Financial Information

Clifton Fine Hospital is dedicated to providing the best possible care for you and your family members, and that includes helping you understand our financial policies. No one will be denied services based on inability to pay and discounts are available based on family size and income.

Clifton-Fine Hospital is a member of the National Health Service Corps.

Your insurance policy is a contract between you and your insurance company. Because each health insurance plan is different, we encourage you to know and understand your plan’s specific benefits. If you have any questions about the co-payment or deductible that is due at the time of service, we encourage you to contact your insurance company directly. Most insurance cards provide a phone number to call for questions and information.

As a service to you, we will file your insurance claim, but to do so we must obtain correct insurance information at the time of your service at the hospital.

We have made prior arrangements with many health plans to accept an assignment of benefits. This means that the insurance company will pay us directly. We will bill them, and you are required to pay any co-payment or deductible amount due at the time of your visit.

If you are insured by a plan that we do not have a prior arrangement with, we will prepare and send the claim for you on an unassigned basis. This means the insurer will send the payment directly to you. Therefore, our charges for your care are due at the time of service.

Click here to view the insurance companies that Clifton-Fine Hospital currently partners with. Please note that Hospital-employed physicians participate with the same insurances as the hospital.

Remember that not all insurance plans cover all services. In the event your insurance plan determines a service to be “not covered,” you will be responsible for the complete charge. Payment is due upon receipt of a statement from our office.

We will bill your insurance company for all services provided in the hospital. You are responsible for any balance due.

Visit our Cost Estimates page for out-of-pocket pricing information.

Click here to view our No Surprise Billing Notice and Forms.

Financial Assistance Policy – Plain Language Summary

Clifton-Fine Hospital will see patients regardless of their ability to pay.

First and foremost, your financial circumstances will not affect your care. Clifton-Fine Hospital is committed to treating all patients with respect and fairness. If you are worried that you will be unable to pay your bill in full, we may be able to help. We offer a financial assistance program and determination is based on certain guidelines. You may qualify for Clifton-Fine Hospital’s Financial Assistance Program if:

  • You do not have health insurance
  • Your health insurance does not cover all of the medical care you need
  • Your household income is equal to or less than three hundred percent (300%) of the Federal Poverty Level

Eligible Services: Emergent and or Medically Necessary health care services provided by Clifton-Fine Hospital.

Eligible Patients: Patients receiving eligible services, who submit a Financial Assistance Application; including related and supporting documentation, and who are determined to be eligible for Financial Assistance by Clifton-Fine Hospital leadership. Eligible patients do not have health insurance coverage, or do not otherwise qualify for any governmental or private program that provides health insurance coverage.

How to Apply: Financial Assistance Applications may be obtained as follows:

Clifton-Fine Hospital
Attention: Business Office
1014 Oswegatchie Trail Road
Star Lake, NY 13690

Notice 2015-46, Section 03.02 allows a hospital facility to specify providers by reference to a department or a type of service. All departments in the hospital follow the financial assistance policy except for hospitalist and radiology interpretation services.

Clifton-Fine Hospital’s Financial Assistance Program is provided in compliance with Public Health Law 2807-k(-9-a). Public Health Law 2807-k(9-a) states that self pay discounts should be equal to the discount taken by the hospital’s largest volume payer. Clifton-Fine Hospital is a designated Critical Access Hospital and Medicare is our largest volume payer. The formula to calculate Medicare discounts would effectively create no discount at all for self pay accounts. It is Clifton-Fine Hospital’s intent to provide a discount to all patients who do not have primary insurance and will do so based on the discount taken by our largest volume, non-governmental insurer, Blue Cross, plus five percent (5%). Since the current contract with Blue Cross provides a fifteen percent (15%) discount, the current self pay discount will be twenty percent (20%). The Financial Assistance Program will be applied to remaining balances after the Self Pay Discount has been applied.

View our Financial Assistance Policy here.

View our Financial Assistance Award Guidelines here.

What If I Feel I Was Billed Incorrectly or Have Questions?

If you believe that your Clifton-Fine Hospital bill is incorrect, please contact our Business Office immediately at 315-848-8000, Monday through Friday, from 8:00 am until 12:00pm and 1:00pm until 4:00pm. A patient account representative will attempt to answer any questions and/or resolve billing problems. We make every attempt to ensure each bill is correct.

Billing Office Contact Information:

Phone: 315-848-8000 . Office Hours: Monday-Friday 8am – Noon and 1pm – 4pm

You are now leaving

Samaritan Health is not responsible for content, privacy policy, accuracy or legality of any website assessed through a link on A link to another website does not constitute an endorsement, guarantee or approval by Samaritan Health of the linked website or the information, products or services contained therein