Adirondack Health is dedicated to improving price transparency for services. We want to help you understand the distinction between facility fees and professional fees.
New York State recently adopted a new law that requires patients be notified of any hospital facility fee that may not be covered by health insurance. Facility fees are billed separately from a physician’s professional fee. All out-of-pocket costs are determined by individual health insurance plans.
Below is a list of Frequently Asked Questions regarding facility fees. Patients with additional questions about a facility fee may contact Adirondack Health – Patient Financial Services at pricing@adirondackhealth.org or call 518-897-2217.
No. There are two types of fees that make up a medical bill, a physician fee and a facility fee. In a nonhospital setting, these fees are billed together. Facility billing is the hospital’s technical charge for services. Unlike physician-based billing, facility costs are not built into the hospital reimbursement structure (ex: facilities/maintenance, lighting/electricity). The facility fee is the reimbursement for the use of hospital space and resources.
There will be no change to the way Adirondack Health bills your health insurance.
Adirondack Health Emergency Room; Inpatient and Outpatient diagnostic departments and clinics including Saranac Lake Health Center, Lake Placid Health Center, Keene Health Center, St. Regis Falls Health Center, Tupper Lake Health Center, and Lake Placid Sports Medicine; and specialty clinics such as Women’s Health, Vascular, Wound Care, ENT, Cosmetics, Pain Management, Urology, Cardiology, Rheumatology, Bariatrics, and Oncology.
Facility fees cover a portion of your care within the hospital, such as the cost of supplies, equipment, diagnostic tests, and/or services rendered by technicians, nurses, and other members of your care team. The facility fee does not cover the care provided by physicians and other medical professionals. Please note that a facility fee will not be charged for certain services related to preventative care. A hospital facility fee is separate from, and charged in addition to, the fee billed by your doctor for the professional services provided during the visit. In a non-hospital setting, these fees are billed together.
The actual facility fee a patient is charged will depend on the duration of the patient’s visit and the particular services received during the visit. Visits that require expensive supplies or equipment will generally result in a higher facility fee.
As a reminder, there are no new fees and there is no change to how facility fees are billed to your insurance company. The amount of the facility fee that a patient will be responsible for paying out-of-pocket will depend on the patient’s insurance coverage. Patients can contact their insurance company to determine their estimated financial responsibility for a facility fee, including applicable copayments, coinsurance, and deductible amounts. If you experience trouble paying your balance, Adirondack Health offers a Financial Assistance Program. All patients are welcome to apply.
You can obtain additional information about the pricing of Adirondack Health’s services by using the Patient Estimator Tool on our Price Transparency page. On that page, you will also find Adirondack Health’s Uninsured Discount Policy which includes options for those patients who are unable to pay their balances in full.
For additional information on financial assistance, please refer to our Frequently Asked Questions, which can be found here. On that page you will also find information on how Adirondack Health bills for services provided in a hospital outpatient clinic, including the Saranac Lake and Lake Placid campus locations.
If English is not your primary language and you have difficulty communicating effectively in English, you may request a copy of this notice in another language.
This notice is required by NYS Public Health Law § 2830
