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Payment and Insurance

If You Are Covered By Insurance

If you have insurance, you will want to determine the extent of your insurance coverage. If you are in a managed care plan, you will want to determine whether the North Shore-LIJ Health System is in-network. If not, you may still be treated here, but your eligibility for insurance coverage and your personal financial responsibility may differ.

Please notify us immediately if your insurance carrier changes in order to prevent delay in processing your claims with the correct carrier and possibly even the denial of your claim.

We will verify your insurance benefits with your insurance plan as well as precertifications or authorization requirements. You are responsible for obtaining a referral from your primary care provider, if required.

When you arrive for treatment, if you are in a managed care plan, you may be asked to pay your co-pay. Most managed care plans require that separate co-pay be collected for each hospital stay and outpatient encounter.

North Shore-LIJ will file your insurance claim for both inpatient hospital and outpatient visits. Once your claim is satisfied by your carrier, you may receive a statement indicating your responsibility. Your prompt payment of all amounts for which you are personally responsible will help us continue our mission to provide comprehensive quality healthcare and medically essential services.

If You Are Not Covered By Insurance

If you have no insurance, during financial pre-screening a financial representative will give you an estimate of the cost of your treatment and you may be asked to provide a deposit. This estimate may differ from the actual cost of your care. You are responsible for the charges incurred. For outpatient recurring services (i.e., clinic care), a financial representative can assist qualified applicants for government entitlement programs. For more information, contact our Health Access Center at (516) 465-8254.

Payment Options

If you are a self-pay patient or if you have a financial obligation to the health system after your insurance has fulfilled its financial responsibility, you will be expected to pay the balance due.

If you cannot pay your patient balance in full, you may be able to arrange a payment plan. A customer service representative can be reached at (888) 214-4065 to provide information about available payment plans.

Financial Assistance

If the cost of your care is beyond your financial means, financial assistance is available to the uninsured and the under-insured. Reduced fees apply to patients seeking medically necessary services who are fully uninsured or who have exhausted their benefits for a particular service. Financial screening will be conducted to establish eligibility for reduced fees. To qualify, you will be required to fully cooperate and provide certain financial documentation, including applying for government entitlement programs. Income is based on federal poverty levels for family size and income, modified to reflect overall financial assets and local cost of living index. For more information call the Financial Assistance Unit at (800) 995-5727.

Refund Policy

Refunds will be issued in original form of payment if it is determined that the patient has a credit balance on their account.

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