Office Policies
OFFICE HOURS:
Our office is open weekdays at 9:00 a.m. with extended hours on most Mondays and Thursdays for previously scheduled well visits and sick visits. There may be some exceptions to these days and times, depending on the availability of doctors and nurse practitioners. Otherwise, we close at 5:00 PM.
We also offer a walk in hour Monday-Friday 8:30-9:30 a.m. (holidays excluded) for sick children. Your child will see whichever provider is available (nurse practitioner or physician). To request a particular provider, please call nurse triage after 8:00 a.m. No chronic or long-term issues. Current acute illness only. Last visit is at 9:30 a.m. After 9:30, sick visit appointments are made by nurse triage.
HOSPITAL CARE:
Our pediatricians round at the Beth Israel and the Brigham & Women's Hospitals every day and will examine your newborn and discuss your baby's health and care with you. Our physicians will see your child if they are admitted to Children's Hospital.
WELL VISIT APPOINTMENTS:
Your child will be seen by your pediatrician or nurse practitioner at the following ages:
For newborns: 48 hours after discharge (the physician will discuss with you before your baby is discharged from the nursery).
2 weeks, 1, 2, 4, 6, & 9 months
1 year old, 15 & 18 months
2 years old, 2½ years old
At age 3 and after: annual through age 18
One of our nurses will contact you regarding your first newborn appointment.
At that first appointment, we will ask you to arrive early so that you can provide information about your baby and your family's health history. Before leaving our office, please see one of our schedulers to schedule your subsequent appointments. We do charge a fee for appointments not cancelled 24 business hours prior to the appointment.
To register an older child, please speak with one of our schedulers who will send an informational packet and registration form to you. Send the completed information back to us with a copy of your child's insurance card. Also forward a copy of your child's previous medical records. This information must be received prior to scheduling an appointment.
SICK VISIT APPOINTMENTS:
If your child becomes sick or injured or you have a concern, please call to speak with a nurse who is available every weekday beginning at 8:00 A.M. The nurse will schedule an appointment for the same day (or next day, if appropriate) for you if your child needs to be seen. Please call (617) 735-8585 and select option 2 to speak with a nurse. If our nurses are on the telephone with other parents, please leave a message and one of our nurses will return your call as quickly as possible.
EMERGENCIES:
One of our pediatricians or nurse practitioners will be on call evenings, holidays and weekends for emergencies. Please dial our main number (617) 735-8585 and follow the instructions on our voice mail.
CHECKING IN FOR YOUR VISITS:
We suggest that you try to come a few minutes early for your appointments. When you come to the office for a sick or well visit, the front desk staff will check you in. One of our staff members will verify your address and insurance information for accuracy. Please bring your child's current insurance card to each appointment. We do not bill for co-pay. Co-pays are expected at time of visit.
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:
When your baby is first born, call your insurance company as soon as possible to:
add your new baby to your policy effective as of the baby's date of birth, and
designate a Centre Pediatric physician as your baby's PCP (primary care provider) effective as of the baby's birth date.
Write down the name of the representative that you speak with and note the date the conversation took place.
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.
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.
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.
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.
Click here to find out more about our billing and insurance policies.
STATEMENTS:
If you receive a statement (bill) from us in the mail, it means that your insurance company has denied the claims that were billed. We try to include the reason for the denial on our bill. If you disagree with this denial, please call your insurance company customer service right away. If you have any other questions about our statements, please call us right away. You may reach our billing office at (617) 277-PEDS (7337) Option 3.
REFERRALS:
Many health insurance plans, especially managed plans like HMO's, require you to receive approval from your pediatrician (PCP) before you take your child to a specialist and then you must obtain a referral number.
Please be aware that insurance companies can deny payment for services even if you have a referral. You must call your insurance company directly about what services may not be covered.
If your insurance is the "managed" type (if you don't know, call your insurance company), please follow these steps:
Step 1: Verify with your company that you need a referral. Even if your insurance is managed, you may not need a referral for some services. Example: most companies do not require a referral for annual or biannual eye exams, or for laboratory tests. Most companies have PPO plans that do not require referrals. Check with your company before you begin the referral process.
Step 2: Speak with your pediatrician or nurse practitioner about the need for a referral and receive medical approval for that referral. Although you no longer need a referral for emergency room visits, it is wise to call first because your pediatrician or nurse practitioner can often expedite your emergency room visit if one is necessary.
Step 3: Make an appointment with the specialist whom your provider has referred you to. When you call the specialist, be sure to ask for the specialist's provider ID number for the type of insurance that you have and the specialist's NPI number. At that time, please confirm that the specialist is a member of your health insurance network; otherwise you may be subject to "out of network" costs.
Step 4: Inform our referral coordinator of the information necessary to process your referral paperwork. You can do that in these ways:
Click on referral request form at the top of the referrals page. Furnish the information requested and click on submit.
Pick up our Referral Request Form in our office and fill it out when you come to the office or you can mail or fax it back to us.
Go to the referrals page and print a copy of the Referral Request Form that you can fill out and mail or fax to us.
Call the Centre Pediatrics referral line at (617) 277-PEDS (7337), option 1. Leave us your full name, your child's name, your address, and your fax number if you have one. We will mail or fax to you our Referral Request Form which you complete and mail or fax back to us.
It takes approximately 5 business days to process your referral. Most referrals are now electronic, so there is no hard copy. Your specialist should be able to access your referral information via the POS devise or over the telephone. If you have questions, please contact our Referral Coordinator at (617) 735-8585. Click here to request a referral.
HEALTH FORMS:
Please remember to request your child's health form at the time of his/her annual visit. This form will be accepted at day care programs, schools, athletic programs and camps for one year after the date of the routine physical exam. We do charge a fee for the preparation of this form and we urge you to make a copy of the form for use throughout the year. Processing time is about three (3) weeks. To request a health form, call (617) 277-PEDS (7337) Option 2. Click here to get to the health forms page.