Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act requires all hospitals to publish hospital price information, a list of health plans in which we participate and a list of physician’s who may be treating you that are contracted or employed by Nathan Littauer Hospital & Nursing Home.

Average Inpatient DRG

It is important to recognize standard charges do not necessarily provide a quote of actual charge, how much it will cost for a specific patient’s care. It also does not account for any patient specific variables in a person’s medical condition, complications, length of stay or other ancillary services that may be required to treat a specific individual’s condition.

Standard charges do not provide a guarantee of actual charges or cost of care.

Standard charges do not take into consideration applicable insurance or the availability of other potential discounts which may apply.

Patients should contact the hospitals financial services department or their respective insurance company for specific information regarding actual out of pocket costs.

Average Inpatient DRG (XLSX)

Charge Description Master Information for Consideration:

The Charge Description Master (CDM) is a comprehensive listing of items at standard charges that may be billed to patients, payers and/or healthcare providers.

It is important to recognize standard charges do not necessarily provide a quote of actual charge, how much it will cost for a specific patient’s care. It also does not account for any patient specific variables in a person’s medical condition, complications, length of stay or other ancillary services that may be required to treat a specific individual’s condition.

Standard charges do not provide a guarantee of actual charges or cost of care.

Standard charges do not take into consideration applicable insurance or the availability of other potential discounts which may apply.

Patients should contact the hospitals financial services department or their respective insurance company for specific information regarding actual out of pocket costs.

Download Charges Description Master Spreadsheet (xls)

Out of Network Disclosure:

Nathan Littauer Hospital & Nursing Home Disclosure

This is a guide to assist you with verifying available benefits. Since each plan offers many networks, you are strongly encouraged to contact your insurance plan to determine if you may utilize Nathan Littauer Hospital & Nursing Home within your network of providers.

  • Medicare
  • Medicaid
  • Fidelis
  • American Progressive/Today’s Options
  • Blue Shield of Northeastern NY
  • Empire Blue Cross and Blue Shield
  • Excellus Blue Cross and Blue Shield
  • Capital District Physicians Health Plan
  • Mohawk Valley Physicians Health Plan
  • GHI/Emblem
  • UnitedHealthcare
  • Pomco
  • 1199 Benefit Fund
  • Tricare
  • Hamaspik
  • Humana

Out of Network and Surprise Bills-Independent Review Resolution-

A surprise bill is a bill received by an insured for services rendered at our facility by an out of network physician where a network physician is unavailable or the patient had no knowledge that the physician was out of network, or did not consent to the referral of the out of network physician; or an uninsured patient who did not receive the required disclosures.

Patients who receive out of network emergency physician bills should not have to pay more than their usual in-network cost sharing and/or copayment amounts, regardless of the network status of the physician. Similarly, patients who receive out of network non-emergency services because there were no adequate in-network physicians available, or because they received a referral to an out of network provider without the proper disclosures, will not have to pay more than their usual in-network co-pay/cost-sharing.

The law establishes a dispute resolution mechanism (Independent Review Resolution) for patients, plans and physicians who disagree about out of network reimbursement for “surprise bills” and emergency services. As part of the IDR entity’s review, the IDR will consider, among other things, whether there is a “gross disparity” between the fee charged by the physician as compared to other fees paid to similarly qualified non-par physicians in the same region, the level of training, education and experience of the physician, and the circumstances and complexity of the case, including the time and place of the services.  Decisions by the IDR entity must be made within 30 days of the dispute’s submission.

If you feel you are receiving a “Surprise Bill” for services that you were unaware were out of network and wish to discuss the review process please contact the physician’s office directly. For a formal independent review you may contact the regions Independent Review Resolution contractor.

Physicians who may deliver care at Nathan Littauer Hospital & Nursing Home

Employed Medical Staff:

These employed physicians utilize the same insurance networks as listed above for Nathan Littauer Hospital & Nursing Home.  Each may be reached at the telephone number listed or by mail at 99 E. State Street, Gloversville NY 12078.

Download List of Medical Staff

Contracted  or Physicians with Privileges:

These contracted physicians or physicians with privileges below operate independently from Nathan Littauer Hospital & Nursing Home and negotiate their own contracts with insurance carriers. You are strongly encouraged to contact your insurance plan to determine if the providers below are part of your network of participating physicians.

Name/Address Phone
Gloversville Emergency Medicine Services, PC
P.O. Box 731584
Dallas TX 75373-1584
(888) 703-3301
Gloversville Physician Medicine Services, PC
4849 Greenville Ave, Suite 400
Dallas, TX 75206-9805
(518) 775-4264
Millennium Medical Imaging
P.O. Box 130
Latham, NY 12110
(518) 786-1291
Lee, Jungeun Jay MD
P.O. Box 363
Latham, NY 12110
(800) 235-0045
Mohawk Valley Orthopedics
434 S. Kingsboro Ave Suite 102
Johnstown, NY 12095
(518) 773-4242
Cardiology Associates of Schenectady
2546 Balltown Rd Suite 300
Schenectady, NY 12309
(518) 773-2303
Hassam, Akber MD
2 Fon Clair Terrace
Johnstown, NY 12095
(518) 762-8898
Keshava, H B MD
1185 County Highway 122
Gloversville, NY 12078
(518) 752-5160