Patient Financial Services

Payment for your care

Payment for care

 

We realize that healthcare bills can be confusing. Patients should familiarize themselves with the terms and conditions of their insurance coverage. Those patients without insurance coverage are responsible for paying the full cost of their care.

When you become a non-emergency hospital patient in New York state, you are entitled to receive information about how you will be charged for the services you receive. This is particularly important if you could receive care from hospitals or providers that are not in your health plan's network, or if you are not covered by a health plan.

This website details how hospitals and physicians charge patients, as well as links to helpful resources that can guide your decisions.


Help paying your bill

The hospital’s Financial Assistance Program can help patients who are uninsured and those with limited insurance. Call the Customer Service/ Patient Accounts (Patient Financial Services) Department for details at (631) 444-4151, or 4-4151 from a hospital phone. A Medicaid representative is available to assist with the Medicaid application Monday through Friday, 8 am to 4 pm, and can be reached by calling (631) 444-7587, or 4-7587 from a hospital phone.


Non-emergency hospital patients at Stony Brook University Hospital, are entitled to receive information about how you will be charged for the services you receive. This is particularly important if you receive care that is not in your health plan’s network, or if you are not covered by a health plan. Inpatient Hospitalization: Stony Brook is a participating provider in many health plan networks. However, some health plans use smaller networks for certain services they offer, so it is important to check whether we participate in your specific plan

Physician Services While You’re in the Hospital The physician services you receive while a patient in our hospital are not included in the hospital charges. Physicians who provide services at Stony Brook may be independent voluntary physicians. If your physician does not participate in your specific plan, you may want to choose a different physician who does.

Specialty or Other Services While You Are Hospitalized: Stony Brook has contracts with a number of physician groups such as anesthesiologists, radiologists and pathologists so that they can provide services at our hospital. You should contact these groups directly to find out which health plans they accept. 

Understanding Your Hospital Charges: We created a sample list of charges for our most common hospital procedures. Please keep in mind that these charges are just examples. There are different factors that affect what a patient actually pays depending on specific contracts that a health plan, insurer or other third-party payer (like Medicare) may have with us. Insured, in-network patients are usually only responsible for copayments, coinsurance and/or deductibles

If You Don’t Have Health Insurance: Contact our Financial Assistance Office to see if you may be able to get help paying for your hospital bills at (631) 444-4151, or 4-4151 from a hospital phone. Get Help.  

Financial Assistance Program

Inpatient Hospitalization

Stony Brook University Hospital recognizes that there are times when patients in need of care will have difficulty paying for services provided. The hospital’s Financial Assistance Program provides discounts to qualifying individuals, based on income. 

Who qualifies for a discount? 

A financial aid application is offered to patients who have limited income, have no health insurance, are underinsured or would like to be screened for discount eligibility. You cannot be denied medically necessary care because you need financial assistance. You may apply for a discount regardless of immigration status. Everyone in New York State who needs emergency services and non-emergency, medically necessary services at Stony Brook University Hospital can receive care and may be eligible for assistance based on income limits that have been established by federal guidelines. 

Can someone explain the discount? Can someone help me apply? 

Yes. Free confidential help is available. 

Call our Financial Assistance Office at (631) 444-4151, or 4-4151 from a hospital phone. 

If you do not speak English, someone will help you in your own language. The financial counselor can tell you if you qualify for free or low-cost insurance, such as Medicaid, Family Health Plus and Child Health Plus. If the counselor finds that you don’t qualify for low-cost insurance, he or she will help you apply for a discount. The counselor will help you fill out the forms and tell you what documents you need to bring. 

How do I apply for a discount? 

A financial assistance application is available online at stonybrookmedicine.edu/billinginformation. You may also pick up an application from the cashier in the Emergency Department, the main cashier on Level 5 of the hospital, or the Patient Accounts (Patient Financial Services) Office at 31 Research Way in East Setauket. A financial assistance application will be sent to you upon your request if you call our Financial Assistance Office at (631) 444-4151, or 4-4151 from a hospital phone. You will need to supply copies of all requested documentation. If you cannot provide these, you may still be eligible to apply for financial assistance. 

Additional Healthcare Insurance Options 

For those who are under age 65 and who do not have a disability, you may be eligible for coverage through NY State of Health, the state’s official health plan marketplace. For information, call (855) 355-5777 or visit nystateofhealth.ny.gov. In order to apply for coverage, you may need to have proof of the following: 

  • Citizenship 
  • Immigration Status 
  • Social Security Number 
  • Residency 
  • Income 

Individuals who are age 65 or older, or who have a disability, are blind and/or are in need of longterm care coverage, may be eligible for Medicaid. 

The New York State Department of Social Services requires a paper application to be submitted to your local center. Call Stony Brook Medicine’s Financial Services at (631) 444-7583, or 4-7583 from a hospital phone, to make an appointment to apply for Medicaid. 

For information regarding: 

Medicaid 

Call 516-326-0808 x3686 

Extended Time Payments 

Call (631) 444-4151, or 4-4151 from a hospital phone. 

Financial Assistance Program (sliding scale fee reduction based on income) 

Call (631) 444-4151, or 4-4151 from a hospital phone, or visit stonybrookmedicine.edu/billinginformation

Hospital Health Plans

Payment for care

 

Stony Brook University Hospital is a participating provider in many health plan networks. Below is a list of the health plans in which we participate. Some health plans use smaller networks for certain services they offer, so it is important to check whether we participate in your specific plan.

Click here to view a list of the health plans Stony Brook University Hospital participates in.

 

 

Good Faith Estimates

Payment for care

 

If you are uninsured, you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. 

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call,

Stony Brook University Hospital Customer Service - (631) 444-4151

 

 

Understanding Your Hospital Charges

Payment for care

 

Hospital Price Transparency

Stony Brook University Hospital strives to ensure that our patients are cared for in every regard.  We take great pride in the excellence of the clinical outcomes we deliver; and, we also recognize that the quality of our patient’s experience is impacted on many levels including the ease with which you are able to understand and navigate the financial aspects of your care.

Standard Charges

The standard charge data provided includes only hospital charges and excludes professional charges for physician services which are billed separately by non-employees of the hospital.  The standard charges also do not necessarily represent patient’s actual out-of-pocket cost.

Gross Charge
Amount billed for each item or service.

Discounted Cash Price
Amount billed for each item prior to any discount offered to patients based upon eligibility for the hospital’s financial assistance program.

Payor Specific Negotiated Charge
The charge negotiated with each third party payor.

Minimum Negotiated Charge
The lowest negotiated charge amongst all third party payors.

Maximum Negotiated Charge
The highest negotiated charge amongst all third party payors.

Shoppable Services

Stony Brook University Hospital has identified a list of shoppable services which are common elective hospital procedures.  Standard charges for shoppable items can be accessed on the link provided.

When reviewing these files, it is important to keep in mind that many factors affect what a patient actually pays, most notably their health insurance benefit plan design.  Most health plans, insurers and other third-party payers (such as Medicare and Medicaid) pay for hospital services based upon specific contracted charges or regulatory enacted rates.  Insured, in-network patients are usually only responsible for co-payments, co-insurance and/or deductibles as determined by their insurer.  For a better understanding of your potential out-of-pocket expenditure, please contact your insurer or benefit plan administrator.

The amount charged may only be relevant for patients receiving care at Stony Brook University Hospital who are deemed “out-of-network” by their insurance plan and/or for those who are uninsured.  For these patients, the amount billed may be reflective of the charge amounts listed here; however, the amount a patient pays may be much lower because of the hospital’s financial assistance policy The financial assistance program assists patients with limited income who have difficulty paying for hospital services. Financial Assistance Frequently Asked Questions

For more detailed information about your hospital charges or for an estimate of the costs related to your upcoming procedure, please contact the office of Patient Financial Services at (631) 444-4151.

“Shoppable Services” (Last Updated 7/26/2024)

“Standard Charges” (Last Updated 7/26/2024)

 

 

Your Rights and Protections Against Surprise Medical Bills

Payment for care

 

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

Click here to understand more about your rights and protections against surprise medical bills

 

Last Updated
06/24/2022