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