Financial Assistance

What is the Financial Assistance Program?

The Financial Assistance Program at CVPH is designed to help people who are uninsured or underinsured and do not have the ability to pay. All patients receive medical care regardless of ability to pay. You must meet the eligibility requirements. You are expected to contribute to your care based on your ability to pay. This is not an insurance program, and is not meant to replace benefits that are, or could be, received from government-supported programs. It is the intention of CVPH to offer assistance to our most financially needy patients. View our Financial Assistance Policy.

CVPH provides financial assistance to all eligible NYS residents for emergency services in our primary services areas: Clinton, Franklin and Essex counties of New York State and for non-emergency medically necessary services. CVPH may extend financial assistance to other geographic areas on a case by case basis. For more information please refer to our Plain Language Summary of the Financial Assistance Program.

Related Documents:

• Credit and Collection Policy
• Financial Assistance Policy
• Financial Assistance Policy Summary

Who is eligible?

Participants must meet the eligibility requirements (below) and comply with the guidelines. This program is only for services provided by CVPH.

Who Is not eligible?

Those who exceed the income and other guidelines.

The Financial Assistance Program does have limits to what it will cover. What isn't covered?

• Services provided by physicians that do not work for CVPH
• Cosmetic surgery
• Charges not incurred at CVPH
• Prescriptions

How and when do I apply?

Anyone wishing to apply should contact CVPH one of the following ways:

• Download Application
• Download the Financial Assistance Program (FAP) Application Checklist
• Phone (518) 562-7075. We would be happy to provide you with an appointment to assist you in completing your application.
• Email us at patientaccounting@cvph.org
• Visit our Financial Advocates outside the main lobby at 75 Beekman Street, Plattsburgh. We're open Monday through Friday, 8 am-4:30 pm.

You can apply for the Financial Assistance Program any time prior to services being rendered. If you're applying after services have been rendered, you have a maximum of 120 days from the date of service to make application. Once you have received the application, you have 20 days to submit the completed form. While your application is being processed, you may disregard any bills from CVPH until you have received a written decision on your application.

You should also check with the physician arranging for your hospital services to determine whether the services of any other physicians will be required for your care. Your physician can provide you with the name, practice name, mailing address and telephone number of any physicians whose services may be needed. Your physician will also be able to tell you whether the services of any physicians employed or contracted by CVPH are likely to be needed. Contact information for these physicians can be found on the "Doctors and Specialists" tab on this page.  CVPH collaborates with some independent physician groups, such as, radiologists and pathologists, to provide services at the hospital. You should contact these groups directly to find out which health plans they participate in, including:

Associates in Radiology of Plattsburgh, NY
PO Box 2007,
East Syracuse, NY  13057-4507
Phone: (800) 480-3127

Virtual Radiologic
11995 Singletree Ln, Ste 500
Eden Prairie, MN 55344-5349
Phone: (844) 706-9577

Tele-Physicians, P.C.
1768 Business Center Dr, Ste 100
Reston, VA 20190-5359
Phone: 1 (833) 888-1357

Where do I go for government supported health insurance?

If you're unsure of how to obtain information about government supported health insurance, you can contact one of our certified Financial Advocates, Adirondack Health Institute at (866) 872-3740. Adirondack Health Institute will provide assistance in applying for Medicaid, Child Health Plus and Family Health Plus. Both agencies work with staff at CVPH to help community members obtain/apply for government-supported health insurance. For more information about these services please contact them directly or call us at (518) 562-7075.

How do I know I qualify?

Up to 400% of the Federal Poverty Guideline

What documentation is required?

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

• All household income documents; pay stubs or W2 withholding form
• Pension or retirement benefits
• Rental income statements
• Unemployment insurance benefits
• Proof of the balance in your HSA/HRA if applicable
• Verification of residency

 What happens after I apply?

A determination will be based on information provided. You will be notified in writing of the determination. 

• 100% - 150% approval: No balance due.
• Partial approval: Those who have been accepted and who have income between 151% and 400% of the federal poverty guidelines will receive a partial sliding scale discount based on the reimbursement rate of the highest volume commercial payer.
• Denial: Denials are based on information provided by you and will be specific as to what financial assistance eligibility the patient did not meet.

What If I am denied?

If you are denied financial assistance, a written explanation will be provided. You may appeal your denial and provide additional information in writing to:

Katherine Peterson
Financial Assistance Program
PO Box 2868
Plattsburgh, NY 12901

Can I make payment on my balance after the Financial Assistance Program?

Yes, CVPH offers a patient payment plan or contract account in order to assist you in fulfilling your financial obligations. Payment in full is preferred; however, financial arrangements are available.

If you have a financial hardship, please call our Financial Advocates. We will be happy to assist you with options. All payment arrangements must be approved and coordinated with the Financial Advocate at (518) 562-7074 after receipt of the first bill. As new services are incurred, additional balances can be moved to the payment agreement. The agreement will have to be re-evaluated to determine the financial arrangement. You must contact CVPH Patient Accounting at (518) 562-7074 to have the balance added to the contract account.

CVPH Providers Participating in the Financial Assistance Program