Your Rights as a Hospital Patient in New York State
Questions or Complaints About Your Hospital Bill or Health Insurance
- As a hospital patient, you are entitled to an itemized bill.
- Your hospital bill may identify a charge called a "surcharge." These surcharges fund important public programs and have existed in previous years, although they may not have shown as separate costs on the bill. The surcharge represents an additional amount due on total hospital bills in New York State and, depending on your insurance contract, the New York State Law allows a portion of these costs to be billed to you.
- Hospitals negotiate payment rates with insurers, HMOs and other types of managed care plans, as well as commercial insurers and self-insured groups. These rates may vary. Contact your insurer with any questions you may have regarding your coverage.
- If you have questions about your coverage, the services billed or amounts paid, contact the hospital's billing office and your insurer to resolve any questions/problems that you may have.
For Medicare Patients
If you are a Medicare patient and have questions about your hospital bill, call your Medicare carrier: 1-800-633-4227
For Managed Care Patients
If you are enrolled in a managed care plan and you are having trouble getting care or feel your care is not satisfactory, you may complain to the plan. The plan's handbook MUST tell you how to complain and how to get an immediate review. If you are not satisfied with the HMO or plan's response to your complaint, contact the New York Stat Department of Health at:
1-800-206-8125
Medicare managed care enrollees may call the IPRO Beneficiary Complaint Hotline or their HMO regarding quality of care issues.
1-800-331-7767