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.

Price Transparency:

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Centers for Medicare and Medicaid Services

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Health Data NY

 

Understanding Healthcare Prices: A New York Consumer Guide

 

We have provided links to websites for the Centers for Medicare and Medicaid Services as well as the Health Data NY to provide access to historical charges and reimbursement for Nathan Littauer Hospital & Nursing Home. A quote for hospital services can also be obtained by calling (518) 773-5555.

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

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 many 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.

Medical Staff Name Specialty Phone:
Behar, Susan MD Anesthesiology (518) 775-4208
Moberg, Paul MD Anesthesiology (518) 775-4208
Carstens, Jan MD Family Practice (518) 883-8620
Klausner, Eric MD Family Practice (518) 883-8620
Perreault, Paul MD Family Practice (518) 661-5441
Pesses, David MD Family Practice 518) 775-4201
Vacek, James MD Family Practice (518) 775-4201
Alvarez, Luz MD Gastroenterology (518) 752-5275
Ramani, Kamini MD Gastroenterology (518) 725-6080
Rehman, Hamid MD Gastroenterology (518) 883-8620
Brandis, Robert MD Internal Medicine (518) 661-5493
Fotidar, Akhilesh MD Internal Medicine (518) 773-5690
Kesari, Parvathi MD Internal Medicine (518) 773-5690
Narala, Karuna MD Internal Medicine (518) 661-5493
Schwartzman, Michael MD Internal Medicine (518) 736-1500
Sherman, Diana MD Internal Medicine (518) 773-5690
Shnaidman, Clara MD Internal Medicine (518) 883-8620
Lynch, Matthew MD Neurology (518) 883-6339
Zoltay, Gabor MD Neurology (518) 773-5691
Dowling, Peter MD Obstetrics and Gynecology (515) 773-5729
Farwa, Ume MD Obstetrics and Gynecology (518) 883-8634
Mycek, John A. MD Obstetrics and Gynecology (518) 775-4360
Nguyen, Patricia MD Obstetrics and Gynecology (518) 773-5729
Colt, Shannon MD Pediatrics (518) 762-6731
Hanafi, Walid MD Pediatrics (518) 661-5725
Horowitz, Lawrence DO Pediatrics (518) 773-7520
Solby, Richard DO Pediatrics (518) 762-6731
Sunkara, Maruthi MD Pediatrics (518) 775-4234
Tantuwaya, Brijesh Kumar MD Pediatrics (518) 883-8624
Harbeck, Tara DPM Podiatry (518) 883-8862
Lataillade, Pierre MD Pulmonology (518) 775-4333
Filippone, Nicholas MD Surgery (518) 773-5687
Togbe, Bennet MD Surgery (518) 773-5687
Wasiczko, Robert MD Surgery (518) 775-4208
Husson, Paul MD Urology (518) 773-4133

 

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