Important Numbers

Financial Assistance Program

The Brooklyn Hospital Center (TBHC) is committed to providing the best possible patient care to all who need it. TBHC has established a Financial Assistance Program (FAP) to provide assistance to qualifying patients.

Patients are eligible for financial assistance if:

     - They are uninsured or have exhausted their health insurance
       benefits
     - They are residents of the United States
     - Their family income is below 300% of the Federal Poverty
       Guidelines

Please note, the Financial Assistance Program applies only to medically necessary services provided and billed by the hospital. Cosmetic and any other services deemed not medically necessary are not eligible for financial assistance, fee waivers, discounts, or time payment plans.

The Financial Assistance Program does not apply to:

     - Physician bills
     - Patients enrolled in managed care or other insurance plans

Patients who may be eligible for other government sponsored health insurance programs, like Medicaid, may be asked to apply for these benefits. Our financial counselors can assist with this process.

The Application Process

      - All applications must be received within 90 days from discharge for
       inpatient services, and 90 days from the date of service for outpatient
       services.
     - Once the application is received, patients have an additional 20 days
       to submit the required documentation.
     - Financial Counseling will review all applications and notify the patient
       in writing within 30 days after receipt of completed application.

Required Documentation for Income and Asset Verification 

In order to determine the fee-scale amount and eligibility for financial assistance, the patient will have to provide the following documentation:

     - Alien Registration Card, birth certificate or passport
     - Social Security Card or awards letter
     - Pay stubs or W2 withholding forms
     - Income tax returns
     - Pension or retirement benefits
     - Rental income statements
     - Unemployment insurance benefits
     - The New York State self-pay surcharge currently in effect will be
       added to all fee-scaled amounts.

Exemptions

Certain types of care will be provided to self-pay patients, regardless of payment compliance at registration. These include:

     - Care in the Emergency Department
     - One follow up of an Emergency Department visit (e.g., suture removal)

2012 Federal Poverty Guidelines

The Brooklyn Hospital Center will determine a sliding fee scale for each service based on Federal Poverty Guidelines and the patient's income level as follows:

Financial Aid Application Form [23]

Patient Relations

Patients are the most important individuals at The Brooklyn Hospital Center.

The Department of Patient Relations is dedicated to maintaining a high degree of patient satisfaction throughout the Hospital Center. We address individual needs in a timely and respectful manner. The information obtained through problem-solving process is used to improve care and operations for all.

Patient Representatives--who serve as liaisons connecting you, members of your family and the hospital--work together to help create a positive experience for patients and their loved ones.

If you need help resolving a hospital issue, please request a Patient Representative through the Patient Relations office.

PUBLIC NOTICE [24]

Services

     - Patient advocacy
     - Encouraging communication between patient and the treatment team
     - Addressing patient concerns
     - Resolving conflicts or disagreements
     - Keeping patients informed of their rights and responsibilities
     - Ensuring that patient rights are respected
     - Offering help with Advance Directive planning
     - Helping to maintain patient privacy and confidentiality
     - Coordinating the efforts of the hospital's Bioethics Committee

Staff

     - Agatha George, Assistant Director
     - Rabbi Jonas Gruenzweig, Chaplain/Patient Representative

Related Information

     - Bio-Ethics Committee [25]
     - Language Assistance Program [10]
     - Department of Pastoral Care [26]

Patient Rights and Responsibilities

As a patient in a hospital in New York State, you have the right, consistent with law, to:

1. Understand and use these rights. If for any reason you do not understand or you need help, the hospital MUST provide assistance, including an interpreter.
2. Receive treatment without discrimination as to race, color religion, sex, national origin, disability, sexual orientation or source of payment.
3. Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
4. Receive emergency care if you need it.
5. Be informed of the name and position of the doctor who will be in charge of your care in the hospital.
6. Know the name, positions and functions of any hospital staff involved in your care and refuse their treatment, examination or observation.
7. A no smoking room.
8. Receive complete information about your diagnosis, treatment and prognosis.
9. Receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment.
10. Receive all the information you need to give informed consent for an order not to resuscitate. You also have the right to designate an individual to give this consent for you if you are too ill to do so. If you would like additional information, please ask for a copy of the pamphlet, "Do Not Resuscitate Orders—A Guide for Patients and Families."
11. Refuse treatment and be told what effect this may have on your health.
12. Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
13. Privacy while in the hospital and confidentiality of all information and records regarding your care.
14. Participate in all decisions about your treatment and discharge from the hospital. The hospital must provide you with a written discharge plan and written description of how you can appeal your discharge.
15. Review your medical record without charge. Obtain a copy of your medical record for which the hospital can charge a reasonable fee. You cannot be denied a copy solely because you cannot afford to pay.
16. Receive an itemized bill and explanation of all charges.
17. Complain without fear of reprisals about the care and services you are receiving and to have the hospital respond to you and if your request it, a written response. If you are not satisfied with the hospital's response, you can complain to the New York State Health Department. The hospital must provide you with the Health Department telephone number.
18. Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.
19. Make known your wishes in regard to anatomical gifts. You may document your wishes in your health care proxy or on a donor card, available from the hospital

Patient's Responsibilities

In providing care to a patient, The Brooklyn Hospital Center has a right to expect behavior on the part of patients and their relatives and friends, which, considering the nature of the patient's illness is reasonable and responsible.

1. To provide, to the best of his/her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters relating to his/her health.
2. To report unexpected changes in his/her condition to the responsible practitioner.
3. For reporting whether he/she clearly comprehends a contemplated course of action and what is expected of him/her.
4. For following the treatment recommended by the practitioner primarily responsible for his/her care. This may include following the instructions of nurses and allied health personnel as they carry out the coordinated plan of care, implement the responsible practitioner's orders and enforce the applicable Hospital Center rules and regulations.
5. For keeping appointments and, when he/she is unable to do so for any reason, for notifying the responsible practitioner or the Hospital Center.
6. For his/her actions if he/she refuses treatment or does not follow practitioner's instructions.
7. For assuring that the financial obligations of his/her health care are fulfilled as promptly as possible.
8. For following Hospital Center rules and regulations affecting patient care and conduct.
9. For being considerate of the rights of other patients and Hospital Center personnel and for assisting in the control of noise, and observing the policy regarding the number of visitors allowed and visiting hours.
10. For being respectful of the property of other persons and of the Hospital Center.

Language Assistance

Free interpreter services are available for all patients who need them, regardless of ability to pay.

Services

     - Providing bilingual staff and telephonic interpreter services.
     - Providing video remote interpreting system for sign language interpretation.
     - Monitoring language service provision throughout the hospital.
     - Responding to issues concerning language service.

Please notify your nurse or doctor if you require interpretation services.

You can also contact our Language Assistance Coordinator directly at 718.250.8292. The Language Assistance Program office is only open during normal business hours, but interpreters are available 24 hours a day, 7 days a week.

Insurance

The Brooklyn Hospital Center accepts a variety of private and public insurance plans. If you do not see your plan below, or if you have a question, please call our Patient Accounts/Billing Department at 718.250.8080.

Please note that some private physicians affiliated with The Brooklyn Hospital Center may not accept your insurance, even if listed here. Please verify insurance with your physician.

If you do not have insurance, you may eligible for assistance from the Financial Assistance Program [30], which can also be reached through the Patient Accounts/Billing Department.

Download the Financial Assistance Brochure [30].

Having trouble getting insurance because of a pre-exisiting medical condition?
The NY Bridge Plan [31] is here!

In March 2010, Congress passed the health care reform law, the Patient Protection and Affordable Care Act. The law created a temporary program until January 2014 that makes coverage available for individuals who have a pre-existing medical condition, have not had insurance for six months, and who are legal citizens or US residents.

This new program is called the Pre-Existing Condition Insurance Plan (PCIP) [31] and will be available throughout the country. In New York State, the PCIP plan is the NY Bridge Plan [31], administered by GHI, an EmblemHealth company.

PCIP plans will operate until the year 2014. At that time other provisions of health care reform will go into effect and state health benefit exchanges will be available for individuals to purchase coverage.

Prenatal Care Services

Prenatal Care Services at The Brooklyn Hospital Center provides pregnant women with free comprehensive prenatal care from the beginning or pregnancy (if they have no or partial insurance) up until two months after delivery.

There are no immigration requirements and no age limit. Minimal documentation is needed.

The program employs professional staff who are fluent in the languages of the communities they serve. We offer culturally sensitive activities and snacks for patients and their children.

Services

     - Medical Care/Delivery
     - Sonograms and Laboratory Tests
     - Medications/Vitamins
     - Hospital Care for mother and child
     - Dental Care
     - Nutrition
     - Visiting Nurse Services
     - Free pregnancy test
     - HIV & Genetic Counseling
     - Childbirth Classes
     - Social Service Support
     - Baby's Health care for a year after birth

Program Staff

     - Terrence DeSouza, Prenatal Care Services Eligibility Counselor 
     - Sakibeh Mustafa, Outreach Coordinator 

Admitting Office

The Admitting Office is committed to facilitating the admission, discharge and transfer (ADT) of all patients. We also ensure the information obtained from each patient is clear, concise, accurate and kept confidential at all times.

Pre-Admission Testing

If your surgeon determines that testing is required, you will be scheduled for an appointment with the Pre-Admission Testing Department. This testing may be done a few days before your procedure. Pre-admission testing takes approximately two to three hours and may include blood tests and X-rays. During your testing session, you will meet with a nurse and an anesthesiologist who will complete a health history and review your medications.

The pre-admission testing area is located in the Peri-Operative Suite on the 3rd floor.

Pre-Operative Instructions [34]

Patient Instructions

Admitting office staff will ask for information, including insurance. The information is entered into our computer system so that a record can be created. Once created, a permanent medical record number is assigned. That medical record number identifies you. Each time the person presents for treatment, we will repeat the same questions to ensure our information is up-to-date.

Cashier Services

Cashier services are available in the Emergency Department. Patients without insurance or whose insurance has a co-pay can make a payment on discharge from the Emergency Department. A cashier is available, 1st floor West Pavilion – 9:00 am to 5:00 pm, Monday to Friday, to pay other bills.

Click here for more information on the Financial Assistance Program [7].

Financial Assistance Brochure [35]

Billing & Charges

We understand how overwhelming it can be to deal with health and billing issues all at the same time. We also know that medical bills and insurance details can get confusing. Our goal is to make the process as easy as possible for our patients to understand.

Hospital Statement

Hospital bills are based on the type and complexity of the care received. The amount owed may include insurance deductibles, non-covered services or items, co-payments, co-insurance or, in appropriate cases, and balances due after insurance has paid on a charge [36]. (We may provide additional relevant documentation to help process a claim for the correct benefit.)

We file a claim with the patient's insurance carrier. For certain types of insurance coverage, if there is a balance due after the insurance company has processed the claim, or if the person does not have insurance, we will mail a statement (see sample bill) that shows the balance due after insurance payments.

Payment Expectations

Account balances are to be paid 21 days from the statement date. If a person is unable to pay in full by that date, the person is advised to contact our Patient Business Representatives to make payment arrangements.

If a person feels they are unable to pay for all or part of the healthcare received from The Brooklyn Hospital Center, we have developed a Financial Assistance Program (FAP) to help patients who are unable to pay their health care due to lack of insurance or insufficient insurance coverage. We also encourage people to apply for charity care/financial aid. Please call 718.250.8080 for information and/or an application form.

Frequently Asked Questions [37]

Completed application forms are to mailed to:

The Brooklyn Hospital Center
Patient Financial Services
121 DeKalb Avenue, Room 105
Brooklyn, New York 11201

Billing Sample [39]

Medical Records

The Health Information Management Department (HIM) maintains health records in a private and secure manner and provides this information to patients or legally authorized representatives upon written request within 10 business days for non-emergent requests.

Forms

Patient Authorization for the Release of Medical Information form (PDF) is to be filled out (notarized if mailed or faxed) and presented at the HIM Department during regular business hours.

Authorization for Disclosure of the Results of HIV Antibody Blood Test is also to be filled out and returned at the same time.

Please click on the links below to download the forms in a PDF format.

Patient Authorization for the Release of Medical Information form (PDF) [40]

Authorization for Disclosure of the Results of HIV Antibody Blood Test [41]

Patient Education

We're all familiar with the dictum Knowledge Is Power, but in the context of health care, knowledge also means better medical outcomes and increased safety. The Brooklyn Hospital Center strongly encourages patients to learn about their illness and treatment options.

Please visit our Healthcare Library [42] for extensive information on Pediatrics, Women's, Men's and Senior's health, as well as Cancer.

You can also visit our Human Atlas [43] where you can learn about various medical topics through videos, 3D models and imagery.

Health Advisory

For information regarding the Influenza A(H1N1) / Swine Influenza (Flu) please visit:
http://www.nyc.gov/html/doh/html/home/home.shtml [45]
http://www.nyc.gov/html/doh/downloads/pdf/cd/swine_flu_faq.pdf [46]
http://www.cdc.gov/swineflu/
[47]
From New York City Health Department:
http://www.nyc.gov/html/doh/html/cd/cdinflu.shtml [48]

From Centers for Disease Control and Prevention:
General information about swine flu [49]
Swine Flu Case Definitions [50]
Swine Flu Infection Control and Patient Care [51]
Preventing the Flu [52]
INFLUENZA A(H1N1) / SWINE FLU DOCUMENTS AVAILABLE IN MULTIPLE LANGUAGES [53]

Keeping Brooklyn healthy.

Hard Times and Health Insurance [54]

To assist the hundreds of thousands of New Yorkers who are scrambling to maintain health coverage after losing a job, United Hospital Fund [55] has produced a new consumer guide, Hard Times and Health Insurance: Staying Covered When You Lose Your Job [54]. The guide presents practical advice on state and federal protections, and how to exercise them. Perhaps most important, the guide includes information on how to take advantage of COBRA premium assistance provided in the federal stimulus law enacted last month.

DOWNLOAD THE GUIDE >> [54]

H1N1 Information

This section of our web site provides links to critical resources about the H1N1 virus and necessary precautions to prevent or limit a flu outbreak. Our goal is to ensure the safety of patients, visitors, staff, students, and our community.

Symptoms of H1N1 virus

The symptoms of H1N1 virus in people are similar to the symptoms of regular human flu and include

• fever
• cough
• sore throat
• body aches
• headache
• chills
• fatigue
• Some people have reported diarrhea and vomiting associated with this flu.

 Five Tips for Preventing the Spread of H1N1

1. Avoid close contact.
   Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
2. Stay home when you are sick.
   Stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
3. Cover your mouth and nose.
   Cover your mouth and nose with a tissue or your sleeve when coughing or sneezing. It may prevent those around you from getting sick.
4. Clean your hands.
   Washing your hands often will help protect you from germs. Alcohol based hand cleaners also work.
5. Avoid touching your eyes, nose or mouth.
   Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
6. Practice other good health habits.
   Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Please select a link below for up-to-date information about the H1N1 virus:

[56]

[57]

[58]

Greater New York Hospital Association [59]

New York City Department of Health and Mental Hygiene [45]

 

ShareThis [44]

Patient Safety

Patient safety is a top priority at The Brooklyn Hospital Center. Don't hesitate to ask if you have a question or concern about the care your care.

If you prefer, you can have a family member or a friend ask for you. If you feel like language is a stumbling block, ask your doctor or nurse about our free Language Assistance [10] Program.

When in doubt, please....

     -- SPEAK UP if you have any concerns.
     -- ASK QUESTIONS when you don't understand.
     -- EDUCATE YOURSELF about your illness.
     -- KNOW your medications.

Food Service

The Brooklyn Hospital Center Food Service is proud to offer a five star menu that offers a variety of meals. The menu is designed in accordance with the American Dietetic Association Diet Manual and meets Recommended Daily Intakes (RDI). Each day a diet technician will select food preferences from each patient. Clinical dietitians and diet technicians are available to provide consultations for patients and their family members.

Meals are served during these hours: