Billing & Insurance Information

A Convenient & Straightforward Approach to Medical Billing

At Montefiore St. Luke’s Cornwall, we are committed to assisting patients both with healthcare coverage, and those who are uninsured, to navigate their health care services. Often times, the financial aspect of a hospital visit can seem daunting and overwhelming whether one is insured or uninsured. The information included below can help with this process.

It is important to understand that benefit and coverage rules and policies differ from insurance carrier to carrier, and plan to plan. It is critical, therefore, for individuals to know and understand the specifics of their plans.

Any patient having inadequate insurance coverage, or no insurance coverage, will be assisted in obtaining more appropriate coverage when applicable, or will be requested to make the appropriate deposits at the time services are rendered.

Know Your Policy

Montefiore St. Luke’s Cornwall is a participating hospital provider in various types of insurance carries, including government, commercial, and managed care organizations. Failure to provide accurate and current insurance information, and required referrals when you are admitted could result in a reduction of benefits by your insurance company. Our organization strongly recommends that patients read, question, and ultimately understand the provisions and policies of their individual plan, to reduce or eliminate potential financial penalties imposed by the insurance carriers for non-compliance of insurance plan rules and policies.

Many insurance plans have co-payments, deductibles, and/or out of pocket expenses like coinsurance amounts. Patients and insurance subscribers should familiarize themselves with their individual plan agreement, as well as any details, rules, and exclusions that may result in patient financial responsibility.

Important Empire Insurance Update Regarding Machine Readable Files

Medicare Part A & B

If you are age 65 or older, have End Stage Renal Diseases, or are permanently disabled receiving Social Security Disability Insurance, you may qualify for Medicare benefits. Medicare Part A provides benefits for inpatient hospitalizations, while Part B covers services such as observation hospital stays, ambulatory surgery, emergency services, physician services, and outpatient diagnostic testing. Your insurance card will indicate what coverage you are entitled to, along with the effective dates of coverage. Medicare Part A has pre- determined your co-payment responsibility for each covered procedure or test performed on an outpatient basis in a hospital setting.

Medicaid

Medicaid is a state-run health care system for patients not covered by other healthcare insurance. Eligibility is based upon earnings, family size, and other criteria determined by social services. Anyone who believes he/she may be eligible to receive these benefits should apply at their local Department of Social Services. Patients may also find themselves enrolled in a managed care program or NYS Health Exchange plan. Managed care programs often offer similar benefits to traditional Medicaid, but are subject to similar rules and regulations of managed care and HMO policies such as selecting a primary care physician, referrals and authorization requirements for services.

Patients enrolled in Medicaid managed care programs and the NYS Health Exchange are sometimes restricted as to which facility they may seek non emergent treatment. Medicaid beneficiaries should contact their local department of Social Services for more information regarding Medicaid benefits, coverage, and managed care options.

Billing Information

We at Montefiore St. Luke’s Cornwall will work with each patient to obtain their most current and accurate insurance information so that a bill can be submitted timely to the insurance carrier. All insurances have time requirements that must be followed throughout the billing process, so it is the patient’s responsibility to ensure that current information is provided to the hospital at each visit, and any additional information requirements such as coordination of benefits, injury documentation, or other required questionnaires is provided upon request.

Hospital charges do not include physicians’ fees. Patients should be aware that they will receive separate bills for the professional services rendered which include emergency room physicians, radiologists for interpreting your x-ray procedures, anesthesiologists for the administration of anesthesia during surgery, pathologists for their services, your admitting physician and other physicians involved in consultation. You are responsible for providing insurance information to those other providers.

Important Information Regarding "No Surprise Billing" (English)

Important Information Regarding "No Surprise Billing" (Spanish)

If you have questions about your bill, please call Customer Service at: (845) 816-2186.

Important Information for Self-Pay Patients

For those patients who are uninsured or underinsured, Montefiore St. Luke’s Cornwall strives to provide information and assistance whenever possible to ensure that patients may gain access to or extend their coverage. Please speak to a hospital representative at time of registration in order to get more information on potential assistance available.

Montefiore St. Luke’s Cornwall is the first local hospital to provide discounted rates for self-pay patients, just as all hospitals provide discounts for insurance companies. Current self-pay rates are equal to the most current Medicare rates, as published by CMS.

Financial Assistance

As a not-for-profit hospital, Montefiore St. Luke’s Cornwall is dedicated to our mission of providing quality health care to the people of our community. In emergency situations, every patient is treated, regardless of the ability to pay. Care first is at the core of our MSLC philosophy. In non-emergency situations, we are committed to working with patients so that quality care can be provided.

For patients without health insurance or those that may not be able to pay in full for their health care, we offer a financial assistance program. MSLC provides financial aid to patients based on their income and needs. We also assist patients in obtaining health insurance if they qualify, and can work with patients to arrange a manageable payment plan. MSLC staff is available to give you the help and support you need to make your hospital experience a pleasant one.

It is important that you contact us if you cannot pay your hospital bill; federal and state laws require all hospitals to seek full payment on patient accounts. Clear communication is important to this process; if we are not notified of a financial issue, your unpaid bills may be turned over to a collection agency, which could affect your credit rating.

In addition to charging our self-pay patients at our Medicare rates, MSLC offers a discount of 100% for anyone earning less than 200% of the Federal Poverty Guidelines and a 50% discount for anyone earning between 200% and 300%.

For more information, please contact our Patient Accounts Department at (845) 458-4900. Your account will be handled with confidentiality and courtesy by our staff of professionals.

Applying For Financial Assistance

Patients must complete the Montefiore St. Luke’s Cornwall issued application. Patients must provide required proof of identity and income. Financial Assistance is handled on a case-by- case basis.
Forms of documentation that can be used to support your Financial Assistance Application are as follows:

Most recent W2 and/or tax returns
Pension letters
Social Security Determination Letter
3 months of most recent pay stubs/wages
Unemployment compensation statement
3 months of Bank Statements

Notarized attestation letter/letter of support explaining income, support, and/or current financial situation if other proof of income is not available may be accepted.

Pricing Transparency

The Centers for Medicare & Medicaid Services’ Hospital Price Transparency Rule requires all hospitals to post a list of standard rates that represent the pricing information for all medical items and services that Montefiore St. Luke's Cornwall provides, as well as negotiated rates with insurance companies. It is important to note that the list of pricing information required by this rule does not necessarily reflect your out-of-pocket financial responsibility for your hospital visit. Why? The most common reasons are:

We are required to list the price paid by your insurer—but this does not necessarily reflect your out-of-pocket cost.
The medical services provided may vary from what was originally planned based on necessary circumstances at the time of your care.
You may also receive services from physicians or practitioners who are not employed by this hospital; their fees are not reflected in this listing.

It is also important for you to know that this price listing does not guarantee coverage, benefits, or payments. Since your financial liability may vary based on the particular terms of your insurance policy and the status of your health insurance benefits (i.e., deductibles, out-of-pocket maximum, co-insurance, and copays) at the time you receive care, your eligibility and the amount of your coverage will ultimately be determined by your health insurance provider. It is for this reason, Montefiore St. Luke's Cornwall utilizes a price estimator tool that provides consumers with out-of-pocket cost estimates based on their personalized health plan benefits. We encourage you to utilize our consumer-friendly tool and/or take advantage of speaking with one of our Managers at (845) 458-4957.

We are committed to being transparent and compliant with the Centers for Medicare & Medicaid Services rules, and are providing the following link to our machine-readable file. As stated earlier, the price information contained in this file is NOT an estimate of your out-of-pocket costs nor an accurate representation of charges since each episode of care is unique and charges are based on the actual services received. Additionally, while the file is posted based on the Centers for Medicare and Medicaid Services reporting requirements, it may be too large for consumers to open without special software. We again encourage you to utilize our consumer-friendly tool and/or take advantage of speaking with one of our Managers at (845) 458-4957.

You may view or download the standard rates file (file last updated updated 06/28/2024)