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Patient Financial Assistance Program
If you recently incurred medical bills at Nassau
University Medical Center or one of our Community
Health Centers, you may be eligible for a reduction
of your bill based on your financial status.
In addition, clinic patients may be eligible for
assistance with prescriptions through the Patient
Financial Assistance Program.
The Patient Financial Assistance Program's financial
screening office is located on the Ground Floor,
Room 505, at Nassau University Medical Center.
Patients who have already received a bill should
call 1-888-571-7949.
New Patients, or those who have not yet received
a bill for their care, should call 516-572-6669
What are the general requirements to qualify
for the Patient Financial Assistance Program?
- In order to receive Patient Financial Assistance
you cannot be eligible for any other health coverage
such as Medicaid, Medicare, Child Health Plus, Catastrophic
Healthcare Expense Program, Workers' Compensation
Insurance, No-fault Automobile Insurance or any
other private or employer sponsored insurance.
- You must complete an application and provide proof
of income, family size, residence, and other resources.
- You must apply for Patient Financial Assistance
within ninety (90) days of receiving treatment or
the date you were discharged, and complete your
application, including all necessary documentation,
within 30 days thereafter.
How is eligibility determined?
- How much your bills are reduced is based on established
guidelines that include your income, your resources,
and the size of your household.
How do I apply for patient assistance?
-
Make an appointment with the financial screening
office, Ground Floor, Room 505, at Nassau University
Medical Center.
- Fill out an application and provide the necessary
documentation.
Identification (only one)
- Driver's license with photograph
- Birth Certificate/with photo ID
- Passport
- Alien Registration card/work permit
Proof of address (only one)
- Recent rent receipt and/or utility bill
- Recent letter addressed to member of household (must
be postmarked)
- Driver's license with photograph and address
Proof of income and/or Maintenance (only
one)
- Current pay stubs for past 4 weeks
- fficial letterhead from employer indicating gross
salary and tax deductions
- Most current year income tax and W2 statement
- Copy of unemployment insurance check
- Copy of Social Security/Pension check
- If you cannot obtain any of the above, a notarized
letter from a respected member of the community
(clergy, doctor, attorney, etc.) is acceptable.
Resources (only one)
- Copies of recent bank statements or any other account,
such as brokerage account
Approval Process:
If it is determined that you may be eligible for
Medicaid or other similar benefits, you must apply
for coverage and receive a final decision regarding
your eligibility before you can apply for Patient
Financial Assistance
If you are approved for Patient Financial Assistance,
your bills will be reduced according to the guidelines
of the Patient Financial Assistance Program.
Screening must be updated each time you are admitted
to the hospital for in-patient services and annually
for clinic and Community Health Center patients.
Appeal Process:
If you disagree with the decision made by the financial
screener, you may file a written appeal to have
your eligibility re-evaluated. You should follow
the instructions contained in your notification
letter. Appeals must be filed within twenty (20)
days of your receipt of the hospital's notification
letter.
Our Mission:
To provide comprehensive, high quality health care
regardless of ability to pay. This reflects our
role as a major public multi-facility system committed
to excellence in health care delivery, medical education
and research. And the values driving this mission
-- caring, integrity, and pride -- guide the day-to-day
operation of our hospital.
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