As of December 19, 2024 Aetna/Meritain and Trinity Health (parent company of St Joe's Hospital in Syracuse, NY) are still in active negotiations to renew their in-network contractual agreement which is set to expire on December 31, 2024. Meritain has mailed letters to any Jefferson-Lewis Healthcare members who qualify for continuing care that could be potentially impacted by the expiration of this agreement. We will continue to post updates on this as they become available.
Overview of the Independent Dispute Resolution (IDR) Process
(Financial Services Law Article 6)
The instructions below outline how to submit a dispute through the Independent Dispute Resolution (IDR) Process for Surprise Bills or Emergency Services:
For disputes between a healthcare provider and a health plan involving an insured patient, healthcare providers must initiate the IDR process by logging onto the IDR portal application to obtain a tracking number. The healthcare provider must then complete the IDR provider and insurer application then send the application to the assigned independent dispute resolution entity.
If you get a surprise medical bill or a bill for out-of-network emergency services and want the services to be treated as in-network, complete and sign the assignment of benefits form, a submit a copy to your healthcare provider and the Plan. Please include a copy of any bill you received for services.
For disputes involving uninsured patients or patients with employer or union self-insured coverage, or insureds who do not assign benefits for surprise bills, the patient must complete the IDR patient application and send it to NYS Department of Financial Services, Consumer Assistance Unit/IDR Process, One Commerce Plaza, Albany, NY 122 57.
For assistance or questions with the IDR process, please visit the following website: https://www.dfs.ny.gov/apps_and_licensing/idre or contact the New York State Department of Financial Services by phone at (800)342-3736, by email at IDRquestions [at] dfs [dot] ny [dot] gov or using their website at www.dfs.ny.gov.