Visitor & Patient Guide

For Patients

• Admitting Procedures
• Advance Directives
• Billing
• Ethics Committee
• HIPAA Privacy
• Leaving the Hospital
• Meal Times
• Patient Advocacy
• Patient Forms
• Patient Responsibilities
• Personal Services
• Spiritual Considerations
• Medical Records

For Visitors

General Information

• Policies

• FAQs

• Resources

• Forms

• Pay My Bill Online

• Contact Us

Billing

Our Billing Policies

At Brookhaven Memorial Hospital Medical Center we recognize that dealing with medical bills and the details of insurance can get confusing.  Your satisfaction is of the utmost importance to us.  It is our goal to provide you the highest level of customer service and to provide you the information and options necessary to make the billing process as easy as possible.

Hospital Statement

If the proper information has been provided, we will file a claim with your insurance carrier.  If there is a balance due after your insurance company has processed your bill or if you do not have insurance we will mail you a hospital billing statement.

The amount you owe may include insurance deductibles, non-covered services or charges, as well as co-payments, co-insurance or, in some cases, a balance due after insurance has paid.  We will not bill you unless permitted to do so under your health plan's provisions and applicable law.

Other Fees

Please be advised that for Anesthesia, Radiology, Cardiology and Laboratory/Pathology, Physician's Assistant and certain other Physician's Services, including Emergency Room, depending upon your insurance coverage and the hospital's arrangement with your carrier, in addition to the hospital bill, there may be separate bills generated for the hospital and physician services.  Please see our FAQ and Resources pages for more detail.

Payment Policy

We request balances be paid at the time of service or upon receipt of your statement.  We will be happy to assist you in meeting your financial obligation by:

• Filing insurance claims where we have been provided valid and/or complete insurance information at time of registration.
• Providing patients with itemized bills upon request.
• Accepting check, money order, Visa, MasterCard, Discover and American Express payments via mail:

Brookhaven Memorial Hospital
101 Hospital Road
East Patchogue, New York 11772

And online at:

            http://www.brookhavenhospital.org

• Appealing insurance denials whenever appropriate.  Click here for Appeal Consent Form.
• Screening patients for Medicaid eligibility and as appropriate providing facilitated enrollment through both the Nassau Suffolk Hospital Council's facilitated enrollment program and other third parties.  See our Resources page for more information regarding the Nassau-Suffolk Hospital Council's program.
• Assisting patients who are unable to make payment in full with monthly payment arrangements through our Customer Service Department.  To investigate such arrangements please call Customer Service at 631-654-7150 or e-mail us at CustomerService@bmhmc.org.

Financial Assistance

Brookhaven Memorial Hospital Medical Center provides care to uninsured patients who meet certain criteria under the Hospital's Charity Care Policy without charge or at amounts less than current established rates. 

Patient eligibility for partial charity care will be based on a sliding fee scale when family income adjusted for the size of the family does not exceed the following amounts:

(For family units with more than 8 members, +$3,740 for each additional member.)

If you think you may be eligible for free care or care at reduced rates and wish to request it, please complete the Hospital's charity care application and return it to the Patient Financial Service Department at the address below.  Click here for Charity Care Application.

Documentation to support the income for all related family members residing at the same address must also be submitted.  Brookhaven's Patient Financial Services Department will make a written determination of eligibility after reviewing the application and the information submitted to support the family income reported.  If however, based upon income and family size, we believe that you may qualify for Medicaid benefits, you may first need to apply for Medicaid or NY State's Family Health Plus or Child Health Plus programs for the uninsured before a determination will be made under our charity care policy.

If you are returning the form in person, please bring it along with proof of family income to the Hospital's Cashier's office.

Please call the Patient Financial Services Department at (631) 654-7130 or 7140 if you have any questions regarding this process.

Required Charity Care Documentation

The completed, signed application listing all family members must be filled out and returned to the Patient Financial Services Department along with the following:

1. Proof of Income for the last three (3) months.

   Examples are:pay stubs, W-2's, Social Security checks, unemployment checks.

2. Copy of Income Tax filed for the prior year.

3. If you have no income information and you are supported by another person, then a letter is required from that person as well as proof as to their income.

4. If you paid in Cash, a statement from your employer on company letter head with income information is required.

Return Completed Application to:

Brookhaven Memorial Hospital Medical Center
101 Hospital Road
East Patchogue, New York 11772
Attention:  Patient Financial Services Department