Disputing a Medical Bill in
New York
Medical Billing Laws, Consumer Protections & Information
New York
The State of New York gives consumer protections and has other laws and regulations for patients receiving care from, or otherwise being billed by, a provider in the state. Here are some of the most important state-specific laws and protections related to medical billing in New York.
CREDIT REPORTING PROTECTIONS
New York prohibits reporting patient medical debt to credit agencies. Medical debt cannot be a factor in a person's credit score.
AMBULANCE SURPRISE BILLING
Patients in New York have protections against balance billing above the insurance benefit for ground ambulance services. This protection exceeds those under the federal No Surprises Act.
Hospital Price Limits
New York hospitals may not charge uninsured or underinsured patients whose income is under 400% of the federal poverty level more than what the hospitals receive under Medicaid.
PRICE TRANSPARENCY
8%
Only 8% of the hospitals in New York are compliant with the federal Hospital Price Transparency Rule requiring hospitals to publish their prices, according to an independent audit. If you received a bill from a non-compliant hospital, that can be a reason to dispute the bill.
MEDICAL DEBT IN
NEW YORK
6.1%
6.1% of people in New York report having medical debt in a given year, on average.
HOSPITAL PRICES
3.3 x cost
The average hospital in New York charges 3.3 times what it costs to render the services. That means for every $100 in cost, it bills $330, of which $230 is profit.
Medical Billing Laws & Consumer Protections
All of U.S.
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These federal laws and consumer protections apply to
all 50 U.S. states and the District of Columbia.
NO SURPRISE BILLING
The No Surprises Act protects people using insurance from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.
GOOD FAITH ESTIMATE
A medical provider must issue a Good Faith Estimate in advance of services to a patient not using insurance. The Good Faith Estimate is a disclosure of expected services to be rendered and their charges.
BALANCE BILLING - EMERGENCY
A provider may not bill an insured patient for emergency services above the in-network payment responsibilities (coinsurance, deductible, copayment) under insurance benefits.
BALANCE BILLING - AT AN IN NETWORK FACILITY
For services an insured patient receives while visiting a participating hospital or facility, a provider may not bill the patient above the in-network payment responsibilities (coinsurance, deductible, copayment) under insurance benefits.
COLLECTIONS PROTECTIONS
The three nationwide credit reporting companies – Equifax, Experian, and TransUnion – do not include medical debts (1) below $500, or (2) less than a year old on consumer credit reports.
Dispute your problem medical bill now.
You have so much to gain by finding out if Patient Fairness can help with your problem medical bill. Complete the Problem Medical Bill Assessment and we'll tell you if we identified opportunities to question and/or dispute the medical bill. We'll even suggest some ways to dispute or reduce the medical bill if we can't help.