Insurance

Centre Pediatrics currently bills to many different companies with many different plans. The options and coverages vary so considerably and are so numerous that we cannot keep track of the details of all the various plans. We urge you to become familiar with your insurance so that you understand its rules, coverages and limitations. All insurance companies have time limits for billing claims and HMO plans have especially strict and short filing limits. If the information that we use for billing comes directly from your insurance company via your child’s card, we have more success in meeting filing limits and avoid having to transfer claims to you.

A few tips that we believe will ensure that your company pays the claims submitted by us on your behalf:

  1. When your baby is first born, call your insurance company as soon as possible to:
    1. add your new baby to your policy effective as of the baby’s date of birth, and
    2. designate a Centre Pediatric physician as your baby’s PCP (primary care provider) effective as of the baby’s birth date.
  2. Write down the name of the representative that you speak with and note the date the conversation took place.
  3. If the representative gives you an ID number and/or suffix (some insurance companies do and some do not) write down that information carefully and stress that you want a card sent as soon as possible.
  4. As soon as you receive your child’s card and have verified that the information is correct, make a copy of both sides, put your child’s name and date of birth on the copy and send it to our billing office. If your child has a visit in the office in the near future, bring it with you and we will copy it.
  5. If your insurance changes, please notify us as soon as possible with a copy of your new insurance card(s) and the effective date of the new policy. Please remember to designate a Centre Pediatric physician as the PCP for your child with the new insurance company.
  6. Most insurance companies will send an EOB (explanation of benefits) form to you about claims they are or are not paying. If you do not understand it or have any questions, call your insurance company as soon as possible.

 

We would like to make you aware that we do not accept the following insurances:

  • HPHC/BIDMC Select Plan
  • BMC (Boston Medical Center)
  • BMC/MASS HEALTH
  • Tufts Spirit Plan
  • Fallon/MASS HEALTH
  • BCBS/HUGHP
  • CIGNA Local Plus or CIGNA Local Plus IN (not able to accept as of 1/1/2018)