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For Patients > Patient Guide > Patient Financial Assistance Policy
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Patient Financial Assistance Policy English Availability of Financial Assistance Massachusetts Eye and Ear Infirmary is committed to providing all of our patients with high-quality care and services. As part of this commitment, the Hospital works with individuals with limited incomes and resources to find available options to cover the cost of their care. The Hospital will help uninsured and underinsured individuals apply for health coverage through a public assistance program or the Hospital's financial assistance program (including but not limited to MassHealth, the Premium Assistance Payment Program operated by the Health Connector, the Children's Medical Security Program, the Health Safety Net, and Medical Hardship), and work with individuals to enroll as appropriate. Assistance for these programs is determined by reviewing, among other items, an individual's household income, assets, family size and all expenses. While the Hospital assists patients in obtaining health coverage through public programs and financial assistance through other sources whenever appropriate including the Hospital, the Hospital may also be required to appropriately bill for and collect specific payments, which may include but not be limited to, applicable co-payments, deductibles, deposits, and other amounts for which the patient agrees to be responsible. When registering for services or if receiving a bill, the Hospital encourages patients to contact our staff to determine if they and/or a family member are in need of and eligible for financial assistance. In working with patients to find available public assistance or coverage through the Hospital's financial assistance, the Hospital does not discriminate on the basis of race, color, national origin, citizenship, alienage, religion, creed, sex, sexual orientation, gender identity, age, or disability in its policies or in its application of policies. We understand that each individual has a unique financial situation. Every request for assistance is handled confidentially and requires the cooperation of the applicant. Information and assistance regarding eligibility for public assistance programs and/or coverage through the Hospital's financial assistance program may be obtained by contacting the Hospital Financial Coordinators: Mass Eye and Ear Financial Coordinators 243 Charles Street Boston, MA 02114 Hours of operations: Monday through Friday, 8AM – 5PM Phone number: 617-573-5664 Email Address:
[email protected] Please do not delay in speaking with a Financial Coordinator to explore your options. Enrollment in programs is time sensitive.
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How to Apply for Patient Financial Assistance
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Patients may apply for financial assistance by: Completing, signing and dating the Financial Assistance Application, Attaching copies of supporting documentation to the Financial Assistance Application, and Mailing or delivering the Financial Assistance Application and supporting documentation to the following address: Mass Eye and Ear Financial Coordinators 243 Charles Street Boston, MA 02114 Hours of operations: Monday through Friday, 8AM – 5PM Phone number: 617-573-5664 Email Address:
[email protected]
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You may fill out the Financial Assistance Application using a computer, and then print and sign the completed application; or you may print the blank application and fill it in by hand. A Financial Assistance Application Checklist is available to help you gather supporting documentation for your Financial Assistance Application. Financial Assistance Applications and Checklists are also available in the Financial Coordinators area on the lobby floor of the hospital's main campus located at 243 Charles Street, Boston, Massachusetts 02114, and may also be requested by telephone by calling a Hospital Financial Coordinator at 617-573-5664 from Monday through Friday between 8:00 a.m. to 5:00 p.m. More information regarding Massachusetts Eye and Ear Infirmary's policies regarding financial assistance and credit and collections policy, can be found in the Financial Assistance Policy and the Billing and Collections Policy. Here is information regarding our Amounts Generally Billed (AGB) rate. And here is the Massachusetts Eye and Ear Infirmary List of Financial Assistance Policy-eligible providers.
Español Spanish Disponibilidad de asistencia financiera Massachusetts Eye and Ear Infirmary está comprometido a brindar cuidados y servicios de alta calidad a todos nuestros pacientes. Como parte de este compromiso, el Hospital trabaja con personas con ingresos y recursos limitados para que encuentren opciones disponibles y puedan cubrir así el costo del cuidado que reciben. El Hospital ayudará a que las personas no aseguradas y subaseguradas soliciten cobertura médica a través de un programa de asistencia pública o del programa de asistencia financiera del Hospital (entre ellos MassHealth, Premium Assistance Payment Program - Programa de Asistencia de Pago de Primas - que dirige Health Connector, Children's Medical Security Program - Programa de Seguridad Médica para Niños -, Health Safety Net - Red de Seguridad Médica -, y Medical Hardship - Dificultad Médica -), y trabajará con las personas para que se inscriban según corresponda. La asistencia que brindan estos programas se determina mediante la revisión del ingreso familiar, de los bienes, del tamaño de la familia y de todos los gastos, entre otras cosas, de cada persona. Si bien el Hospital brinda asistencia a los pacientes para que obtengan cobertura médica mediante programas públicos y asistencia financiera mediante otras fuentes cuando sea apropiado, incluso mediante el mismo Hospital, es posible que el Hospital deba facturar y recaudar adecuadamente ciertos pagos, que pueden incluir, entre otros, copagos, deducibles, depósitos y otros montos pertinentes por los que el paciente se hace responsable. Cuando el paciente se registra para recibir servicios o cuando recibe una factura, el Hospital los alienta a que se comuniquen con nuestro personal para determinar si dicho paciente o un familiar necesitan y son elegibles para recibir asistencia financiera. Cuando se trabaja con pacientes para encontrar asistencia pública o cobertura disponibles a través de la asistencia financiera del Hospital, el Hospital no discrimina por la raza, color, lugar de procedencia, ciudadanía, condición de extranjero, religión, credo, sexo, orientación sexual, identidad de género, edad o discapacidad en lo que respecta a sus políticas o a la aplicación de dichas políticas. Entendemos que cada persona tiene una situación financiera particular. Cada solicitud de asistencia es confidencial y requiere la cooperación del solicitante. Puede obtener información y ayuda sobre la elegibilidad de los programas de asistencia pública o sobre la cobertura que brindan los programas de asistencia financiera del Hospital comunicándose con los Coordinadores Financieros del Hospital: Mass Eye and Ear Financial Coordinators 243 Charles Street Boston, MA 02114 Horarios de atención: De lunes a viernes, de 8 a. m. a 5 p. m. Número de teléfono: 617-573-5664 Correo electrónico:
[email protected] No tarde en comunicarse con un Coordinador Financiero para explorar sus opciones. La inscripción en los programas tiene plazos definidos. Puede encontrar más información sobre el programa de asistencia financiera del Hospital, incluidas la Política de Asistencia Financiera y el formulario de solicitud, en el sitio web del Hospital: http://www.masseyeandear.org/for-patients/patient-guide/financial-assistance Política de asistencia financiera de Massachusetts Eye and Ear Infirmary Disponibilidad de asistencia financiera Formulario de asistencia financiera Política de facturación y cobro de Massachusetts Eye and Ear Infirmary Montos generalmente facturados Massachusetts Eye and Ear Infirmary Lista de proveedores Política-elegibles de asistencia financiera
Chinese (MassHealth()(Health Connector) (Health Safety Net)(Medical Hardship)) (co-payment)deductible)
/ Mass Eye and Ear Financial Coordinators 243 Charles Street Boston, MA 02114 , 5 617-573-5664
[email protected]
http://www.masseyeandear.org/for-patients/patient-guide/financial-assistance
русский Russian Доступность финансовой помощи Массачусетская клиника глазных и ЛОР-болезней обязуется оказывать всем своим пациентам медицинскую помощь и услуги высокого уровня качества. В соответствии с данным обязательством, Клиника работает с лицами с низким уровнем доходов и ресурсов, помогая им найти доступные варианты для покрытия расходов на медицинское обслуживание. Клиника будет оказывать помощь лицам, не имеющим страхового покрытия или имеющим недостаточное страховое покрытие при подаче заявлений на покрытие расходов на медицинское обслуживание через программу государственной помощи или программу финансовой помощи Клиники (включая, в числе прочего, программы MassHealth, программу помощи в оплате страховых взносов через портал Health Connector, План обеспечения медицинского обслуживания детей, программу Health Safety Net и Medical Hardship), и взаимодействовать с такими лицами для содействия их вступлению в программу, в применимых случаях. Возможность помощи для участия в данных программах, в числе прочего, определяется в результате анализа семейного дохода такого лица, его активов, размера семьи и всех расходов. Несмотря на то, что Клиника оказывает пациентам помощь в получении медицинского страхования через программы государственных денежных пособий и финансовую помощь из других источников, где это приемлемо, включая помощь Клиники, Клинике также может потребоваться выставить выставлять в счет и взимать отдельные платежи, которые могут включать в себя, в числе прочего, применимую частичную оплату, вычитаемые франшизы, депозиты и другие суммы, за уплату которых пациент соглашается нести ответственность. Клиника рекомендует пациентам при регистрации для целей оказания услуг или при получении счета обратиться к нашим консультантам, чтобы определить, нуждаются ли они сами и/или кто-либо из членов их семей в финансовой помощи, и имеют ли они право на ее получение. Политика Клиники и ее практическое применение не допускает дискриминации по расовому признаку, цвету кожи, национальному происхождению, гражданству, статусу иностранного подданного, религии, конфессии, полу, сексуальной ориентации, гендерной идентичности, возрасту или инвалидности при взаимодействии с пациентами с целью поиска доступной программы государственной помощи или покрытия медицинских расходов из финансовой помощи Клиники. Мы понимаем, что финансовая ситуация каждого человека индивидуальна. Каждый запрос на помощь обрабатывается конфиденциальным образом, и требует сотрудничества со стороны заявителя. Вы можете получить дополнительную информацию и содействие для определения возможности своего участия в программе государственной помощи и/или покрытия медицинских расходов из финансовой помощи Клиники, обратившись к финансовым координаторам Клиники: Финансовые координаторы Массачусетской клиники глазных и ЛОР-болезней 243 Charles Street Boston, MA 02114 Часы работы: пн – пт, с 8:00 до 17:00 Номер телефона: 617-573-5664 Адрес электронной почты:
[email protected] Просьба не задерживаться с обращением к финансовому координатору для изучения возможных вариантов. Своевременное обращение крайне важно для возможности принять участие в программе. Дополнительную информацию о программе финансовой помощи Клиники, включая политику финансовой помощи и форму заявления, можно найти на веб-сайте Клиники: http://www.masseyeandear.org/for-patients/patient-guide/financial-assistance Массачусетская клиника глазных и ЛОР-болезней Политика по оказанию финансовой помощи Доступность финансовой помощи Заявление на получение финансовой помощи Политика начисления оплаты и взыскания задолженности Обычная сумма счета Массачусетс глаз и ушей лазарете Список финансовой помощи политики, имеющих право на поставщиков
Arabic
. . ( )MassHealth ) )Connector Health ) . .
(
. / . . . / . : Mass Eye and Ear Financial Coordinators 234 Charles Street Boston, MA 02114 5 - 8 : 617-573-5664 :
[email protected] : . . : http://www.masseyeandear.org/for-patients/patient-guide/financial-assistance
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Português European Portuguese (Veja abaixo para Português do Brasil)
Disponibilidade de Apoio Financeiro O Massachusetts Eye and Ear Infirmary está empenhado em proporcionar a todos os nossos pacientes cuidados e serviços de saúde de elevada qualidade. Ao abrigo deste compromisso, o Hospital trabalha com pessoas que dispõem de rendimentos e recursos limitados para encontrar opções disponíveis para cobrir os custos dos cuidados prestados. O Hospital ajudará os pacientes que não tiverem seguro ou que não tiverem seguro suficiente a requererem cobertura dos cuidados de saúde através de um programa de assistência social pública ou do programa de apoio financeiro do Hospital (incluindo, mas não se limitando à MassHealth, Programa Premium Assistance Payment operado pela Health Connector, Programa Children’s Medical Security, Health Safety Net, e Medical Hardship), e trabalhará com os pacientes para os inscrever nesses programas se for caso disso. O apoio para estes programas é determinado através da avaliação, de entre outros aspectos, do rendimento do agregado familiar do paciente, do seu património, dimensão do agregado familiar e todas as despesas. Apesar de o Hospital ajudar os pacientes a obterem cobertura de cuidados de saúde através de programas e apoio financeiro estatais através de outras fonte sempre que for caso disso, incluindo do Hospital, o Hospital poderá também ser solicitado a facturar devidamente e a cobrar pagamentos específicos que poderão incluir, mas não limitar-se a copagamentos aplicáveis, franquias, depósitos e outros montantes pelos quais o paciente concorda responsabilizar-se. Aquando do registo para utilização dos serviços ou da recepção de uma factura, o Hospital aconselha os pacientes a contactarem o nosso pessoal para se determinar se eles e/ou um membro da sua família necessitam e têm direito a apoio financeiro. No trabalho feito em conjunto com os pacientes com o intuito de encontrar assistência social pública ou cobertura através do apoio financeiro do Hospital, o Hospital não discrimina com base na raça, cor, país de origem, nacionalidade, estatuto de cidadão estrangeiro, religião, credo, sexo, orientação sexual, identidade de género, idade, ou deficiência, nas suas políticas ou na aplicação que faz dessas políticas. Compreendemos que cada indivíduo terá uma situação financeira singular. Cada pedido de apoio é tratado confidencialmente e requer colaboração por parte do requerente desse apoio. Podem ser obtidas informações e apoio relativamente à elegibilidade para beneficiar de programas de assistência social pública e/ou de cobertura de saúde através do programa de apoio financeiro do Hospital contactando os Coordenadores Financeiros do Hospital: Mass Eye and Ear Financial Coordinators 243 Charles Street Boston, MA 02114 Horário de funcionamento: Segunda a sexta, das 08H00 às 17H00 Telefone: 617-573-5664 E-mail:
[email protected] Por favor apresse-se a falar com um Coordenador Financeiro para estudar as suas opções. A inscrição nos programas está condicionada no tempo. Poderá consultar mais informações sobre o programa de apoio financeiro do Hospital, incluindo a Política de Apoio Financeiro e o formulário de inscrição, no sítio Web do Hospital: http://www.masseyeandear.org/for-patients/patient-guide/financial-assistance Português Europeu: Massachusetts Eye and Ear Infirmary – Política de Apoio Financeiro Disponibilidade de Apoio Financeiro Pedido de Apoio Financeiro Massachusetts Eye and Ear Infirmary – Política de Facturação e Cobranças Montantes Geralmente Facturados Massachusetts Eye and Ear Infirmary Lista de fornecedores de Política elegíveis Assistência Financeira português do Brasil: Política de Assistência Financeira da Enfermaria de Olhos e Ouvidos de Massachusetts Disponibilidade de Assistência Financeira Formulário de Requisição de Assistência Financeira Política de Faturamento e Cobrança do Massachusetts Eye and Ear Infirmary Quantias Geralmente Cobradas Massachusetts Eye and Ear Infirmary Lista de fornecedores de Política elegíveis Assistência Financeira
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243 Charles Street Boston, MA 02114
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