Genetics Program Insurance

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As we are all aware, health insurance has become much more complicated. The Genetics Program currently bills to many different companies with several different plans. It is important for you to become familiar with your insurance so that you understand its rules and coverages and know whether your visits and testing will be covered.

Many insurance plans require that you or your child has a primary care provider (PCP), a doctor who takes care of most of your routine medical concerns. With these plans, a referral from your or your child's PCP is needed for an appointment in the Genetics Program.

It is important that you bring your or your child's insurance card with you to each appointment. Presentation of the insurance card will help reduce the likelihood of misbilling.

If you or your child does not have health insurance or you choose to pay for the care on your own, Children's Hospital has many programs that can help pay for medical care. Staff in the Outpatient Financial Center (617-355-5999) can provide more information about these programs. If you do not qualify for any of these programs or are not using insurance to pay for the visit, you will be required to pay a $50 deposit at the time of your visit. The rest will be billed to you later. Children's Hospital does offer a 10% discount on all hospital charges paid on the day of the visit.

Co-Pays

Many insurance plans require that you pay for part of the charge for a specialist visit. This is called the co-payment. Co-pays are due at the time of your visit. You can check your insurance card or with your insurance company for your co-pay amount. We accept the following:

  • Cash
  • Personal check
  • Mastercard/VISA 

A Bank of America ATM is located on the first floor of the building. A Citizens Bank ATM is located near the Patient Entertainment Center above the Main Lobby. A receipt for your payment will be provided at the time of registration.

Waiver Fee

If you do not have a referral from your PCP, you will be asked to sign a waiver assuming all payment responsibility for the visit. You will be asked to pay the $50 deposit. If you are able to obtain a referral from your physician before noon the following business day, we are able to refund your waiver deposit minus your co-pay. For example if your co-pay is $15, and you were able to obtain a referral, you would be refunded $35. After noon, the daily bank deposit is complete, and we are unable to refund your money until the insurance company has paid for your visit.

Insurance card

We will ask to see your or your child's insurance card so that we can verify we have the correct information. Please remember to bring your or your child's card to the office for each visit. If you change insurance companies, please notify the office immediately so we may update our records.

Monthly Statements

We only send you a monthly statement if you have a balance due. Usually, this means that your insurance company has transferred the responsibility to you for either the entire charges or for part of the charges. If you do not agree with the transfer of charges, please call your company right away to straighten out the situation.

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO
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