Billing

It is our office policy to expect payment at the time services are rendered unless prior arrangements have been made. If your health plan or insurance company requires a co-payment, we require that to be paid at the time of your visit. For your convenience we accept MasterCard, Visa, Discover and American Express. We also offer discounts for services when the charges are paid in full at the time of the visit. Please note that this does not apply to co-payments or coinsurance when the remainder of the bill is paid by your health plan.

We are aware that unforeseen problems may arise and cause a family to encounter financial problems. Please feel free to discuss any problems with our billing department, which is located in our Woburn office (781-933-6219).

All of our billing is done by computer. You will receive an itemized bill only once and subsequent bills will show only the balance due. Payments are accepted by phone during normal business hours. As of September 2013, we offer online bill payment.

Making a Payment Online

 

Once you receive your bill, click on the "Patient Payment" button where you will be re-directed to our payment vendor's website site. You can submit your payment through this secure site at your convenience.

 

Insurance 

Our practice participates in most health plans with the following insurance companies. Participation in these plans may change without notice. Please contact your insurer for details.

  • Aetna
  • Aetna US Healthcare Inc.
  • Blue Choice
  • Blue Cross Blue Shield
    (except Anthem of NH)
  • Cigna
  • Fallon Community Health Plan
  • Fallon Wellforce ACO through Masshealth
    (for existing patients only)
  • Harvard Pilgrim Health Care
  • Healthcare Value Management
  • Healthsource
  • HMO Blue
  • Neighborhood Health Plan of MA
    (Commercial plans only)
  • Private Healthcare Systems
  • Tufts HMO
  • Unicare
  • United Healthcare 


We
do not accept any new patients with:

  • NH Medicaid  10/2013
  • Masshealth
    (including Boston Medical Center plan, Network Health, Neighborhood Health) 

Referrals

To improve our communication about your child’s care with other physicians, please call our Referral Department (781-933-0254) before your child sees a specialist. After the appointment has been scheduled, please call and be prepared to leave the following information on their voice mail:

  • child’s name & DOB
  • specialist’s name
  • appointment date and the reason for the appointment
  • insurance plan & ID number if you have a new plan
  • best daytime phone number to reach you

You may also enter your referral request on the Patient Portal.  Regardless of your insurance plan’s referral requirement, you should still call the Referral Department so that they can send your child’s clinical history to the specialist prior to the appointment. Your call will ensure that the proper documentation has been sent, in addition to processing any necessary referrals.

What is a referral?

  • A referral verifies that the PCP's office has authorized the member's care to that specialist. Because your PCP knows your history and health care needs, he/she is best qualified to help you decide whether or which specialist is needed. For example, the athletic trainer can "recommend" physical therapy, but the PCP needs to agree and approve the request.
  • Referrals are no longer required for Emergency Room visits, but please be aware that walk-in urgent care visits do require a referral and should only be used if our offices are closed or you obtain prior approval to do so.
  • It is the insured's responsibility to understand their benefits and that a referral is not a guarantee of payment. Please make sure that the specialist we referred you to is contracted with your insurance.

Referrals vs. Recommendations March 2015

If your clinician provides you with a referral for a specialist, this should be considered a recommendation for a provider most suited to handle your child’s problem. An insurance referral should be considered an authorization for services in network and you must call our office to request a referral once you have scheduled the appointment. If your insurance plan does require referrals, it is essential that you call our Referral Department with the appointment details so that an authorization can be prepared and sent to your insurance company. We will also send relevant office notes to the specialist, which can be very helpful in providing your child’s history before his/her evaluation.

If you neglect to call for a referral authorization, you will be financially responsible for the cost of the specialist. It is your responsibility to understand your insurance benefits so you should familiarize yourself with your plan’s referral requirement.

Also be aware that many insurance companies do require authorization for visits to urgent care clinics. You should call our Referral Department on the following business day to alert us of your child’s visit & the need for referral authorization if your plan requires one.