Thank you for choosing Holliston Pediatric Group as your child’s health care provider. The following is a copy of our financial policy. Patient care is not permitted without the written consent of the receipt and acknowledgement of the understanding of this policy.
Insurance: We accept most insurance plans. Please contact your insurance company to verify we are listed as a contracted provider before scheduling an appointment. Please bring a copy of your insurance card to every visit. A scanned copy of the assigned account holder’s current insurance card and driver’s license is required to be kept on file. Please present newly issued insurance cards upon check-in at the next scheduled visit. If you have an HMO insurance plan, please assign one of the physicians in our practice as your child’s primary care physician (PCP) prior to your visit. If we cannot confirm that one of our providers is listed as your child’s PCP, we will ask that the appointment be rescheduled. If your insurance coverage changes, it is your responsibility to notify HPG within 30 days. If we are unable to bill your insurance company because coverage information has not been provided in a timely fashion, these uncovered services would be your responsibility.
Questions to ask your insurance company
- Does your plan cover Well Care visits?
- What is your coverage regarding other office or sick visits?
- Are there restrictions to vaccine coverage?
- What is your primary care copay and deductible?
- Does your plan cover in-office labs?
- Does your plan cover after hours care?
- Does your plan require a year +1 day between annual well exams or are you covered once per calendar year?
Change of Insurance/Change of Account Information/Adding your newborn: Please notify the office as soon as possible of any and all account changes, including co-pay amounts, insurance updates, and change of mailing address. If the account holder does not notify the office within 30 calendar days of these changes, the assigned account holder becomes responsible for any and all charges. Newborns need to be registered with your health insurance plan as soon as possible after birth. Failure to do so will result in the assigned account holder being responsible for any and all charges.
Payments: While HPG is contracted with most of the major health insurance carriers, it is your responsibility to understand and comply with the terms of the contract between you and your insurance carrier (we are not part of that contract).. Payment, in full, is due at the time of service. This includes applicable co-pays, co-insurance and payments for services not covered or denied by the insurance company. Holliston Pediatric Group accepts cash, personal checks, debit cards, and all major credit cards.
Co-Pays: Holliston Pediatric Group is required by insurance contracts to collect all co-pays at the time of service. Failure to collect co-pays puts the responsible party and Holliston Pediatric Group in default of the insurance contract.
Additional charges incurred at Well Visits: Due to all the recent changes in insurance/billing requirements, there is understandably some confusion around charges incurred during a routine well visit. Most insurance companies do not require a co-payment for a well child visit. However, any acute illness, new concern or management of a chronic diagnosis (for example, ADHD, chronic abdominal pain, asthma) at the time of the well visit may result in a second billing code in addition to the well visit code. Therefore, you may see a charge for an office visit in addition to the well visit. Your insurance company might apply a copay and /or deductible for this additional billing code depending on your coverage. Evaluating and coordinating care for these additional medical issues is important. However, if you prefer, we will schedule a separate visit to address any ongoing medical conditions or acute illnesses.
Self-Pay Accounts: If you do not have insurance, please come prepared to pay for your visit in full upon check-out. We offer a 25% discount for all self-pay services paid in full on the day of the service.
Payment Plans: Holliston Pediatric Group understands that full payment may not be possible in certain circumstances. As a courtesy, Holliston Pediatric Group may offer the assigned account holder a payment plan. Payment plans are approved on a case-by-case basis and may be discussed with our management team. Patients with a payment plan must be in full compliance with all conditions of the agreement at time of visit. Failure to make scheduled payments on the payment plan, or not paying off a balance in full, may result in your account being turned over to a collection agency and your family being dismissed from the practice. If you are experiencing financial hardship, please contact our billing supervisor at 508-429-2800, option 6.
Outstanding Balances: If you have a personal balance on your account, a monthly statement will be sent. Unless authorized in writing, payment is due upon receipt of the statement or within 30 calendar days. If you are experiencing financial hardship, please contact our billing supervisor at 508-429-2800, option 6.
Collection Accounts: If your account is submitted to a collection agency, all associated fees are the responsibility of the assigned account holder. The assigned account holder will receive written notification by way of a dismissal letter and given 30 calendar days to find a new health care provider. If your account is sent to collections and then paid in full, the assigned account holder may request the practice to reinstate the account. If the practice permits reinstatement, there is a $25 reinstatement fee to be charged to the account holder. The fee must be paid prior to scheduling any future appointments.
Returned checks: A$35 fee will be charged for any checks returned for insufficient funds. If the fee is not paid within 10 days, your account may be forwarded to our collection agency. Accounts with repeated returned checks will be required to pay by cash or credit card.
Missed appointments: Missed appointments represent a cost to us, you, and to other patients that could have been seen during the time set aside for your child. Cancellations are required 24 hours prior to any well visit, follow up or consult appointments and two hours prior to any sick visit appointment via a phone call to the practice. A “no show” fee may be applied if an appointment is missed and not canceled within the stated time frame.
After Hours/Weekend/Holiday Care: There is a small additional fee for non-preventative care visits that occur after 5pm daily, on weekend days and on federal holidays. If that fee is not covered by your insurance carrier, the assigned account holder is financially responsible for the charges.
Medical Records: Requests for copies of medical records will be charged a fee in accordance with the regulations established by the Board of Registration of Medicine. This fee can range from $0 – over $25 depending on how extensive the medical record is.
Billing Inquiries: Questions about a bill should be directed to our billing department at 508-429-2800,option 6.
Review and consent of this policy is required prior to services rendered
05/01/2022