Our practice is pleased to accept most major health plans. For specific plans, please inquire with our patient accounts department. It is your responsibility to insure that you have active health insurance and that one of our pediatricians is listed as your child’s Primary Care Physician (for those plans that require you to have a PCP).
If an HMO provides your family’s health insurance, please become familiar with its regulations. You must know which hospitals and specialists your policy authorizes and the requirements for referrals.
We are happy to help you learn and understand the policies and procedures of your insurance plan benefits. However insurance is a contract between you and your insurance company. We are not a party to this contract. We file insurance claims on behalf of our patients. We can not become involved in disputes between you and your insurance company regarding deductibles, co-payments, covered charges, secondary insurance, “usual and customary” charges, etc. other than to supply factual information as necessary.
While many insurance carriers provide payment in full for our services, some do not. Certain services and procedures provided by Hyde Park Pediatrics (such as wart treatments, vision screens, etc.) may be your responsibility through your deductible. Some care provided during a well child visit may be deemed as sick care by an insurance company, prompting a copay and separate charge. There is no way for us to know what services and procedures your particular policy covers until we file the claim and receive a response from your insurance company. It is your responsibility to know what services and procedures are covered under your policy and which services and procedure may be applied to your deductible. Any questions on whether a particular service or procedure will be covered or applied to your deductible should be directed to your insurance carrier prior to your visit in our office; there is no way for us to access this information.
You are responsible for full payment of any charges for medical services provided to your family that are not a covered benefit of your insurance plan. If your insurance company requires a copayment, our office staff is contractually obligated to collect the copayment at the time of service. We accept payments in cash or personal check and by major credit cards.
Self-pay patients are responsible for payment at the time of service. Future appointments cannot be scheduled until payment is received.
Payment plans are only available in extreme financial hardship. Payment plans are offered at the sole discretion of Hyde Park Pediatrics and may require you to provide financial data to prove financial hardship. Failure to meet payment deadlines on a payment plan will result in the balance being due.
Occasionally a child’s health insurance is provided by a non-custodial parent. Because our provider-patient relationship exists with the caretaking parent in these circumstances, the ultimate responsibility for payment rests with the adult who accompanies the child to the office.
If you have questions regarding any of these policies or wish to discuss a bill you have received, please call our patient accounts office directly (617-361-9022, ext. 1) any time Monday through Friday, 10 a.m. to noon, and 1 to 4 p.m.