Financial Policy

CMO charges a  $50 fee for missed appointments.  This has been made necessary by increasing numbers of people not keeping their appointments, which is very frustrating when we are so busy and there are so many other people who want to be seen sooner.  This fee is not covered by your insurance and will apply if you fail to notify us of a cancellation at least 2 hours in advance of your appointment time (or, for appointments in the first two business hours of a day, prior to our closing the day before). If you need to cancel an appointment please call as soon as you know during business hours.  Please do not call after hours, and do not leave messages for or page our on-call providers for this purpose. On-call providers can NOT inform administrative staff of changed appointments. Should a true emergency arise that causes a missed appointment, please contact Nicole as soon as possible to discuss the fee.

Parents are responsible for all office charges, and payment is expected at the time of service. All insurance co-payments and balances are due at the time of the visit. A 10% discount is available for payment in full at the time of the visit by cash, check, or credit card. Unpaid balances are billed monthly, and accrue interest if not paid within 30 days. For your convenience we accept Master card, Visa, Discover and American Express cards and are happy to bill most insurance carriers directly. In cases in which a contractual relationship exists between our office and your plan, you are asked to pay any co-payment or co-insurance at the time of the visit. If your Plan requires, you must contact them PRIOR to a first appointment to name us as your Primary Care Provider, or to obtain a referral. Parents are ultimately responsible for any charges or portion thereof for which payment is denied by insurance for whatever reason, except where prohibited by law or prior contractual agreement.

Our participation in various insurance plans, HMO’s, and PPO’s is subject to change – usually based upon the plan’s own willingness to accept Boston Children’s Hospital and MGHfC as our primary affiliations. In general we have always tried to “sign up” with as many plans as possible in order to maximize choices to our patients. We are currently contracted with:

  • Aetna
  • Blue Cross/Blue Shield of MA
  • Blue Cross/Blue Shield from other states participating in the “Blue Card Program”
  • Cigna
  • Coventry (HCVM)
  • Fallon Community Health Plan (NOT Fallon Select)
  • Harvard Pilgrim Health Care
  • Humana
  • Multiplan (PHCS)
  • Neighborhood Health Plan (Commercial Only)
  • Tufts Health Plan/Network Health (As of 3/1/18-“Tufts Health Together with Boston Children’s ACO“)
  • Tufts Health Plan Commercial
  • United Health Plan
  • Tricare-Champus
  • New Hampshire Healthy Families
  • New Hampshire Medicaid
  • We will submit for most other private insurance plans.

Unpaid balances are billed monthly. We use computer billing and are aware that sometimes errors do occur. Please email if you have a question about your bill. Most problems can be settled quickly and easily, and your email will prevent any misunderstandings. If you are having trouble paying your bill or are unable to pay on the day your child needs to be seen, please explain the situation to us. Satisfactory arrangements can almost always be made. We strive to remain flexible and understanding of individual circumstances, are certain to have suggestions, and will do our best to help. Financial considerations should never prevent a child from receiving the care they need at the time they need it.

3.20.2020 Updates

The ongoing global pandemic has presented major challenges to us, and it’s been necessary to come up with solutions that will allow us to keep our doors open to providing care to your families.
With the need to have patients stay home when they can and defer appointments when possible, we’ve needed to consider ways of meeting not only our usual expenses, but the unique and unexpected costs that have come with the coronavirus (protective equipment, as an easy example). That means looking at all the services we provide, beyond standard office visits. This includes medical advice we offer in phone calls and via the MyChart portal. Even though these have been billable services for many years, we’ve waived doing so and provided them free of charge. We are simply not in a position to do so any longer. Without alternate sources of income, it’s a question of even being able to stay open.
It is our understanding that, under the direction of Governor Baker, insurance companies will be required to cover these costs. We are hopeful that your out of pocket costs will be minimal. The last thing we want is for anyone to decide not to call or contact us because they are worried about paying for it, or being a source of hardship to anyone during an extremely difficult time for everyone. If you end up with costs that are a burden, please let us know. We will work this out together.