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Insurance and Related Information and Referral Web Form

We accept all commercial insurance plans, CHAMPUS, Medicaid, and participate in many managed care plans and HMO's (including Tufts, HMO Blue/Blue Choice, Harvard Pilgrim Healthcare and Aetna/US Healthcare). Please check with us if you are considering changing insurance programs to find out if we participate in that plan. Chances are, we do.

To insure proper billing please provide us with your insurance card for each dependent child at the time of the visit and report any address or phone number changes to our front desk staff. For newborns, please notify your health insurance company and your employer so that your baby can be added to your policy. This is very important and must be done within 30 days after birth so that your insurance company does not reject any bills for health care provided. Also, managed care patients must select a Primary Care Provider (PCP) prior to the first visit with our practice; if not you will receive a bill.

Some insurances require copayments at the time of the medical visits. Insurance company policy and our office policy is that copayments must be paid at the time of the visit. We accept cash, check, Visa, or Mastercard.

We will bill your commercial insurance company for medical services provided and work diligently to obtain payment. If your insurance company fails to make payment then the balance for medical services will be your responsibility. The balance will be due with the first bill. In addition any copayments, deductibles and noncovered services are due at the time of the visit. Please notify us immediately if you receive a bill that appears inaccurate so we can work together to come to a resolution.

Any billing questions should be directed to:

Please notify us at least 24 hours in advance if you need to cancel or change an appointment. If you fail to notify us, you will be charged for the visit.

Problems associated with financial hardships should be directed to our office manager at the earliest convenience.

Patients choose one doctor from our group to be their "primary care doctor," however, patients may see any physician from our group, regardless of their insurance plan. Your insurance plan may require that you receive pre-approval from our office before seeing an outside specialist, or obtaining other medical services. Please read your insurance information or call your insurance patient relations/customer service coordinator to ascertain whether you need such pre-approval.

To request a referral, please read the instructions below; then click on the following link and complete the web form:

Referral Web Form

There are several steps involved in a referral to a specialist. (1)Referrals need to be preauthorized by the primary care physician prior to making the first appointment with the specialist. (2)The appointment with the specialist must then be made. Note that you must have already made the appointment before making the insurance referral request as you will need the date of the appointment, the name of the specialist, and other relevant information to submit this request. (3)Completing the Insurance Referral request webform by clicking on the above link. The insurance referral should be requested at least one week before the visit and preferrably even further in advance. Referrals will be processed much more quickly using the webform and so this method is STRONGLY preferred over other methods of leaving referral requests. If you have questions about your referral, or if it has been more than one week since submitting the information on the webform and you were told by the specialist that the referral did not go through, then please call (781) 698-2535. Please leave a detailed message including the patient's name, date of birth, specialist's full name and address, primary care doctor, reason for visit, and date of visit.

A Patriot Pediatrics "Certificate of Health," (School/Camp form) will be given out at the time of the annual physical. Please make multiple copies for upcoming requirements such as school, sports and camp. If additional copies are requested there will be a processing fee to be paid when the form is picked up at the office.

Our staff will be happy to assist you.

Please dial our main number at
(781) 674-2900
with any further questions.