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Paying for Your Care

Paying for Your Care

We understand that hospital billing can be very confusing. We’re here to walk you through the process, to answer your questions, and to help in any way we can. If you phone us, you will reach experienced and friendly people who want to help you find the information you need. We understand that when you are injured or ill, healing and recovery are your first priorities. We also know it is easy at times like this to forget, or be overwhelmed, by the business side of medical care. We are here to assist you in the process of settling your bill.

About Pricing

Since each individual patient is unique, please call Patient Accounting at (607) 274-4400 for information about any medical procedures/hospital pricing or hospital length of stay.

Cayuga Medical Center at Ithaca strives to price our items/services in a defensible manner, which is reflective of our cost to provide healthcare services to our patients. We take into account standard Medicare reimbursement amounts for each item/service when setting our prices, and are always looking to remain competitive with similar services that are provided in our local market area whenever possible.

Stated prices for supplies and pharmaceuticals are based on current market rates. Prices for these items are subject to change on a regular basis, and the CDM file will note the date of validity for pricing shown. Cayuga Medical Center at Ithaca will work to update the CDM file on the website periodically to reflect updates, and at minimum, will do so annually.

Prices listed do not include physicians’ fees. You will be billed separately. These may include charges from your surgeon, anesthesiologist or radiologist.

The information you contact us about is based on the average Cayuga Medical Center hospital charge for specific services. We’re unable to provide you with what your deductible, co-insurance or co-pay will be and whether a procedure will be covered by your insurance. Please contact your insurance company directly for this information. The amount you will owe depends on your insurance plan.

Overview of Admissions Process

The first stop for every patient, both inpatients and outpatients, is the Admissions Department. There are several ways you might check in to the hospital, and they all start at the Admissions desk:

You might need emergency treatment, in which case you check in with Emergency Department registration on your arrival at the hospital.

Your primary care physician might have ordered pre-admission testing for you. If so, you simply need a brief stop at Admissions.

During a visit to your physician’s office, s/he may determine that you should be admitted to the hospital. Your physician will call and make arrangements. When you arrive here, you simply need to stop at the Admissions desk to check in.

If you are registering for outpatient services, you may take advantage of express check-in by calling (607) 274-4353. If you call ahead 24 to 48 hours, it will help us streamline your check-in. We can verify pertinent information and then when you check in at Admissions, you will be directed immediately to the appropriate department in the hospital.

When you check in, the person at the desk will take down (or verify, if your information is already there) all the information needed to get you into the system: contact information, insurance information if you are covered, etc.

Overview of Insurance Billing and Payments

One insurance policy is not like the next. If you are covered by health insurance, one of several possibilities will apply:

CMC accepts your insurance and the service(s) you seek are covered by your policy.
CMC accepts your insurance, but some or all of the service(s) you seek are not covered by your policy.
CMC does not accept your insurance.

We suggest that you discuss coverage with your employer or your private insurance carrier before you seek treatment at Cayuga Medical Center, both to make certain you are insured and to learn how much of your treatment is liable to be covered by your policy. Any amount not paid by your insurance is your responsibility. We accept cash, personal checks and most major credit cards (American Express, Discover, Visa, and MasterCard). If your insurance policy requires a co-pay, that payment is required upon registration.

When you get your bill, if you are unable to pay your entire balance due in a single payment, we will work with you to set up a payment plan. Financial assistance is also available for those who qualify. You may contact us at (607) 274-4400 to set up a payment plan or to apply for financial assistance, or you can apply for financial assistance online. Click for online financial assistance guidelines and application. Cayuga Medical Center will bill both your primary and secondary insurance carriers, so it is important for you to make sure you have provided CMC with current insurance information.

What Your Bill Will Include

Inpatient bills will include:

  • Charges for hospital tests and services
  • Room accommodation
  • Supplies
  • Drugs

Outpatient bill may include:

  • Emergency room visits
  • Clinic or therapy visits
  • Observation or holding bed
  • Tests
  • Other services (including lab specimens sent to us by physicians’ offices) supplies

One of the aspects of hospital billing that may seem confusing is that you will receive separate billing statements from all of the doctors who assisted in your care: not only your referring physician but other doctors who may have served as consultants on your case, including emergency room physicians, cardiologists, radiologists or other specialists, for example people who read x-rays or interpret lab tests. You may not even have met these doctors in person, but they assisted in your treatment in some capacity. The bills will not necessarily arrive at the same time because the varying departments may be on different processing schedules. Please feel free to call us if you have questions about any of the bills related to your treatment.

Physician Billing

If you have questions regarding your physician bill, please contact:

For Anesthesia Services:
(607) 277-3790

For Imaging Services:
ABC Accounts Manager
(517) 787-6440, ext. 4161
(to check network status and obtain bill estimates)

For Laboratory Services:
Pathology Associates of Ithaca
(888) 618-4581

For Urgent Care and Emergency Services:
Cayuga Emergency Physicians
(800) 700-9078

For Inpatient Medical and Intensive Care Services:
Cayuga Medical Associates
(888) 814-6459, ext. 359

For Sleep Services:
United Medical Associates
(607) 770-0025

For Radiation Oncology Services:
Medical Management Services
(800) 689-1901 or (607) 277-3257

Patient Accounting:
We are here:

  • To help you understand your billing statement
  • To establish a payment plan for a billing statement
  • To process a payment on a billing statement
  • To update or change the insurance we have on file for you
  • To assist you in applying for financial assistance
  • To help appeal an adverse decision made by your insurance company

Patient Accounting hours:
8:00 a.m. – 5:30 p.m., Monday – Thursday
8:00 a.m. – 3:00 p.m., Friday

Financial Assistance Program (FAP)

Cayuga Health System is committed to providing excellent care regardless of an individual’s ability to pay. If you are considering financial assistance to help cover the costs of your care, you may be eligible for free or low cost, State or Federally funded insurance programs like Medicaid. A financial counselor can refer you to someone who can help you apply for these programs. Cayuga Health System’s FAP covers all medically necessary care provided by those outlined in our provider list.

Cayuga Medical Center, Schuyler Hospital, and Cayuga Medical Associates participate in Cayuga Health System’s FAP. One application will qualify you for financial assistance at any of the participating facilities.

Qualifying for Financial Assistance
Whether you are uninsured or insured, you may qualify for full or partial financial assistance if your household income is at or below 300% of the Federal Poverty Level for the 48 Contiguous States & D.C. To see if you household income qualifies please visit: aspe.hhs.gov

  • If your household income is at or below 100% of the Federal Poverty Level, only a nominal fee (outlined below) is required, the rest will be covered by financial assistance.
Inpatient Services $150/Discharge
Ambulatory Surgery $150/Discharge
MRI Testing $150/Discharge
ED/Clinic & Physician Services $15/Visit
Prenatal & Pediatric Clinic Services No Charge
Ancillary Services No Charge
  • If your household income is greater than 100%, but less than 300% of Federal Poverty Level, you may be eligible for a sliding scale discount.

Applying for Financial Assistance
FAP applications can be accessed electronically by clicking on the “Financial Assistance Application” button. Paper FAP applications are available in our Patient Accounting Office.

  • Patients may apply up to 240 days from the date of your first billing statement (Application Period)
  • You may be sent to collections if a complete application is not submitted and no payment plan arrangements are made with our Patient Accounting Office.
  • If you need assistance filling out the application please contact our Financial Counselor(s)
  • By applying and qualifying for the financial assistance program
    • You may not be charged more than the Amounts Generally Billed to an insured patient
    • You must notify a financial counselor if your household income changes $5,000 or more
    • You will receive a card noting the effective dates of your FAP eligibility and will not need to reapply for a 12 month period following the determination of your eligibility

Our financial assistance brochure is available in Chinese. Please contact a financial counselor.

Cayuga Medical Center
Patient Accounting Attn: Financial Assistance
101 Dates Drive
Ithaca, New York 14850
Financial Counselor: 607-274-4400
Hours: 8:00am – 4:00pm

On-Line Bill Pay

Thank you for taking advantage of our new On-Line Bill Pay feature. This service allows you to quickly and conveniently pay your hospital bill anytime of the day or night, 7 days/week, 365 days/year!

Billing statements are mailed approximately every four weeks. Payment in full is requested upon receipt of your statement. We accept payments using the following charge cards: VISA, MasterCard, American Express, and Discover.

To pay your bill, please have your billing statement in front of you.

You will need to have the account number from the bill(s) you are paying along with the credit card you would like charged.

To begin processing your payment, click on the link below. Your information will be kept confidential via our secure server.

Disclosure Statement

Important Information about Paying for Your Care at Cayuga Medical Center

Cayuga Medical Center is a participating provider in many health plan networks. Some health plans use smaller networks for certain products they offer so it is important to check whether we participate in the specific plan you are covered by. Our list will tell you if we do not participate in all of a health plan’s products.

It is also important for you to know that the physician services you receive in the hospital are not included in the hospital’s charges. Physicians who provide services at the hospital may be independent voluntary physicians or they may be employed by the hospital. 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. Cayuga Medical Center contracts with a number of physician groups, such as anesthesiologists, radiologists and pathologists, to provide services at the hospital. Please review the provider list to see which doctors and physicians groups might provide services to you at CMC. The provider list will tell you whether or not your doctor participates in the Hospital’s Financial Assistance Policy, but you should contact these groups directly to find out which health plans they participate in.

You should also check with the physician arranging for your hospital services to determine whether the services of any other physicians will be required for your care. Your physician can provide you with the name, practice name, mailing address and telephone number of any physicians whose services may be needed.

Hospitals are required by law to make available information about their standard charges for the items and services they provide. This information is available by contacting Patient Accounting at (607) 274-4400.

If you do not have health insurance, you may be eligible for assistance in paying your hospital bills. Information about financial assistance is available by clicking here or you may contact Patient Accounting at (607) 274-4400.

Frequently Asked Questions

I believe my insurance provider should have paid my bill, but they haven’t. What should I do?

Here are the next steps to take:

  1. Contact your insurance company to verify that they have received and processed the claim.
  2. Review your insurance policy to determine if the service is covered. If you are unable to determine this, call your insurance company to see if the procedure is covered. Their personnel will have the most accurate and up-to-date information about your policy and your claim.
  3. Call the Financial Counselors at (607) 535-8639 ext. 2321 or 2356 to make sure we have the most up-to-date insurance information on file for you.

Will my insurance cover my visit?

Your insurance policy specifies whether or not services we offer will be covered. If you are not sure if a service is covered we suggest you contact your insurance company. Their telephone number should be on your policy and your insurance identification card.

My insurance has changed. What should I do?

In order for your claims to be paid promptly, we need your most up-to-date insurance information so that we bill the correct insurance company. Please bring your current insurance card to all appointments so we can verify your most recent insurance information. If your insurance has changed, please advise the receptionist when you check in for services. You may also call (607) 274-4400 to update your insurance information. Keeping us current will help prevent any delays in processing your insurance claims.

I have insurance. Why did I get a bill?

As a courtesy to you, we bill your insurance company directly for services rendered. The charges become your responsibility if your insurance company does not pay them. If you receive a bill, the most likely explanation is either that your insurance policy does not cover the services you received or we do not have your most up-to-date insurance information so we were not able to bill your insurance company.

How did Cayuga Medical Center determine how much I owed?

We as healthcare providers do not determine a patient’s co-payment or deductible amounts. Healthcare providers have contracts with insurance companies and the insurers pay us predetermined amounts for specific services provided. The amount the insurance company will pay is decided by the insurance plan and if that amount does not cover the balance of the bill, the remainder becomes the responsibility of the patient.

Can I pay all or part of my statement with credit?

Certainly. You may simply write your credit card information in the space provided on the front of your statement or call Patient Accounting at (607) 274-4400 for assistance.

Why did I get a bill for a balance I already paid?

If a payment was received after the statement date, it will appear again on your next statement.

How do I change the mailing address on my statement?

You may fill out the change of address section of the statement when you send in your payment.

Will my insurance pay for the charges listed on my statement?

Your statement tells you which charges your insurance company did and did not pay. The balance on the statement (“patient balance”) represents the amount left after the insurance company has paid its share. We request payment in full for the patient balance within 30 days of receipt of the statement. If you need to make payment arrangements, you can do so by calling Patient Accounting at (607) 274-4400

What forms of payment do you take?

In addition to cash and personal checks, we accept Discover, MasterCard, VISA, and American Express.

You can mail your payment to:
Cashier
Cayuga Medical Center
101 Dates Drive
Ithaca, New York 14850

If I get a bill from a physician for services provided while I was in the hospital, can I send my payment to Cayuga Medical Center?

The physicians are housed in independent practices which have their own billing and collection services. In order for your payment to be recorded and accurately and promptly, payment should be sent directly to the address listed on your bill, not to the hospital.

My insurance company is telling me that Cayuga Medical Center is billing for an emergency room visit when I actually received care at the Urgent Care Center. Why?

We use standard billing forms to bill for services provided. The Universal Billing form contains codes that have been established as the industry standard for billing. We have found this Universal Billing form to be the most efficient and effective vehicle for billing. However, the “one size fits all” approach does not fill every need with equal clarity. The bill can seem a bit confusing if you are not familiar with the codes, but there is a code included in your bill (456) that indicates you were treated in Urgent Care Services. The amount of your bill and the record of the procedures done in your treatment are correct and are not affected by any references to the emergency room.

My insurance company based their payment on Usual, Customary, and Reasonable (UCR) rates, and they did not cover all my costs. Are your rates unusually high?

To the contrary, on average Cayuga Medical Center is one of the lowest-cost providers in the region. We’ve worked hard to keep our costs down because we are fiscally responsible and responsive to our customers. Our charges are “usual, customary, and reasonable” for this region. Our charges are very competitive to those of surrounding area hospitals.

Whom do I contact to discuss a discount?

In order to be fiscally responsible and to conserve resources for our financial assistance program, we do not have a discount program as such. However, we do maintain our financial assistance program to help those who have the willingness to pay but not the resources to do so. Our no-discount policy includes Cayuga Medical Center employees, board members, and physicians. The Medical Center’s charges are very competitive and payment plans are available.

Definitions of Important Terms

Advanced Beneficiary Notice (ABN)

An Advanced Beneficiary Notice is a form advising you that tests performed by your doctor may not be covered by Medicare. The purpose of the Advanced Beneficiary Notice is to let you know in advance that these services may not be covered and to advise you that you will be responsible for payment of these charges.

Approved Amount

Insurers assign a set cost to each medical procedure. Any amount above that cost is considered the responsibility of the patient. Therefore, the “approved amount” is the amount of the hospital’s charge that an insurance payer will recognize in calculating benefits. (Under Medicare, this is also called the “Medicare Allowable Charge”.)

Birthday Rule

This rule is called upon to decide which parent’s plan is to be considered the primary plan for dependent children. According to the Birthday Rule, the primary plan will be the plan of the parent whose date of birth (month and day) falls earlier in the calendar year.

For example, if the father’s birth date is March 4 and the mother’s birth date is January 22, the mother’s plan would be primary. If both parents have the same birth date, the primary health plan will be the one that has been in effect for the longer period of time.

The Birthday Rule is endorsed by the National Association of Insurance Commissioners (NAIC).

Co-insurance

In some insurance policies, the insured person and the insurer share the cost of services. The insurer pays a certain percentage and the insured person pays the rest. This system is one way of lowering the cost of the insurance policy. The co-insurance is the percent of the approved charge that the insured person pays.

Co-payment

In some insurance policies, the insured person pays a specified flat fee per visit or per unit of service (e.g., $50 for emergency services), with the insurer paying the balance. The co-payment is the flat fee that the insured person pays.

Deductible

An insurance deductible is the minimum amount the patient must pay out of pocket before the insurance company will pay anything toward charges. Usually the deductible is not a one-time fee but is reactivated yearly.

Medicare Medical Savings Account

Some people are eligible for a Medicare health plan option made up of two parts: one part is a Medicare MSA (Medical Savings Account) Health Policy with a high deductible. The other part is a special savings account, called a Medicare MSA (Medical Savings Account.) The funds in the Medical Savings Account are traditionally used for such things as deductible payments, preventive care not otherwise covered, etc.

Original Medicare Plan

Some people are eligible for a Medicare health plan option made up of two parts: one part is a Medicare MSA (Medical Savings Account) Health Policy with a high deductible. The other part is a special savings account, called a Medicare MSA (Medical Savings Account.) The funds in the Medical Savings Account are traditionally used for such things as deductible payments, preventive care not otherwise covered, etc.

Private Fee-for-Service Plan (PFFS plan)

A PFFS plan is a Medicare Advantage health plan offered by a state-licensed provider who contracts with Medicare and Medicaid to provide Medicare benefits plus any extra benefits it chooses to provide. Some Medicare Advantage plans require patients to choose their healthcare providers from a prescribed network; in most cases, persons insured by a PFFS plan may use any health provider who accepts Medicare, rather than choosing from a specified network.

Referral

A referral is a recommendation from your primary care doctor to see a certain specialist or receive certain services. Referrals are sometimes required before an insurance company will pay for treatment. Some specialists will only see patients who have obtained a referral.

Urgent Need Care

Urgent Need Care addresses unexpected illness or injury that needs immediate medical attention but is not life threatening. Such care is billed under the heading of emergency services.

Additional Information

Provider List
Financial Assistance Application
Financial Aid Brochure
Charge Description Master
DRG Reimbursement Rates

***These charges represent only the standard charges provided by Cayuga Medical Center at Ithaca
• It does not provide a quote or guarantee of actual charges, e.g., how much it will cost for a specific patient’s care. It does not account for any variables in a patient’s medical condition, complications, length of stay, use of laboratory tests, pharmaceuticals, etc.
• It also does not account for whether a patient has health insurance or the availability of other discounts
• Patients should always contact Cayuga Medical Center at Ithaca’s Patient Financial Services staff for specific information.

Patient Accounting
(607) 274-4400

Billing Questions?

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