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Paying For Your Care

Prompt payment for healthcare services allows CPH to continue to provide high-quality care. Before scheduling a visit or procedure, check with your insurance company to find out if the particular service you need is covered. Insurance coverage can change. Something that may have been covered a year ago may not be covered now. Your insurance company is the most current source of information on coverage. Please note that some services are billed separately. You may receive a bill from an organization that partners with us to provide care to our patients. Co-payments may be due at time of visit.

 

CPH Financial Assistance

    Financial assistance is available for our physician office and hospital services to those who qualify. Household income eligibility is up to 300% of the Federal poverty guidelines. If you believe you may qualify for assistance or would like to learn more, please contact the Patient Friendly Billing team at (315) 261-5150.

    Financial Assistance Application
    Financial Counseling/Assistance Options
    Important Information About Paying for Your Care At CPH

    CPH provides over $1.5 million in free care annually to those who qualify.

    GH Financial Assistance

    Financial assistance is available for our physician office and hospital services to those who qualify. Household income eligibility is up to 300% of the Federal poverty guidelines. If you believe you may qualify for assistance or would like to learn more, please contact the Patient Friendly Billing team at (315) 535-9202.

    For more information, please refer to the documents at the links below.

    Financial Assistance Application
    Important information about paying for your care at Gouverneur Hospital 
    Financial Counseling/Insurance Plan Options 
    Financial Assistance Policy 

    CPH Ways to Pay Your Bill

    Payment information is located on your Patient-Friendly Billing Statement (your bill), and is also located on the Registration Disclosure Form provided to all of our patients. 

    Payment Options:

    • Click Here for Secure Online Bill-Pay
    • Call (315) 261-5150
    • By mail to our KeyBank Lockbox
    • For hospital and provider-related services:
                In-person payments M-F 8:00AM to 4:00PM at 50 Leroy Street, Potsdam
                In-person payments M-F 8:00AM to 4:30PM at 145 Market Street, Potsdam
    • For health center-related visits:
                In-person payments M-F 8:00AM to 4:30PM at 12 Elm Street, Potsdam (use rear entrance)
    GH Ways to Pay Your Bill

    Payment information is located on your Patient-Friendly Billing Statement (your bill), and is also located on the Registration Disclosure Form provided to all of our patients. 

    Payment Options:

    CPH Pricing Transparency/ChargeMaster/DRG

    CPH Charge Master: Price File displays hospital-based clinical descriptions, which may not be easily interpreted by non-clinical readers. We are developing an updated output method, which will be uploaded as soon as it is available.

    Charges represent only standard charges; charges do NOT represent a quote or guarantee of actual charges. Care and associated costs are unique to each patient's visit (for example: length of stay, laboratory tests, pharmaceuticals, etc); although some charges for care are standardized, each patient's payment responsibility may vary depending on negotiated discounts with individual insurers. Contact Patient Financial Services at (315) 261-5150 with specific questions.

    CPH Diagnosis-Related Group (DRG): Measure for estimating charges for inpatient conditions. However, they do not always accurately estimate severity of illness, complicated diagnosis, or unforeseen circumstances or conditions. Charges may vary from conditions (DRG) and averages provided.

    Healthcare pricing can be complicated, St. Lawrence Health System will help you understand your anticipated fees. We will be happy to provide you with our average pricing for your medical procedures. Pricing may vary based on your particular health conditions, severity of illness, and other necessary procedures associated with your care. New York State requires that your insurance company work with you to outline your policy provisions. We cannot advise you on what your specific insurance policy may or may not cover until your claim has been processed.

    GH Pricing Transparency/ChargeMaster

    GH Charge Master: Price File displays hospital-based clinical descriptions, which may not be easily interpreted by non-clinical readers. We are developing an updated output method, which will be uploaded as soon as it is available.

    Charges represent only standard charges; charges do NOT represent a quote or guarantee of actual charges. Care and associated costs are unique to each patient's visit (for example: length of stay, laboratory tests, pharmaceuticals, etc); although some charges for care are standardized, each patient's payment responsibility may vary depending on negotiated discounts with individual insurers. Contact Patient Financial Services at (315) 535-9202 with specific questions.

    Healthcare pricing can be complicated. St. Lawrence Health System will help you understand your anticipated fees. We will be happy to provide you with our average pricing for your medical procedures. Pricing may vary based on your particular health conditions, severity of illness, and other necessary procedures associated with your care. New York State requires that your insurance company work with you to outline your policy provisions. We cannot advise you on what your specific insurance policy may or may not cover until your claim has been processed.

    CPH Pricing Request Form

    Complete the pricing request form or contact Financial Services at (315) 261-5150.

    For out-of-network non-emergency services, your insurance company should Fax an Out of Network Single Case Agreement to (315) 261-5028 with any phone follow-up to (315) 261-5150.

    Any price quoted for services is an average amount you may expect to pay for the services you have requested if you are uninsured or underinsured.

    GH Pricing Request Form

    Complete the pricing request form or contact Financial Services at (315) 535-9202.

    Any price quoted for services is an average amount you may expect to pay for the services you have requested if you are uninsured or underinsured.

    Name
    Preferred Contact
    Note: Current Procedural Terminology (CPT) is a medical code set that is used to report medical services to physicians and health insurance companies.
    Do you have insurance?*
    Do you have any financial assistance?

    All requests may take up to 3 business days. The more accurate the information provided above, the faster the request will be completed. Please note that all professional billing (i.e. billing for surgeons, radiologists, physicians, and anesthesiologists) will be done separately and are not included in the estimates unless stated otherwise.

    This estimate is based on our current pricing and is subject to change.  While we make every effort to ensure the accuracy of our estimates, it is impossible to predict final out of pocket costs due to the many variables within the actual services that are not determined until the day of care.  Therefore, please note the estimate provided is not a guarantee of cost for this service.  Additional costs may be involved if the physician chooses to do a different set of testing, additional procedures, or requests consults from other providers on the case.

    Message to the Patient Estimates Team member preparing your estimate
    Hospital Request*
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