Surgery

Insurance and financial information

CHMC Surgical Foundation, Inc. currently bills for all office visits and procedures performed by the surgeons in the Department of General Surgery.

We are contracted with most insurance companies and therefore most likely accept your insurance. However, the options and coverage for these plans vary considerably.

We urge you to become familiar with your insurance to gain a better understanding of its rules and coverage. It is very important that you bring your child's insurance card to our office each time that you visit. All insurance companies have specific billing instructions that are usually found on your insurance card. Presentation of the actual card will reduce the likelihood of any errors.
 

Co-Payments

Co-payments are due at the time of your visit. Insurance companies require that patients pay their co-payment for each scheduled appointment. We appreciate your cooperation in paying your co-payment at the time of registration. Please check your insurance card for the amount due. We accept cash, personal checks, VISA, MasterCard, and American Express. ATM machines (Bank of America and Citizens) are conveniently located in the Hospital.
 

Waiver Fee

If you do not have a valid referral from your primary care provider (PCP), you will be asked to sign a waiver assuming all responsibility for payment of the visit. You will be asked to pay a $50 deposit. If you are able to obtain the referral from your physician before noon the following business day, we will refund your waiver deposit. After that time frame, we will refund your waiver deposit once payment is received from your insurance company for the visit.
 

Missed Visits

If you are unable to show for your visit, we ask that you call the office to cancel at least 1 business day (24 hours) in advance. We have a high demand for appointments, and this will allow other patients to use this time.
 

Referrals

A referral is a form and/or code number from your child's primary care physician or insurance company and is required for office visits with most HMO insurance plans. Referrals can vary in the number of visits they cover, the length of time that visits can be used, and the services covered. Please note that referrals do not guarantee coverage, so please check directly with your insurance carrier.

Below, you will find a list of insurance provider numbers for our attending physicians. Please reference these provider numbers when contacting your primary care physician's office or insurance company to obtain referrals. Confirm that the specialist is a member of your health insurance network, otherwise you may be subject to "out of network" costs.

Insurance Card

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

Uninsured / Non-covered Services

Uninsured patients or services not covered by insurance companies may be eligible for a 40% discount at the time of service. Please contact our office to discuss this option.

Additionally, if you are uninsured or have limited income, you may qualify for public assistance or free care. Depending on your income level, all or part of your medical costs may be covered by the medical center under the free care provision of state Medicaid Law. For more information, contact Financial Counseling at 617-355-7201.

 

Billing Issues

Billing issues are substantially reduced when families contact their insurance company directly prior to their initial visit and obtain any necessary authorization in advance.

Should you experience billing issues, please contact our billing office at 800-224-7070. You may need to also contact your primary care physician's office or insurance company to help rectify the account.

A list of FAQs regarding billing is available online.