Insurance and billing
We will bill most insurance carriers for you if proper information is provided to us. Co-payments and deductibles are due at the time of service. Any care not paid for by your existing insurance plan will require payment in full upon notice of insurance claim denial. All MassHealth patients must be enrolled with the Tufts Health Together through Boston Children’s ACO. A valid MassHealth/Tufts Health Together card must be presented at each visit to verify eligibility.
Your insurance (particularly PPO plans) may exclude, or limit, certain services like labs and screening, based upon the benefit levels chosen by your employer. You should carefully review your benefit description for details. Please note, as of January 1, 2021 medical coding laws have changed how visits are billed. The laws take into account medical decision making and treatment plans. These changes may also apply to well visits. If a medical condition is encountered or addressed during a routine well visit, a co-pay may be charged to you depending on your insurance plan. We do not choose how a visit is charged and we have to follow these federal guidelines. Some insurances may deny benefits and you will be responsible for the entire bill. Our billing department can help set up payment arrangements if needed. If your account balance is 90 days past the due date and is not on a signed payment plan, your account will be turned over to our collection agency.
Any returned checks are subject to a $50.00 fee
If we determine that your child needs to see a sub-specialist, we will refer you to the appropriate physician. In many cases a written clearance from our office is required in advanced. Though some insurance carriers do not require a referral, it is your responsibility to understand your plan requirements. To request a referral please fill out this referral request form. This should be done after you have a scheduled appointment with the specialist.
ADHD/Behavioral Health refill line
If an ADHD/Behavioral Health medication needs to be refilled, please call our office and leave the request on the dedicated line. Please allow 5-7 business days to have it completed.
If you need a refill for a medication, please visit your MyChart account and click refill under the child who needs it. One of our nurses may reach out. While most refills are sent within the day of request, please allow up to 3 days and plan accordingly. Please follow up with your pharmacy after the initial request.
Missed appointments/no shows
Quality care for our patients is priority and in an effort to serve you better, we ask for proper notice for all cancellations. Cancellations less than 24 hour notice will be charged $50 for missed office visit appointment. Any behavioral health appointment no show will be charged $75 for the first no show and $125 for any other behavioral health no shows.
* Please remember confirmation calls are a courtesy and ultimately it is your responsibility to know your appointment date and time.