If there is still difficulty in meeting your financial obligation, Adirondack Health will work with you to set up a manageable payment plan.
You must complete the facilitated enrollment process to determine if you qualify for any of the no- or low-cost insurance plans available. Once you have done this, how much you will owe will be determined by the results of the facilitated-enrollment process. Again, this discount could be from 20% to 100% of outstanding bills owed to Adirondack Health.
Yes. Adirondack Health will supply you with the phone number to set up an appointment with an enroller. Many times a telephone call to the enroller, supplying them with minimal financial information, can give you an idea of what you may or may not qualify for in terms of insurance coverage.Enrollers are not employees of Adirondack Health so you will be asked to sign a consent form that will allow the enroller and Adirondack Health to share financial information. This is done in order to to determine what financial assistance can be provided in the most timely manner possible.
Once the facilitated enrollment process is completed, Adirondack Health will notify you within five business days.
All of your bills with Adirondack Health will be placed on hold during this period. If for some reason you choose not to go through the facilitated enrollment process, you must contact us to make arrangements for other payment options that might be available.
No. One application covers all of your outstanding accounts for the previous eight months from your date of service.
We will look at each case individually. Payments plans are possible. Contact us at (518) 897-2217 for more information.
For more information, please do not hesitate to contact our Financial Counselor in our Business Office at (518) 897-2217 or billing@adirondackhealth.org.
Insurance companies have guidelines that may limit coverage based on the diagnosis or frequency of a service (how often the service is performed).In Medicare terms, “not medically necessary” means that the service is not a benefit for the diagnosis or at this frequency. Your treating provider can discuss why this service is medically indicated for you, but Medicare does not consider it medically necessary.
The ABN form indicates that Medicare will probably deny payment for the service and tells you the reason. It will tell you the estimated cost of the service which you will need to pay. It allows you the opportunity to accept or refuse the service and protects you from unexpected expenses if Medicare denies payment. It also offers you the right to appeal Medicare’s decision.For more about an ABN, click here.
In order to ensure that we’re compliant with Medicare rules, this is a newpolicy at Adirondack Health.
A Notice of Financial Responsibility indicates that your insurance company will deny payment for the service and tell you the reason.It will tell you the estimated cost of the service which you will need to pay.It allows you the opportunity to accept or refuse the service and protects you from unexpected expenses if your insurance company denies payment.
"Provider-Based” or “Hospital-Based Outpatient” refers to the billing process for services rendered in a hospital outpatient clinic or location. This is the national model of practice for large, integrated delivery systems involved in patient care.
Adirondack Health employs many physicians and the same type of billing process is utilized for our outpatient care at Adirondack Medical Center - Saranac Lake, Adirondack Medical Center - Lake Placid, and our off-campus locations. This ensures an appropriate payment for the services provided by employed hospital physicians and staff.
Coverage and patient responsibility is dependent upon a particular insurance coverage and it is possible a patient may pay for certain outpatient services that are provided in our provider-based/outpatient locations than at a free-standing facility or physician’s office.
Our four health centers in Keene, Lake Placid, Saranac Lake and Tupper Lake.
It is dependent upon the patient’s insurance and could be less, the same, or more compared to a free-standing facility.Receiving care at Adirondack Health provider-based locations may result in a facility charge as well as a physician charge for outpatient services and procedures. These charges will be reflected on your patient statement and explanation of benefits from the insurance company.
