Insurance_financial | Overview
Unfortunately, many insurance companies do not yet recognize the importance of timely evaluation and treatment of obesity in children. We strongly recommend that you discuss coverage with your insurance company before scheduling an appointment.
Co-payments are due at the time of your visit per insurance company policies. A co-payment is required for each scheduled appointment. Please check your insurance card for amount due. We accept cash, personal checks, VISA, MasterCard, American Express, and Discover. ATM machines (Bank of America and Citizens) are conveniently located in the Hospital.
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.
If your insurance company requires referrals, you will need to obtain a referral for each component of the program that the patient will participate (i.e. medical, nutritional counseling, mental health). Please note that referrals do not guarantee coverage, so please check directly with your insurance carrier.
Please reference our provider numbers when contacting your primary care physician's office or insurance company to obtain referrals. If the patient is being seen by one of our nurse practitioners, please have the referral written to their attending physician. Confirm that the specialist is a member of your health insurance network, otherwise you may be subject to "out of network" costs. Also, since some of our providers work in private practices, be sure to specify that the services will be conducted at Boston Children's.
If you do not have a valid referral from your primary care provider (PCP), Hospital policy requires a guarantor to sign a waiver assuming all responsibility for payment of the visit. Additionally, you will be asked to pay a $50 deposit for each scheduled appointment. Deposits are not required for Medicare or Medicaid (including MassHealth, BMC and NHP) subscribers.
If you are able to obtain the referral from your physician before leaving your appointments that day, we will refund your waiver deposit. After that time frame, the Hospital will refund your waiver deposit once payment is received from your insurance company for the visit.
Please remember to bring your child's insurance card to the office for each visit so we can verify that we have the correct information. If you change insurance companies or if your policy number has changed, please notify the office immediately so that 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 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 first contact the telephone number on the Hospital bill. 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.