Which insurance plans are accepted?

At TBHC , we accept most major insurance carriers. Below, please find a list of our providers. If you do not see your provider in this list, please give us a call for details regarding your policy, payment options and other questions you may have concerning your benefits.

• 1199 National Benefit Fund Self-Insured (646) 473-9200 www.1199nbf.com
• A+ HealthPlan (owned by HealthFirst) Medicaid (888) 801-1660 www.healthfirst.org
• Aetna US Healthcare Indemnity (800) 323-9930 www.aetna.com
• Aetna US Healthcare HMO/POS (800) 323-9930 www.aetna.com
• Aetna US Healthcare PPO, Open Access, Healthy Direct (800) 541-6711 www.aetna.com
• Aetna US Healthcare Medicare (800) 624-0756 www.aetna.com
• "Affinity Health Plan (by February of 2005)" Medicaid, Child Health Plus, Family Health Plus
• Americhoice of New York (formerly MHS) Medicaid, Child Health Plus, Family Health Plus (866) 362-3368 www.americhoice.com
• Americhoice of New York (formerly MHS) Medicare (866) 362-3368 www.americhoice.com
• Beech Street (Medichoice) PPO (800) 877-1444 www.beechstreet.com
• "CarePlus (as of January 1st, 2005)" Medicaid, Child Health Plus, Family Health Plus
• Cigna HMO (800) 345-9458 www.cigna.com
• Cigna PPO (800) 251-0670 www.cigna.com
• Community Care Network (First Health Network) PPO (800) 931-9545 www.ccnusa.com
• Devon Health Services, Inc. PPO (800) 431-2273
• Empire BCBS HMO/POS/CHP/Healthy NY Benefit Plans (800) 552-6630 www.empireblue.com
• Empire BCBS Indemnity (800) 992-2583 www.empireblue.com
• Empire BCBS EPO/PPO/Indemnity POS/NYS and NYC Plans (800) 992-2583 www.empireblue.com
• Empire BCBS Medicare (Senior Plan) (800) 552-6630 www.empireblue.com
• GHI HMO (877) 244-4466 www.ghi.com
• GHI CBP (212) 501-4444 www.ghi.com
• GHI (Bad Debt Program) HealthWorks
• GHI Medicare
• Healthfirst Medicaid (888) 801-1660 www.healthfirst.org
• Healthfirst FHP (888) 801-1660 www.healthfirst.org
• Healthfirst CHP (888) 801-1660 www.healthfirst.org
• Healthfirst Medicare (888) 801-1660 www.healthfirst.org
• HealthNet PHS HMO (800) 848-4747 www.phshealthplans.com
• HealthNet PHS Medicare (800) 848-4747 www.phshealthplans.com
• HealthPlus Medicaid/CHP (800) 450-8753 www.healthplus-ny.org
• HealthSouth PPO (888) 476-8849 www.healthsouth.com
• HIP Medicaid (212) 630-8711 www.hipusa.com
• HIP Medicare (212) 630-8711 www.hipusa.com
• HIP HMO/POS (212) 630-8711 www.hipusa.com
• Horizon Healthcare of New York, Inc. HMO/POS (866) 326-3389 www.horizonhealthcare.com
• Magnacare PPO (800) 235-7267 www.magnacare.net
• Multiplan PPO (800) 546-3887 www.multiplan.com
• New York Hospital Community Health Plan Medicaid, Child Health Plus, Family Health Plus (800) 261-4649
• "Great West HealthCare A.K.A. - One Health Plan" PPO (877) 331-3251 www.onehealthplan.com
• Oxford Liberty (800) 444-6222 www.oxhp.com
• Oxford Commercial (800) 444-6222 www.oxhp.com
• Oxford Medicare (800) 444-6222 www.oxhp.com
• Select Health Medicaid - HIV SNP (866) 469-7774 TBD
• United Healthcare (Not the Empire Plan) PPO (800) 638-8075 www.unitedhealthcare.com
• United Healthcare (Not the Empire Plan) HMO (800) 638-8075 www.unitedhealthcare.com
• United Healthcare (Not the Empire Plan) Medicare (800) 638-8075 www.unitedhealthcare.com
• "The Empire Plan - United Healthcare (Inpatient and Ambulatory Surgery only)"
• Vytra Healthcare HMO/PPO (888) 288-9872 www.vytra.com
• WellCare Medicaid HMO

TBHC: Providing Quality Healthcare Options To All
Sometimes we are faced with situations in life when we just don't have health insurance coverage. Whether you are unemployed, between careers, or simply working for a company that does not provide you with healthcare benefits, not having insurance to cover your medical expenses can be a major source of stress and financial hardship. So, what are your options when and if you find yourself in the hospital - how will you meet your expenses and pay for needed medical care?

Purpose and Scope: Quality Care to All Who Need It
The Brooklyn Hospital Center is proud of its not-for-profit mission to provide quality care to all who need it - 24 hours a day, 7 days a week, and 365 days a year - without regard to their ability to pay. The Hospital Center provides emergency, ambulatory surgery, primary, specialty care and ancillary services to all persons. As a community service to those without health insurance, fees for visits and tests have been substantially discounted from the Hospital Center 's full charges. Payment may take the form of insurance coverage or payment based on a fees schedule as required by federal and state regulations. Financial assistance is available for individuals whose family income is below 300% of the Federal Poverty Level (FPL), with collection practices that recognize the limited financial capacity of those individuals. Patients who are receiving services in the emergency room, or through the ambulatory surgery department, including Radiology, will receive a second bill for physician services. This policy does not cover physician billing. This information is posted at the registration areas in English (and available in Spanish) for the patient's information.

Our Policy
Patients must present acceptable insurance coverage (Medicaid, Medicare, and certain commercial plans), or they will be expected to pay the designated fee at the time of service. This also applies to non-covered services provided to insured patients. Patients who are not covered, or receive services covered under a third-party insurer, will be screened by the Financial Counseling Staff to determine eligibility for Medicaid or other health insurance coverage, such as ADAP +, Medicare, etc. If eligible, the Financial Counseling Staff will assist the patient with applications as needed.

What if I am not covered?

Patients who are not covered by, or receive services covered by, a third-party insurer or governmental program, or those patients that have exhausted their covered services benefits shall be considered ' Self-pay'. The Self-pay visit is payable in full upon each visit registration, prior to being seen, unless the patient falls into an "exception" category.

The following types of visits will be rendered without charge to the self-pay patient:

• Blood pressure check within one day of clinic visit
• PPD reading
• Pregnancy tests
• Completion of WIC forms if there has been an appropriate visit within one month's time

EXCEPTIONS
Certain types of care for the uninsured will be completed in the clinic regardless of payment compliance, although the patient will be billed for the services provided. These include:

• Follow-up of Emergency Department patients for conditions treated in the E.D., such as fracture follow-up (for casted and splinted fractures), suture removal, and other such cases where care has been initiated by E.D. personnel and needs to be completed in the clinic.
• In-patients referred to clinic/center for post discharge follow-up will be seen for one visit in the clinic/center at which time, if unable to pay at the time of visit, will be billed for services rendered. At the initial visit, the provider will determine a plan of care detailing the expected number of visits (up to a maximum of five '5') that should be provided without the fee payment at the time of registration. The plan of care must be approved by the clinic chief, site Medical Director, or Ambulatory Care Medical Director, and forwarded to Registration Staff by the Clinic. These visits will be billed to the patient by Patient Accounting if the patient is unable to pay at each visit.
• Patients seen in the clinic for a Primary Care/Basic Clinic visit who are deemed "conditionally" eligible can have services rendered and will be billed for the visit. (See Conditional Eligibility below.)

SLIDING FEE SCALE
As a service to our community, The Brooklyn Hospital Center has adopted a sliding fee scale for Self-pay patients with limited financial means. This sliding-fee-scale is based on the Hill-Burton Act, and therefore looks at the overall financial picture of a patient when qualifying them.

How do I know if I'm qualified for financial assistance?

INCOME/RESOURCE VERIFICATION:
In order to determine a patient's Sliding-Fee-Scale category, Income/Resource Verification must be obtained. The criteria for determining the category for which a patient is eligible at the time of service include the following:

• Individual or family income
• Individual or family net worth
• Employment status and earning capacity
• Family size
• Other financial obligations
• The amount and frequency of bills for healthcare
• Other sources of payment for the services rendered

The following are examples of documentation required in order to verify income/financial resources for a patient:

• W2 withholding forms from the previous 12 months
• Pay stubs from the previous 6 months
• Income tax returns from the previous 12 months
• Social Security documents
• Railroad Retirement Benefits statements
• Pension/Retirements Benefits statements
• Veteran's Benefits statements
• Rental Income statement
• Forms approving or denying unemployment compensation
• Forms approving or denying workmen's compensation
• Oral verification from public assistance agencies

CONDITIONAL ELIGIBILITY
Patients can be "conditionally" eligible to receive Primary Care/Basic Clinic services, so long as they provide the requested income verification documentation within a reasonable time frame. If the patient fails to produce the requested documentation, the conditional eligibility will be denied and the patient will be billed at full charges.

NOTIFICATION
Information will be provided at the time of registration to all patients registered as self-pay concerning the Hospital Center 's Self-Pay payment policies. Financial Counseling staff in the appointment office will provide information about the Self-Pay policy, insurance coverage, etc., whenever scheduling appointments for patients.

Can I speak with someone at TBHC regarding
insurance coverage or payment plans?

Yes! To learn more about managed care and your health insurance options, please contact Pierre Noel (718) 250-8385