pixel
i

Surprise Billing Disclosure Notice

contact@ubortho.com

Find a Location

UBMD Orthopaedics & Sports Medicine Logo

716.204.3200 

Member of UBMD Physicians Group

Patient
Portal

Patient
Survey

Pay Your
Bill Online

Notice of Nondiscrimination Policy

Translated Resources for Covered Entities

Under Section 1557 of the Affordable Care Act (ACA), covered entities are required to post notices of nondiscrimination and taglines that alert individuals with limited English proficiency (LEP) to the availability of language assistance services. The translated resources are available for use by covered entities and are available athttp://www.hhs.gov/civil-rights/for-individuals/section-1557/translated-resources/index.html

ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Call 716-204-3200.

SPANISH
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 716-204-3200

CHINESE
注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 716-204-3200

KOREAN
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 716-204-3200 번으로 전화해 주십시오.

RUSSIAN
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 716-204-3200

TAGALOG (FILIPINO)
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 716-204-3200

ARABIC
قم م ) ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 716-204-3200

ھاتف الصم والبكم

FRENCH CREOLE
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 716-204-3200

FRENCH
ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 716-204-3200

POLISH
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 716-204-3200

ITALIAN
ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 716-204-3200

URDU
خبردار: اگر آپ اردو بولتے ہیں، تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں ۔ کال

716-204-3200 کر

BENGALI
ল􀇘য্ কর‍নঃ যিদ আপিন বাংলা, কথা বলেত পােরন, তাহেল িনঃখরচায় ভাষা সহায়তা পিরেষবা উপল􀉇 আেছ। েফান কর‍ন ১716-204-3200।

YIDDISH
אויפמערקזאם: אויב איר רעדט אידיש, זענען פארהאן פאר אייך שפראך הילף סערוויסעס פריי פון אפצאל. רופט 716-204-3200

ALBANIAN
KUJDES: Nëse flitni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pagesë. Telefononi në 716-204-3200

GREEK
ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης, οι οποίες παρέχονται δωρεάν. Καλέστε 716-204-3200

Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Sample Nondiscrimination Statement: Discrimination is Against the Law

UBMD Orthopaedics & Sports Medicine complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

UBMD Orthopaedics & Sports Medicine does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

UBMD Orthopaedics & Sports Medicine

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:
  • Qualified sign language interpreters
  • Written information in other formats (large print, audio, accessible electronic formats, other formats)
  • Provides free language services to people whose primary language is not English, such as:
  • Qualified interpreters
  • Information written in other languages

If you need these services, contact Melissa Tuck.

If you believe that UBMD Orthopaedics & Sports Medicine has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

Melissa Tuck
4225 Genesee St., Suite 400
Cheektowaga, NY 14225
716-906-5905, 716-204-4061
mtuck@buffalo.edu.

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Melissa Tuck is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Ave., SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html