If you do not have health insurance or if you have questions regarding financial assistance, please ask for information from Patient Registration staff or contact the Hospital's Financial Representative at 514-5898.
Patient Notice of Financial Assistance
Eastern Niagara Hospital is a not-for-profit organization, focused on its mission of caring for patients 24 hours a day, seven days a week, 365 days a year, regardless of the patient’s ability to pay. The Hospital is proud of its mission to provide quality care to all in need.
If you do not have health insurance and worry that you may not be able to pay in full for your care, the Hospital may be able to help. Eastern Niagara Hospital provides financial aid to patients based on their income, assets and needs. In addition, Hospital staff can assist you in obtaining free or low-cost health insurance or work with you to arrange a manageable payment plan.
It is important that you let the billing staff know if you will have difficulty paying your bill so that arrangments can be worked out. Without that information, your unpaid bills may be turned over to a collection agency which could affect your credit status.
To be eligible for this program, you will be required to provide the following information:
- Three recent payroll stubs
- A copy of a recent tax return
Other Important Information about Paying for Your Care at Eastern Niagara Hospital
Eastern Niagara Hospital is a participating provider in many health plan networks. You can find a list of the plans in which we participate below. Some health plans use smaller networks for certain products they offer so it is important to check whether ENH participates in the specific plan you are covered by. Our list will tell you if we do not participate in all of a health plan’s products.
It is also important for you to know that the physician services you receive in the hospital are not included in the hospital’s charges. Physicians who provide services at the hospital may be independent voluntary physicians or they may be employed by the hospital. Physicians bill for their services separately and may or may not participate in the same health plans as the hospital. You should check with the physician arranging your hospital services to determine which plans that physician participates in. Plan participation information for physicians employed by the hospital can be found on our website at www.enhs.org. Eastern Niagara Hospital contracts with a number of physician groups, such as anesthesiologists, radiologists and pathologists, to provide services at the hospital. Contact information for the physician groups the hospital has contracted with is available on our website at www.enhs.org. You should contact these groups directly to find out which health plans they participate in.
You should also check with the physician arranging for your hospital services to determine whether the services of any other physicians will be required for your care. Your physician can provide you with the name, practice name, mailing address and telephone number of any physicians whose services may be needed. Your physician will also be able to tell you whether the services of any physicians employed or contracted by Eastern Niagara Hospital are likely to be needed, such as anesthesiologists, radiologists and pathologists. Contact information for these physicians is available on our website at www.enhs.org. You should contact these groups directly to find out which health plans they participate in.
Hospitals are required by law to make available information about their standard charges for the items and services they provide. This information is available upon request by calling (716) 514-5881.
If you do not have health insurance, you may be eligible for assistance in paying your hospital bills. Information about financial assistance is available on our website at www.enhs.org or you may contact our Financial Assistance Office at (716)-514-5898.
Participating Health Care Plans:
|HEALTHNOW (BLUE CROSS OF WNY)|
|BLUE CROSS - GENERAL MOTORS BC (GMBC)|
|BLUE CROSS - SENIOR BLUE|
|BLUE CROSS COMMUNITY BLUE|
|FAMILY HEALTH PLUS COMMUNITY BLUE|
|CHILD HEALTH PLUS COMMUNITY BLUE|
|FIDELIS FAMILY HEALTH PLUS|
|FIDELIS CHILD HEALTH PLUS|
|FIDELIS - MEDICARE|
|FIDELIS CARE NEW YORK|
|FIDELIS DUAL - FIDELIS DUAL ADVANTAGE|
|IHA - ENCOMPASS 65|
|IHA - MEDICARE DUAL DIFFERENCE|
|IHA - MEDISOURCE|
|NEW YORK STATE NO FAULT|
|NEW YORK STATE WORKERS COMPENSATION|
|NOVA - NOVA HEALTHCARE|
|CHAMPVA - VA HEALTH ADMINISTRATORS|
|UNIVERA - PLUS MED|
|UNIVERA - SENIOR CHOICE|
|UNIVERA - TRANSITIONS/HEALTHY NY|
|WELLCARE HEALTH PLANS - DUAL|
|WELLCARE HEALTH PLANS - MEDICAID|
|WELLCARE HEALTH PLANS - MEDICARE|
Eastern Niagara Hospital is committed to being transparent about our charges. The information on this site/link contains the charges for all services and items provided by the hospital. The charges are uniform for all patients served by Eastern Niagara Hospital. However, the hospital charges rarely reflect the expected out-of-pocket expense for a specific hospital service. Your own charges and out-of-pocket expenses will depend on one or more of the following:
the actual patient care services received
the terms of your insurance coverage, and/or
your eligibility for financial assistance
If you do not have insurance and would like to speak with a financial counselor regarding options, please call (716) 514-5898. One of our facilitated enrollers will be happy to explain the options available.
If you have insurance, for a fuller understanding of your estimated out-of-pocket expenses, you should contact your insurer.
If you are seeking a price quote for services not covered by insurance, contact the hospital at (716) 514-5881 or email at email@example.com.
Frequently Asked Questions:
Q: What is a hospital chargemaster? Are the listed charges what I will pay for hospital services?
A: The chargemaster is a comprehensive standard price list for the services provided by the hospital (medical procedures, lab tests, supplies, medications, etc.). Because it represents the full range of services the hospital provides, there are thousands of items listed. The charges listed are generally not the amount a patient will pay. If you have health insurance, your out-of-pocket expenses will depend on the specific services you receive, your specific health insurance coverage, and your insurance company’s contract with the hospital. Please contact your insurance company for more information.
If you do not have health insurance, you may be eligible for 1) reduced costs under the hospital’s Financial Assistance Policy, or 2) subsidized health insurance through programs such as Medicaid. Please contact our facilitated enrollers at (716) 514-5898 for more information.
Q: Are charges the same for every patient?
A: Yes, hospital charges are standard for every patient, regardless of insurance status. The total charges on your patient bill will reflect the actual services that you receive, which may vary based on several factors, including your length of stay, the time it takes to complete your procedure, medications you receive, and other health conditions that could make your care more complicated.
In addition, your out-of-pocket expenses will depend on your specific insurance coverage and/or eligibility for discounted care based on the hospital’s Financial Assistance Policy.
Q: How can I get an estimate of my out-of-pocket expenses for a procedure?
A: Patients with health insurance should contact their insurance company to get an estimate of their out-of-pocket expenses for a procedure.
Patients without health insurance should contact our Reimbursement Manager at (716) 514-5881 or email at firstname.lastname@example.org for a price estimate. Information about the hospital’s Financial Assistance Policy, and whether you may be eligible for subsidized health insurance through programs such as Medicaid can be obtained by calling (716) 514-5898.
Q: Can a patient receive charges for services that are not included in the chargemaster?
A: Yes, the hospital chargemaster reflects hospital services only and does not include any professional fees such as physician services that are billed separately. For estimated professional fees, please contact your physician’s office.
Q: If insurance companies and patients without health insurance don’t pay the chargemaster prices, what do they pay?
A: Insurance companies have contracts with the hospital for discounts from charges. In addition, patients with health insurance are responsible for certain cost-sharing requirements such as deductibles, copayments, and/or coinsurance that vary by insurance plan.
Patients without health insurance can apply for support through the hospital to either receive insurance coverage (if eligible) or reduced costs through the hospital’s Financial Assistance Policy. These programs will reduce the amount owed by the patient.
Q: Why do charges for the same procedure or item vary by hospital?
A: Hospitals set their standard charges for services and items based on internal metrics, including the cost to provide patient care—which varies between hospitals. For example, charges will vary based on the location of the hospital, the availability of specialized services such as trauma and transplant services, whether it is a teaching hospital, its level of underpayment from the Medicare and Medicaid programs, and services provided to the uninsured. Again, these listed charges are generally not what insurance companies or patients without insurance ultimately pay.
(Right click or control click to save the files, below, to your computer.)
- ENH Chargemaster - A List of the Hospital's Standard Charges for Items and Services
- MS-DRG Summary - A List of the Average Gross Charge and Average Expected Payment from CMS by MS-DRG Procedure
Section 3202(b) of The CARES Act, requires providers of diagnostic tests for COVID-19 to make public the cash price of a COVID-19 diagnostic test on the provider’s public internet website. Eastern Niagara Hospital offers the following COVID-19 tests for its patients:
COVID-19 Lab Test CPT 87635 Cash Price $31.00
COVID-19 Antibodies Test CPT 86769 Cash Price $18.00
These amounts represent the cash price for the COVID-19 tests offered at Eastern Niagara Hospital. Your actual out of pocket expense may vary based on the Insurance coverage you have. We recommend that you contact your insurance carrier for any specific coverage and out of pocket questions you may have.