Financial Assistance Plain Language Summary
FINANCIAL ASSISTANCE – PLAIN LANGUAGE SUMMARY (PLS)
Orleans Community Health’s Financial Assistance Policy exists to provide eligible patients, partial or fully discounted healthcare services to uninsured, underinsured or patients with an inability to pay for medically necessary services. This is located at the bottom of this page.
Covered Services –
This law covers all of the medical services offered by Orleans Community Health. This includes:
- Inpatient services;
- Emergency room visits; and
- Other outpatient visits, such as to clinics operated by the hospital.
Patients may not apply for financial assistance with bills from any service that is not provided by the hospital. For example, if a patient is treated by a contracted physician working at the hospital but who is not an employee of the hospital, the physician may bill the patient separately for the physician’s services. Patients cannot be denied medically necessary treatment or services because of an unpaid medical bill.
How to Apply: Information on financial assistance and applications may be obtained online at the bottom of this page. Applications are also available at the hospital front desk or Business Office. You may also call (585)798-8053 and request a copy be mailed to you. Mail completed applications (with all documentation/information specified in the application instructions) to the address listed on the application. You can also drop your application at the hospital Front Desk.
Determination of Financial Assistance Eligibility –Patients without insurance and earning up to 400% FPL, and “underinsured” patients earning up to 400% FPL are eligible to apply for financial assistance.
“Underinsured” is defined as patients whose paid medical expenses have exceeded 10% of their income in the last 12 months.
- Income is assessed as the gross monthly income of the household, before
- Paid medical expenses refer to any out-of-pocket costs for emergency or medically necessary care (i.e. deductibles, copays, coinsurance, deposits, ), but do not include the cost of health insurance premiums.
- If care totaling more than 10% of a patient’s income was received at the hospital at which the patient is applying for financial assistance, hospitals may use a patient’s account to determine eligibility. Otherwise, patients must provide proof of paid bills or other documentation to indicate that medical expenses were paid.
Immigration status shall not be considered when determining eligibility.
Patient’s assets (such as house, car, etc.) may not be considered. Eligibility for financial assistance is determined solely on household income.
Patients cannot be required to pay a hospital bill while their application for financial assistance is being considered and can request to apply for financial assistance at any point, including during the collections process
Hospitals may require that patients first apply for Medicaid, Essential Plan, or other public insurance programs
What is not Covered – The Financial Assistance Program will NOT cover services provided by physicians not employed by the hospital such as Emergency Room physicians, Pathologist, Anesthesiologist, Wound Care and Surgeons.
Contracted Physicians
Anesthesia Group: Pathology Services:
Niagara Frontier Anesthesia Services, LLP Quest Diagnostics of Pennsylvania, Inc
4185 Seneca Street 4 Parkway Center
Suite 11 875 Greentree Road
West Seneca, NY 14224 Pittsburgh, PA 15220
(716) 674-8189 (866) 697-8378
Emergency Department Podiatry Services:
Professional Emergency Services Advanced Podiatry Associates
6 Fountain Plaza 2 State St.
Buffalo, NY 14202 Batavia, NY 14020
(716) 691-8838 (585) 343-8150
Gastroenterologist: Cardiology Group:
Dr. Saman Chubineh Sands-Constellation Heart Institute
5875 Transit Rd (585)442-5320
Lockport, NY 14094
(716)240-2296
Urology;
Anees Fazli, MD
2615 Culver Road
Rochester, NY 14609
(585) 336-5320
All patients seeking healthcare services at Orleans Community Health are assured that they will be served regardless of their ability to pay. No one will be denied access to services due to inability to pay; and there is a discounted/sliding fee schedule available based on family size and income.