At NYC Health + Hospitals we are committed to providing you with the best information possible so you can make informed decisions about your care. This includes providing you with a list of hospital charges and an estimate of out-of-pocket costs for the most common services we provide.
You can obtain an estimate of your out-of-pocket costs for many services before your visit via MyChart or by calling 1-844-692-4692 and selecting option 3 to speak to a financial counselor. Our staff can help provide a comprehensive estimate based on your health insurance coverage and benefits information and your financial situation.
Hospitals are also required to make available applicable negotiated charges with contracted insurers for inpatient admissions and outpatient visits. These negotiated charges do not reflect how much you as a patient with coverage from the insurer will have to pay to NYC Health + Hospitals as out-of-pocket costs. These charges also may not reflect the actual amount ultimately paid by insurers. You can access the list here.
NYC Health + Hospitals also maintains a cost estimator tool for patients which provides an estimated out-of-pocket cost to you for the most frequently provided services that may be scheduled in advance. These services are also referred to as “shoppable services.” This estimated out-of-pocket cost is based on your insurance coverage information or self-pay status at the time of your request for the cost estimate. This estimate does not represent a guaranteed price or coverage of the services by your insurance plan, but includes an estimate of the charge the insurer has negotiated for the service, as applicable. The actual out-of-pocket cost to you may vary based on your health insurance coverage and benefits, medical condition and any additional tests or procedures ordered by your physician at the time of the service. You can access the cost estimator tool here.
Things to Know About Estimates
Estimates, also known as “Good Faith Estimates,” are based on the information available at the time of your request and do not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
You may call us at (844) NYC-4NYC (692-4692) and let us know the billed charges are higher than the Good Faith Estimate we provided and ask us how we can help.
If we are unable to assist you directly, you may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS) if you are billed for $400 or more over the estimate provided. If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with NYC Health + Hospitals, you may have to pay the higher billed amount.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises.