Insurance and Billing – Westchester Medical Center Health Network

Medical billing can be a complicated and confusing subject. Understanding what is covered by insurance, how much you’ll pay out of pocket, and how to work with insurance companies isn’t always easy. We know it can be frustrating to deal with medical bills, and we want the cost of the care you receive at WMCHealth to fair, clear, and with as few surprises as possible. We also want patients who do not have the ability to pay to receive the care they need. Here are important things to know about insurance and billing at WMCHealth.

Insurance Companies We Work With

WMCHealth is a participating provider in many health plan networks, including:

Aetna
Aetna Transplant
Affinity/Molina
Anthem/Empire Blue Cross
Carelon Behavioral Health
CDPHP
Cigna Health and Life
CignaLifeSource
Dentaquest
Emblem/GHI/HIP
Empire Health Plus
Fidelis/Centene
First Health
Hamaspik Choice
HealthFirst
Magnacare
MVP
Optum Behavioral Health
Optum Transplant
Oxford
Partners Health Plan
The Empire Plan
United Healthcare
VNS Choice Health Plan
Wellcare
World Trade Center Health Plan
Medicare (Traditional)
Medicaid (FFS)
Tricare

Please remember that some health plans use smaller networks, so please check to see if we participate in your plan. Your level of coverage will depend on your individual health plan. Call us at 914.493.5449 with any questions, and reach out to your health insurance provider to confirm coverage, payment structures, and copays. If you’re not insured, you might qualify for help paying for your hospital bills.

You can also learn about the accepted plans that are available by location here:

Experienced Middle Aged Family Doctor Showing Analysis Results on Tablet Computer to Male Patient During Consultation in a Health Clinic. Physician Sitting Behind a Desk in Hospital Office.

Patients at Westchester Medical Center Health Network should understand how their bill is processed and be familiar with their insurance coverage. Please bring all your medical insurance cards and any special forms required to your pre-admission testing or on the day you are admitted. Items not covered by insurance, such as deductibles and private rooms, are payable in full at the time of discharge.

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About Your Bill

Your bill from WMCHealth does not include your doctor’s fee nor the fees of other physician specialists, such as anesthesiologists, radiologists, pathologists or other consulting physicians to whom you may be referred by your doctor. You will receive a separate bill for services from each of them.

Pay Your Bill

View your hospital bill online here. If you don’t understand your bill, we’ve provided a document on how to read a hospital bill as well as a consumer guide to healthcare prices from the Healthcare Financial Management Association.

For Remittance of Checks

If you (a patient) have received a check from your insurance company at your home address, please endorse the back of the check and mail with the Explanation of Benefits to:

Westchester Medical Center, Behavioral Health Center, and Maria Fareri Children’s Hospital:
- Westchester Medical Center
  Client ID # 400008
  P.O. Box 5044
  New Britain, CT
  06050-5044
Bon Secours Community Hospital and Medical Group
- Customer Service / Financial Assistance Department
  400 Rella Boulevard
  Suite 308
  Suffern, NY 10901
Good Samaritan Hospital and St. Anthony Community Hospital
- Customer Service / Financial Assistance Department
  400 Rella Boulevard
  Suite 308
  Suffern, NY 10901
HealthAlliance Hospital and Margaretville Hospital
- HealthAlliance Hospital
  105 Maty’s Avenue
  Kingston, NY 12401
MidHudson Regional Hospital
- Westchester Medical Center
  Client ID # 400008
  P.O. Box 5044
  New Britain, CT 06050-5044
WMCHealth Physicians Advanced Physician Services
- WMC Advanced Physician Services, P.C.
  19 Bradhurst Avenue, Suite 3100N
  Hawthorne, NY 10532

Co-pay and Deductible Responsibilities

Co-pay or deductible responsibilities should be paid on the date of service. We accept Visa, Discover, MasterCard and American Express.

Patient Accounting

Our Patient Accounting Department is open 8:00 a.m. – 4:00 p.m., Monday – Friday, in order to assist our patients with resolution of their open accounts. Appointments can be scheduled to speak with one of our representatives outside of our normal hours upon your request. All information is kept confidential. For assistance, please contact the Patient Accounting Department at:

Westchester Medical Center, Behavioral Health Center, and Maria Fareri Children’s Hospital: 845.334.2743
Bon Secours Community Hospital and Medical Group: 844.419.2701
Good Samaritan Hospital and St. Anthony Community Hospital: 844.419.2701
HealthAlliance Hospital and Margaretville Hospital: 845.334.2743
MidHudson Regional Hospital: 845.431.8134
WMCHealth Physicians Advanced Physician Services: 914.570.8745

We understand the difficulties surrounding healthcare costs, that’s why we offer financial counseling, charity care and payment assistance to our patients.

Smiling woman checking her phone while working from home

You are responsible for contacting your insurance carrier prior to elective admission (if required) and 24 to 48 hours after Emergency Room admittance or transfer from another hospital. Refer to your contract to ensure you adhere to the terms of your specific plan. If there are any questions about your insurance, a Patient Accounts Representative will contact you either for more information or to explain your responsibilities. It is important that you understand that the final responsibility for payment is with you, the patient.

Charges for Physician Services

Physician services you may receive in the hospital are not included in the hospital’s charges. Doctors might not participate in the same health plans as the hospital, and they may bill for their services separately. Check with the physician arranging for your hospital services to identify any required services from other physicians.

WMCHealth contracts with Westchester Medical Center Advanced Physician Services, P.C., to provide anesthesiology, radiology, and pathology services at the hospital. You can contact WMCAPS directly to find out which health plans they participate in or if you have questions about a bill.

Westchester Medical Center Advanced Physician Services, P.C.
19 Bradhurst Avenue, Suite 3100N
Hawthorne, NY 10532
914.570.8745

How to Pay a Bill

Log in to the patient portal or our bill pay tool to submit payment for care received at WMCHealth. If you have questions about your financial responsibility, please visit the hospital’s location page where you received services. WMCHealth will share any available information about standard charges and how to submit for coverage.

Need Help Paying Your Bill?

Understanding the Lingo

Knowing the commonly used terms could help you better understand your insurance coverage, the billing process, and who to reach out to for help. Here is some of the common language used in billing and insurance.

Coordination of Benefits (COB): COB determines who the primary payer of services is when you’re covered under two or more insurance companies. For example, you could have Medicare and a commercial insurance. COBs prevent duplicate payments. You will be asked to choose which insurance coverage you want to use when you’re admitted.
Co-payment: A fee you pay for a specific service. It’s usually due at the time of service.
Co-insurance: This is the portion of your medical expenses that you’re responsible for paying. For example, if your insurance covers 80% of a bill, the other 20% is your co-insurance, which you pay for.
Deductible: This amount is what you owe each year before your insurance begins making payments.
Explanation of Benefits (EOB): It’s important to know that these are not bills. An EOB shows the amount billed by your doctor or hospital, how much is covered by your insurance, and how much you owe. After you leave the hospital, you’ll get an EOB statement from your insurance provider. This will show the amount covered by your insurance and the amount you owe and will be billed for.
Billing Process: Hospital bills include charges for your room, meals, 24-hour nursing care and medicines, X-rays and lab tests. Doctors, surgeons and specialists may bill separately from the hospital.
Types of Coverage: WMCHealth works with many commercial insurance companies, as well as Medicare and Medicaid. We’ll work with your insurance plan to determine how your bill will be paid. Please take the time to look into the terms of your insurance coverage, since your plan may have special requirements.
Medicare: If you have Medicare, you’ll complete a Medicare Secondary Payer (MSP) form at admission. This ensures that Medicare only pays for services not covered by other insurance you may have. If you have a second type of insurance, this usually covers Medicare deductibles. If you don’t have secondary insurance, you’ll need to pay these amounts yourself.
Self-Pay Patients and Payment: This means you’re planning to pay your bills without help from Medicare or a commercial insurance provider. If that’s the case, you’ll get bills directly from the hospital. When the first bill arrives, call the hospital’s Financial Services Department at 914.493.2089 or 914.493.5449 to set up a payment plan.

It is important for you to know that the physician services you receive in the hospital are not included in the hospital’s charges. Physicians bill for their services separately and may or may not participate in the same health plans as the hospital. You should check with the physician arranging your hospital services to determine which plans that physician participates in. Hospital contracts with WMC Advanced Physician Services, P.C. (WMCAPS) to provide anesthesiology, radiology and pathology services. You can obtain insurance verification information on WMCAPS physicians by contacting:

WMC Advanced Physician Services, P.C.
19 Bradhurst Avenue, Suite 3100N
Hawthorne, NY 10532
914.570.8745

Hospital contracts with Vituity to provide emergency room physician services. If you have questions and/or concerns, please contact Vituity at 1.800.498.7157 or via email at [email protected].

To obtain insurance information on Anesthesiology physicians, please contact:

CareMount Medical
90 South Bedford Road
Mt. Kisco, NY 10549
914.241.1050

Hospital Charges

Hospitals are required by law to make available information about their standard charges for the items and services they provide. If you have any questions about your financial responsibility, please call 914.493.5446.

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