Otolaryngology and Communication Enhancement

Patient Resources

If you have questions about your appointment, how to find us, insurance information, or any other questions pertaining to your visit, you can utilize the following resources to get your questions answered or take a look at our frequently asked questions section.

The Boston Children’s Hospital Health Library contains informational sheets relevant to your child’s surgery. Please find information sheets on tonsil surgeries, ear procedures, sinonasal procedures, and general day surgery information under the sections “Ear, Nose, and Throat Disorders” and “Hearing and Speech Disorders."

Frequently asked questions

Why must I have a referral for my child to be seen?

If you are enrolled in an HMO or other managed care plan, your insurance company may require that we obtain a referral from your pediatrician to authorize the visit before we may see your child.

Can I call my pediatrician and get the referral after my appointment?

It is more difficult to obtain referrals/authorizations after the appointment has taken place for numerous reasons. We strongly recommend that you request and verify that you have a referral in place prior to your appointment. If you do not have a referral in place prior to your visit with us, you will be required to sign our financial waiver stating you will be financial responsible for any medical costs not covered by your insurance.

Can your staff call my pediatrician’s office and get a referral for me?

We typically cannot make these requests for you. However, we will be happy to clarify your plan’s requirements for you. Obtaining and bringing a valid referral is ultimately your responsibility.

What if my child needs tests or surgery?

If the office visit is not authorized by a referral from your pediatrician, any tests ordered at the visit are usually not covered. If your child requires surgery a separate authorization may need to be obtained depending on your insurance plan.

Does my plan require a referral? Who should I contact to verify my referral is in place?

Please call your insurance company in advance to clarify any questions regarding your coverage. Please contact your primary care physician’s office to verify if a referral has been processed. If so, it is recommended to bring in the referral number, amount of visits authorized, and start/end dates with you to your appointment. You may also call our referral coordinator to check the status of your referral.

I’ve driven a long way and I just don’t have a referral. Can you see me just this once?

If you carry out-of-state insurance, your PCP may be considered out of network, which may require a special authorization for your visit. If this is not in place prior to your visit, you may be asked to reschedule your appointment as authorizations are not typically created retroactively. Therefore, we recommend that you call your insurance company to determine if you are considered out of network. Our referral coordinator would also be happy check the status of your authorization.

referral coordinator: Heather Zinna (781-216-2201)

Questions before your appointment

If you have any other general questions about your appointment please call us Monday to Friday from 7 a.m. to 8 p.m., excluding holidays, or chat with us if you see the chat button on this screen. Our patient care representatives would be happy to help.

Patient representatives can be reached at the following phone number: 617-355-6462

Insurance prior authorization

Some insurance plans may require the patient to obtain a referral from your primary care physician for your visit to be approved.

Please note: Clinical procedures may be performed during your visit that may be applied to your deductible or co-insurance (if applicable) and could be an out-of-pocket expense to you. All guardians/subscribers/guarantors are required to sign our financial policy form upon your first visit or if insurance information has changed since your last visit with us.

Questions about insurance and billing

If you have questions regarding billing, please feel free to contact the number(s) below, keeping in mind, the best resource may be contacting your insurance company directly.

Phone: 800-901-8089
Fax: 508-947-7956

Mailing address:

CHMC Otolaryngologic Foundation
P.O. Box 4162
Woburn, MA 01888-4162