> Financial Responsibility and Insurance
Due to federal regulations regarding patient
rights we have been mandated to implement
the following policies as they apply to
All payments are expected at
the time of service.
Payment is required at the time services
are rendered, unless other arrangements
are made in advance. This includes applicable
co-insurances, deductibles and co-payments
for participating companies. Co-payments
must be paid at the time of service regardless
of who brings the child into the office.
In cases (such as divorce) where the custodial
parent is not the insurance holder, the
person accompanying the child is responsible
to pay copayments at the time of service.
Our office will not bill for co-pays. Marblehead
Pediatrics accepts cash, personal checks,
VISA and MasterCard. There is a service
charge of $10.00 for all returned checks.
Marblehead Pediatrics accepts most major
managed care (HMO, PPO), private indemnity,
and Medicaid subsidized plans. It is your
responsibility, however, to call your insurer
to verify that we participate in your plan.
It is required that you bring your insurance
card to every visit. Please do not assume
that we already have your insurance on file.
We do our best to verify your eligibility
and coverage. However, it is your responsibility
to know your plan's benefits, restrictions
and referral requirements and to inform
us of any changes in your plan.
Your co-payment is required at the time
of visit. We do not bill secondary insurances
for co-pays. Cash, checks or most credit
cards are accepted.
Under the Affordable Care Act, there are
no longer any co-pays for well visits. However,
if care is provided for an acute illness
or for chronic illnesses such as Asthma,
ADHD, Acne or other conditions, then your
insurance company may later inform you that
you are responsible for a co-pay for that
portion of the visit.
It is essential to enroll newborn infants
with your insurance carrier within 30 days
of the date of birth. Unless this is done,
the child has no insurance coverage under
your policy. If you fail to do this within
30 days following birth you will be billed
for the services that we have provided.
If we do not receive payment from your
insurance company within 60 days from the
date of service, you will be expected to
pay the balance in full. You are ultimately
responsible for all charges.
If you need assistance or have questions,
please contact our billing department. We
are available to answer your billing questions
Monday through Friday during our office
hours. Please ask for billing when you call.
Patients with an outstanding balance of
60 days past due must make arrangements
with the billing office prior to scheduling
well child appointments. School, camp and/or
sports forms will not be provided for patients
with accounts 60 days or more overdue unless
arrangements for payment have been made
with the billing office. Accounts over 90
days overdue will be considered seriously
delinquent and maybe referred to our Collection
We do realize that there are extenuating
circumstances and that people have financial
difficulties and we are willing to work
with you to help you resolve the problem.
Please call the office and speak to the
office manager to make special arrangements.