The Patient Financial Services staff is available to respond to inquiries by phone regarding billing. Patients may request an itemized statement, pay their amount due with a checking account or credit card, set up a payment plan, and/or provide additional insurance information not given at the time of service.
In addition, our staff can provide some information related to the patient's insurance benefits and exclusions.
","MainContent":"Pay My BillThe Patient Financial Services staff is available to respond to inquiries by phone regarding billing.
Via the phone, patients may request an itemized statement, pay their amount due with a checking account or credit card, set up a payment plan, and/or provide additional insurance information not given at the time of service.
In addition, our staff can provide some information related to the patient's insurance benefits and exclusions.
In most cases, health insurance carriers offer two major types of coverage; HMO plans or traditional plans. HMO plans generally set a fixed dollar amount for office visits, outpatient visits, emergency room visits and sometimes inpatient stays that the patient is required to pay directly to the provider at the time of service. This is called a co-payment.
Traditional plans and Medicare establish a fixed dollar amount that must be paid by the patient (usually annually) prior to any payment made by the health insurance carrier. This is called a deductible.
A co-insurance is typical with traditional plans and Medicare. The health insurance carrier pays a percentage of the charge and the remaining balance is the responsibility of the patient.
The following information is required:
It is very helpful if you show the registration clerk or receptionist your health insurance identification card each time you come in for medical services. You may ask to have this information read back to you to ensure your record is accurate.
It is a practice of Kaleida Health not to bill a patient until we have exhausted all means of obtaining payment from your health insurance carrier. At times, we receive partial payments or denials that we feel are incorrect. Therefore, we must follow the appeal process established by your health insurance carrier to dispute their decision. These processes can result in a delay in billing you for your portion of the bill.
Simply call our customer service department at (716) 859-7200 Monday through Friday between the hours of 8:30 a.m. and 4:30 p.m. and our representatives will be happy to mail you one.
All of the Kaleida Health sites accept Visa, MasterCard, American Express and Discover. You may charge any payment utilizing one of these credit cards. We can also take this information over the phone if it is inconvenient for you to come to a cashier window in person, or you can pay online.
Please call the Self-Pay Quote line at 859-8900. The team provides quotes for patients who would be paying all costs out of pocket, without using insurance. You will leave your name, phone number and the CPT codes for the services you are inquiring about and a team member will get back to you within 48 hours. CPT codes are billing codes used identifying the services; these CPT codes can be provided to you by your referring physician.
If you do not have insurance and would like to speak with a financial counselor regarding options, please call 859-8979 or see the Financial Assistance Program. One of our facilitated enrollers will be able to assist you with the options available.
Please contact your health insurance company directly. They will have access to your specific insurance coverage and will be able to give you the most accurate estimate of what you will be responsible to pay
Kaleida Health, as a hospital system, participates with several insurances, as listed below.
There are often several different plans and/or allowed services offered by an insurance carrier, and Kaleida Health may participate with only certain plans. While we have tried to list the most common plans, if you have any questions, do not see your plan listed, or would like more information, please contact your insurance company to confirm plan participation .
Although Kaleida Health participates with most insurance companies, we may be excluded or limited in our participation of certain product plans offered by an insurance company. Please contact your insurance company directly to determine if your specific product plan participates with Kaleida Health.
| Insurance Company | Insurance Product | Kaleida Health Participates with Insurance Product | Hospital Employed Physicians Participates with Insurance Product Employed Physicians List (pdf) |
Aetna | |||
|---|---|---|---|
| Commercial/Self Funded | Yes | Yes | |
| FEHBP Aetna Open Access | No | No | |
| Medicare | Yes | Yes | |
| Medicaid | No | No | |
| Medicare Full Dual (HMO D-SNP) | Yes | Yes | |
American Health Plan of Pennsylvania | |||
| Special Needs Plan (SNP) | Yes | Yes | |
Amerigroup | |||
| Child Health Plus | Yes | Yes | |
| Medicaid | Yes | Yes | |
| Essential Plans | Yes | Yes | |
Beacon Health Options (Carelon) | |||
| No | No | ||
Beacon Health Strategies | |||
| Commercial/Self Funded | Yes | Yes | |
| Child Health Plus | Yes | Yes | |
| Essential Plans | Yes | Yes | |
| HARP | Yes | Yes | |
| Health Benefit Exchange/Metal Tier | Yes | Yes | |
| Medicaid | Yes | Yes | |
Beech Street | |||
| Commercial/Self Funded | No | No | |
Blue Cross Blue Shield of Western New York (Highmark) | |||
| Commercial/Self Funded Excludes Focus Select | Yes | Yes | |
| Essential Plans | Yes | Yes | |
| Focus Select For Golisano Children's Hospital of Buffalo, please contact insurance company to determine participation | No | No | |
| Health Benefit Exchange/Metal Tier | Yes | Yes | |
| Medicare | Yes | Yes | |
| Medicaid | Yes | Yes | |
Cancer Services of Erie County | |||
| Yes | Yes | ||
Cancer Services of Niagara County | |||
| Yes | Yes | ||
Catholic Health LIFE | |||
| Program All Inclusive Care Elderly (PACE) | No | No | |
Centers Plan for Healthy Living | |||
| Managed Long Term Care | Yes | Yes | |
| Medicare | Yes | Yes | |
| Fully Integrated Dual Eligible (FIDA) | No | No | |
| Special Needs Plan (SNP) | Kaleida Health participates through Magnacare | Physicians participate through Magnacare | |
Champ VA | |||
| Yes | Yes | ||
Cigna | |||
| Commercial/Self Funded | Kaleida Health participates through MVP | Physicians participate through MVP | |
| Medicare | Yes | Yes | |
Claim Doc, LLC | |||
| Commercial | Yes | Yes | |
Coventry | |||
| Commercial/Self Funded | Yes | Yes | |
| Medicare | Yes | Yes | |
| No Fault | Yes | Yes | |
| Workers Compensation | Yes | Yes | |
Department of Veterans Affairs - Patient-Centered Community Care Provider Network | |||
| Yes | No | ||
Elderwood | |||
| Managed Long Term Care | No | No | |
Emblem Health/GHI | |||
| Commercial/Self Funded | Yes | No | |
| Medicare | No | No | |
| Medicaid | No | No | |
| Essential Plans | No | No | |
Empire Blue Cross Blue Shield | |||
| Commercial/Self Funded | Yes | Yes | |
| Medicare | Yes | Yes | |
Fallon Health | |||
| Managed Long Term Care | HighPointe on Michigan only | No | |
| Program All Inclusive Care Elderly (PACE) | Yes | Yes | |
| Special Needs Plan (SNP) | Yes | Yes | |
Family Choice Special Needs Plan | |||
| Yes | No | ||
Fidelis | |||
| Medicaid | Yes | Yes | |
| Medicare | Yes | Yes | |
| Health Benefit Exchange | Yes | Yes | |
| Dual Advantage | Yes | Yes | |
| Fully Integrated Dual Eligible (FIDA) | Yes | Yes | |
| Managed Long Term Care | Yes | Yes | |
| Health and Recovery Plan (HARP) | Yes | Yes | |
| Essential Plan | Yes | Yes | |
| Child Health Plus | Yes | Yes | |
First Choice HealthFor Golisano Children's Hospital of Buffalo, please contact insurance company to determine participation | |||
| Commercial/Self Funded | No | No | |
First Health | |||
| Commercial/Self Funded | Yes | No | |
Healthnet Federal | |||
| Tricare | Yes | Yes | |
HealthPlex | |||
| Medicaid | Yes | No | |
Highmark (New York) | |||
| Please see Blue Cross Blue Shield of Western New York (Highmark) for participating products | |||
Highmark (Pennsylvania) | |||
| Varies by product. Please confirm with Highmark. | Varies by product. Please confirm with Highmark. | ||
Hospice Erie and Niagara | |||
| Hospice | Yes | Yes | |
Humana/Choice Care | |||
| Commercial | Yes. HighPointe on Michigan and DeGraff Skilled Nursing are non- participating | No | |
| Medicare | No | No | |
i Circle | |||
| Medicare | Yes | Yes | |
| Medicaid | Yes | Yes | |
| Medicaid Managed Long Term Care | Yes | Yes | |
Independent Health | |||
| Commercial/Self Funded | Yes | Yes | |
| Family Choice | Yes | No | |
| First Choice Please contact Independent Health for member benefits | Kaleida Health is an in-network, Tier 2 Provider. Cost share may be higher. | Kaleida Health is an in-network, Tier 2 Provider. Cost share may be higher. | |
| Health Benefit Exchange | Yes | Yes | |
| Medicare | Yes | Yes | |
| Medicaid | Yes | Yes | |
| Essential Plans | Yes | Yes | |
| Child Health Plus | Yes | Yes | |
Indian Health Services - Tuscarora | |||
| Inpatient Services Only | Yes | No | |
KALOS Health | |||
| Managed Long Term Care | Yes | No | |
| Medicare Dual Advantage | Yes | Yes | |
Lifetime Benefit Solutions (EBS-RMSCO) | |||
| Commercial/Self Funded | Yes | Yes | |
Magnacare | |||
| Commercial/Self Funded | Yes | Yes | |
| Workers Comp (Buffalo Bills Stadium Workers Only) | Yes | Yes | |
Martin's Point Healthcare (Tricare)/US Family Health | |||
| Tricare | Yes | Yes | |
Medicare | |||
| Traditional Medicare (Part A and Part B) | Yes | Yes | |
Medicaid | |||
| Traditional Medicaid | Yes | Yes | |
Meritain | |||
| Commercial/Self Funded | Kaleida Health participates through Magnacare and Multiplan | Physicians participate through Magnacare and Multiplan | |
Molina HealthCare | |||
| Medicaid | Yes | Yes | |
| Essential Plan | Yes | Yes | |
| Child Health Plus | Yes | Yes | |
Multiplan | |||
| Commercial/Self Funded | Yes Please contact payer to confirm participation | Yes Please contact payer to confirm participation | |
MVP | |||
| Commercial/Self Funded | Yes | Yes | |
| HARP | Yes | Yes | |
| Health Benefit Exchange/Metal Tier | Yes | Yes | |
| Medicare | Yes | Yes | |
| Medicaid | Yes | Yes | |
| Essential Plans | Yes | Yes | |
| Student Health Plan | Yes | Yes | |
Nascentia Health Options | |||
| Medicare | Yes | Yes | |
NOVA | |||
| Commercial/Self Funded | Yes | Yes | |
Optum Behavioral Health | |||
| No | No | ||
Oscar Insurance Corporation | |||
| Health Benefit Exchange/Metal Tier | Kaleida Health participates through Magnacare | Physicians participate through Magnacare | |
POMCO | |||
| Commercial/Self Funded | Kaleida Health participates through Magnacare | Physicians participate through Magnacare | |
| Workers Compensation | Kaleida Health participates through PHCS | Kaleida Health participates through PHCS | |
United Healthcare | |||
American Postal Workers Union | Yes | Yes | |
Commercial/Self Funded | No | Yes | |
Commercial/UMR/Sierra Life & Health Insurance | No | No | |
However, Kaleida participates through PHCS if United member has PHCS logo on their ID card, then member is considered participating/in network. *If United member has Multiplan logo on their ID card, please contact United to confirm participation. |
| ||
| Child Health Plus | Yes | Yes | |
| Commercial/Self Funded-Key Bank and Eaton Corp members only/Thermo Fisher/City of NY | Yes | Yes | |
| HARP | Yes | Yes | |
| Health Benefit Exchange/Metal Tier | No | No | |
| Medicare | Yes | Yes | |
| Medicaid | Yes | Yes | |
| Dual Complete (Special Needs Plan) | Yes | Yes | |
| Managed Long Term Care | Yes | Yes | |
| Essential Plans | Yes (excluding Skilled Nursing Facilities) | Yes | |
| Temporary Assistance for Needy Families (TANF) | Yes | Yes | |
| United Healthcare Dental | Yes | Yes | |
| Student Resources – SUNY International and Domestic | Yes | Yes | |
| Veterans Affairs Community Care Program | Yes | Yes | |
Univera Healthcare | |||
| Commercial/Self Funded | Yes | Yes | |
| Health Benefit Exchange/Metal Tier | Yes | Yes | |
| Medicare | Yes | Yes | |
| Medicaid | Yes | Yes | |
| Child Health Plus | Yes | Yes | |
| HARP | Yes | Yes | |
| Integrated Benefits for Duals & Medicaid Advantage Plus | Yes | Yes | |
| Essential Plans | Yes | Yes | |
Universal American/American Progressive | |||
| Commercial/Self Funded | No | No | |
| Health Benefit Exchange/Metal Tier | No | No | |
| Medicare | Yes | Yes | |
| Essential Plans | No | No | |
UPMC | |||
| UPMC | Commercial | Kaleida Health participates through Cigna | Yes |
| UPMC | Medicare | Yes | Yes |
| UPMC | Medicaid *No SNFs | Yes | Yes *Varies by physician. Check specific physician participation with office. |
US Department of Veterans Affairs | |||
| Yes | Yes | ||
Wellcare | |||
| Medicare | Yes | Yes | |
| Medicaid | Yes | Yes | |
| Managed Long Term Care | Yes | Yes | |
| Health Benefit Exchange/Metal Tier | Yes | Yes | |
| Essential Plans | Yes | Yes | |
| Fully Integrated Dual Eligible (FIDA) | Yes | Yes | |
VNS Insurance Coverage | |||
| Medicare Advantage | Yes | Yes | |
| DSNP | Yes | Yes | |
| MLTC | Yes | Yes |
No. It is possible for a hospital to participate with an insurance plan, but for a physician to not. You should check with your physician office(s) to determine their participation, or contact your insurance company with any questions.