Billing and Payment Policy
We are pleased that you have chosen our practice to manage your child's health care needs. Personal and compassionate care is the first priority amongst our staff. To keep the cost of your healthcare to a minimum, Child Health Center requests that you please review the guidelines below.
Insurance and Billing
We accept most insurance plans including (but not limited to) MassHealth, Network Health, Neighborhood Health, BMC, BC/BS, HPHC, Tufts, etc.
Please be sure to bring your child's insurance card with you each time you visit the office.
Self Pay Patients
Please arrive prepared to make payment in full at the time of service.
Payment for services provided in the physician's office is expected at the conclusion of your visit.
- For your convenience, we accept cash, check and credit card payments.
- For balances after insurance payment, family statements are mailed monthly. Payment in full is expected upon receipt of the statement.
For our patients with financial difficulty, we do offer monthly payment arrangements. Please contact our Billing department to arrange a mutually agreeable payment plan.
Patients with Health Insurance
Insurance is an arrangement between an individual and an insurance company (and sometimes an employer) to help pay the cost of medical care. Each plan has individual limitations as to what it specifically covers. Due to variations in deductible and co-payment requirements, insurance rarely covers the entire bill. Because of the many different insurance plans and coverage types available, it is impossible for Child Health Center to be familiar with each insurance arrangement. As a courtesy, Child Health Center will present a bill for services rendered to your child's health insurance carrier, but it is ultimately the parent/guardian's responsibility to ensure all services are paid in full. It is the responsibility of the parent/guardian to know and understand the details of their child's health insurance coverage. Not all services may be covered by your child's health insurance plan. Therefore, the obligation to understand what services are covered remains the responsibility of the parent/guardian.
Co-payments and any prior patient balance will be collected at the time of service.
Due to filing limitations with many insurance carriers, it is the parent/guardians responsibility to inform Child Health Center of their child's health insurance coverage at the time of each visit. Parents/Guardians who do not present their child's insurance card at the time of the visit may be required to pay for the service. You may be required to sign a non-covered services waiver so that we can bill you directly.
Although your child may be scheduled for a particular type of visit, the provider of service may deem it in the best interest of your child to address other matters of concern which were not originally planned at the time the appointment was scheduled. This may result in another charge billed to your insurance carrier and possibly an insurance/patient cost sharing (deductibles, co-payments and/or co-insurance). This is a widely acceptable industry standard of care. If you have any questions regarding services rendered, please feel free to contact our office.
Primary Care Physician Selection
Your insurance plan may require your notification of the Primary Care Physician (PCP) you have selected to manage your child's healthcare. If this notification is not on file with your insurance plan, services may be denied leaving the entire balance your responsibility. Please notify your insurance carrier promptly of the PCP you have selected for your child.
Services Requiring Referral/Pre-Certification or Authorization
Your insurance may not pay for certain visit or services which have not been referred by your Primary Care Physician (PCP). You are, therefore, responsible to confirm that the Child Health Center Referral Coordinator receives the appropriate referral, pre-certification or authorization details to initiate a valid referral. Please check with our referral coordinator to confirm a referral has been processed prior to receiving specialists services. If we do not receive this information prior to the specialist appointment, you may be financially liable for these services.Patient Balances
All patient balances must be paid in full within 30 days of receiving a bill from Child Health Center. If you have not paid your balance in full within ninety (90) days after the date of the original bill, your account will be reviewed for collection agency placement. You will be held responsible for your entire balance. Records and Forms CHC will charge $15.00 per child to reproduce his/her medical record and payment is due upon receipt. We may increase this fee for excessively large records over 20 pages.Refunds
Patient/guarantor payments resulting in an overpayment on the account will be refunded upon scheduled review of the account or upon parent/guardian request. Refunds under $5.00 will be processed by request only
Any guarantor payments in the form of checks that are returned from the bank as unpaid will be charged back to the guarantor. In addition, a $20.00 bank fee will be charged to your account which will remain the responsibility of the guarantor.
We at Child Health Center firmly believe that immunizations are one of the most important medical breakthroughs of the last century. Vaccines are important for your child. Vaccines save lives. We are a Pro-Vaccine Practice. We expect parents to immunize their children according to the schedule recommended by the American Academy of Pediatrics (AAP).
The AAP and the Center for Disease Control and Prevention (CDC) both recommend administering multiple immunizations at each visit and not “splitting” vaccines. Multiple shots and combination vaccines are utilized for three main reasons:
1. To provide broad immunologic protection to children when they are young and most vulnerable.
2. To minimize the absolute number of shots needed.
3. To minimize the number of office visits, and thus the likelihood of medical error and the cost to the health care system.
Administration of simultaneous immunizations has been extensively studied and determined to be safe and efficacious. There is no negative effect on the normal childhood immune system. There is no medical benefit to splitting vaccines (and there is increased potential for harm by doing so). We at Child Health Center strongly support these recommendations. Splitting vaccines leads to medical errors and increases risk to the undervaccinated child, In addition, it poses a risk to other children in our practice who may come into contact with your child.
are happy to provide you with literature and websites on vaccines, as
well as to answer any and all questions you may have.
Thank you for entrusting us with the care of your children. (for more information: http://www.cdc.gov/vaccines
Emergency Room & Urgent Care Center Policy
Urgent Care Centers (UCCs) have recently started opening in our area. While visits to Urgent Care Centers do not cost as much as emergency room visits, they do not operate the same as emergency rooms. In most cases, Urgent Care Centers offer the same basic services as your primary care provider. In many cases they are not staffed with pediatricians.
We accommodate urgent, same day visits from 9:00am – 4:30PM pm on Monday through Friday as well as weekends and holidays from 9:00 am – 12:00 pm. We also are pleased to provide 24 hour physician coverage for phone calls.
Child Health Center will NOT honor a request for a back-dated referral to an Emergency Room or Urgent Care Center for anything other than an acute life-threatening emergency. Child Health Center requires a telephone call to our triage nursing staff (available 24/7) who, along with our clinicians, will help decide whether the medical situation requires services other than what our office can provide.
If we feel the medical situation requires more than we can offer, we are happy to refer. Otherwise, it is our belief that with our knowledge of our patients, we are in the best position to give the ideal care to your children.Office No-Show and Late Policies
Physical exam and consultation time slots are precious and very much in demand. In an effort to serve you better, we ask for proper notice for any cancellation.
We make every effort to be on time for all our appointments. Unfortunately, when even one patient arrives late, it can throw off the entire schedule for that session. In addition, rushing or “squeezing in” an appointment shortchanges the patient and contributes to decreased quality of care (and increases medical errors). In light of this, patients arriving more than 10 minutes after their appointment time will be asked to reschedule. We apologize for any inconvenience this might cause.
Any child requiring emergency care will be seen as soon as possible.
It is the policy of this practice to maintain a cooperative and trusting physician-patient relationship with its patients. When such a physician-patient relationship has not been formed or a physician-patient relationship is no longer proceeding in a mutually productive manner, it is the policy of this practice to terminate the physician-patient relationship within the bounds of applicable state and federal laws, rules, and regulations; the American Medical Association guidelines, and this policy so that the patient can develop the type of trusting relationship with another physician that is essential to successful continued care and treatment.
The staff identifies a patient with whom the physician-patient relationship has not been created or that has been affected negatively. The types of circumstances that can result in termination include, but are not limited to, the following:
- Noncompliance with treatments recommended by the practice, physician, or other healthcare provider
- Failure to pay, consistent with our payment policy
- Consistent failure to keep appointments
- Threatening or abusive behavior directed at office staff, physicians, other healthcare providers, or patients
- The patient OR parent is deceptive or lies
- The patient abuses medication
- The patient decides to leave the practice
In most cases, the patient/parent/guardian will receive a warning (verbal or written) if any of the above circumstances have occurred, hoping to resolve the issue. If the behavior continues, the patient/doctor relationship will be terminated.
Adolescent Confidentiality Policy
At Child Health Center, we recognize that adolescence is an important time of transition toward adulthood. During this period of transition, we are committed to empowering our adolescent patients to assume more responsibility for their own healthcare. Please remember that any patient under the age of 18 musts be accompanied by a parent or guardian.
In an effort to provide the best quality of care for our adolescent patients please be aware of the following:
- Beginning at age 13, each patient will be encouraged to meet with a clinician for a portion of the visit without a parent present. We believe that this private time provides an opportunity to discuss sensitive topics that an adolescent may not feel comfortable addressing otherwise. During this time, a teenager will always have the option of requesting a nurse to be present in the room as a “chaperone” if they desire.
- The information discussed by an adolescent and the clinician is considered private and confidential. This means that it will not be shared with anyone without the permission of the adolescent. While this information is considered confidential, we always encourage our adolescent patients to be open and honest with their parents and can often help facilitate the process of sharing sensitive information. The confidentiality parameters noted above extend beyond the visit in our office and may include telephone calls. For this reason, we routinely collect the cell phone numbers of our adolescent patients.
- The only time that we would break confidentiality is in the rare circumstance that we think a patient poses a severe risk to him/herself or another person, or if there is concern for immediate risk of life or limb.
- This policy is consistent with Massachusetts state law surrounding adolescent confidentiality as well as the policies of the American Academy of Pediatrics and the Society for Adolescent Medicine. If you have specific questions or concerns about this policy please share them with your healthcare provider