Billing & Insurance
Everyone pays according to their ability, and our comprehensive network of services aims to prevent health challenges before they start. We provide cancer screenings, nutrition services, and we also address social barriers to a person’s well-being, like access to health insurance.
Insurance Enrollment
If you don’t currently have insurance our Outreach and Enrollment staff can help. They will work with you to find an insurance program that fits your budget and help you get signed up. Coverage is often available regardless of citizenship or immigration status.
For more information and assistance enrolling in an insurance plan:
Call 914-502-1478
Email insurancecoverage@odfmc.org
Visit any of our locations.
Insurance Plans We Accept
We accept most forms of private insurance, as well as the following:
- Medicaid
- Children’s health insurance
- Several carriers on the NY State of Health Marketplace
- Medicare
Sliding Fee Schedule
Our sliding fee discount program is based on an individual’s income and family size.
Sliding Fees for Uninsured Patients
Below are nominal fees that would be paid by patients who fall within 100% of the federal poverty level.
Service – Fee
Medical – $25.00
Dental based on type of service – $35 to $95
Specialty (includes Podiatry and Optometry) – $25.00
Behavioral Health and Nutrition – $15.00
Obstetrical – $60.00
Optometry – $25.00
Sliding Fees for Uninsured Patients
Our sliding fee discount program allows patients with insurance to receive discounts on their copays and deductibles.
For more information on our sliding fee scale and other payment options, please contact us at 914-OD-CARES (914-632-2737).
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” (GFE) explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate (GFE) for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate (GFE) in writing within 1 business day of making your appointment (if your appointment is made 3-10 days in advance) or within 3 business days (if your appointment is made more than 10 days in advance). You can also ask your health care provider, and any other provider you choose, for a GFE before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate (GFE), you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate (GFE).
- As a Federally Qualified Health Center (FQHC), Open Door Family Medical Center offers discounts based on income in accordance with federal poverty guidelines and household size. Our Insurance and Enrollment team can help determine if you qualify. You can qualify even if you are insured. Please note that Sliding Scale Fee is not insurance, and qualifying for Sliding Scale Fee at Open Door Family Medical Center only covers services accessed at Open Door Family Medical Center.
- For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
If you believe you’ve been wrongly billed, you may contact https://www.cms.gov/medical-bill-rights/help/dispute-a-bill.
Good Faith Estimate Disclaimer
Your Good Faith Estimate shows the costs of items and services that are reasonably expected for your healthcare needs for an item or service. The estimate is based on information known at the time the estimate was created. Your Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. If you are billed for more than your Good Faith Estimate, you have the right to dispute the bill. You may contact the healthcare provider or facility listed to let them know the billed charges are higher than your Good Faith Estimate. You can ask them to update the bill to match your Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on your Good Faith Estimate. If the agency disagrees with you and agrees with the healthcare provider or facility, you will have to pay the higher amount. To learn more and get a form to start this process, go to http://www.cms.gov/nosurprises or call 1-800-985-3059.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 1-800-985-3059.
NPI Numbers
Sleepy Hollow Open Door — 1619136140
Saugerties Open Door — 1780166645
Port Chester Open Door — 1285893719
Dental Van — 1073919973
Ossining Open Door — 1467487637
Mt Kisco Open Door — 1629237151
Mamaroneck Open Door — 1487194155
Brewster Open Door – 1003152240
Open Door Tax ID Number — 132813103
