Insurance

We Accept Most Insurance arriers


Insurance plans have become very complicated

over the last couple of years. In particular, the issue of deductibles and

copayments are confusing and understandably a big concern for you and your family.

There are many different insurance plans

which make it impossible for your provider to know the details of all of them. Therefore, if you have any questions about your covered benefits, we ask that you refer to the “covered services” section of your
insurance handbook or call the member services department of your insurance
company.

We require a copy of your insurance card to be on file to assist in filing claims with
your insurance company.

Our focus has always been, and will continue to be, to provide excellent care and
treatment for your children. We look forward to this continued relationship.

Boy with blond hair, using an abacus, indoors. He is looking down intently.

Insurance plans we accept:


A variety of managed care, PPO, HMO, and POS insurance plans are accepted. Please contact our office for more details.

  • Aetna
  • Blue Cross Blue Shield of Massachusetts
  • Cigna
  • Coventry (HCVM)
  • Fallon Community Health Plan
  • Harvard Pilgrim Health Care
  • Health New England
  • Humana
  • MassGeneral Brigham Health
  • MassHealth Standard - only for secondary payer - Primary for Department of Children and Families
  • Multiplan (PHCS) Three River
  • Tricare
  • Unicare/Wellpoint
  • United Health Plan
  • WellSense Boston Children’s ACO - the only MassHealth plan that we accept

Insurances plans we do not accept


  • Blue Cross Blue Shield of Massachusetts - Medicaid and Medicare, BCBS Steward
  • Cigna - Local Plus
  • Fallon Community Health Plan - Medicaid and Direct Care
  • Humana - All non-Choice Care PPO Products
  • Mass General Brigham Health - Medicaid, Allies, Select HMO Plans, Value HMO Plans
  • Tufts Health Plan - all plans
  • United Health Plan - Medicaid and Medicare


Please contact your health insurance company to confirm that your specific insurance plan is accepted at Boston Children’s Hospital Network/PPOC Network.


If we are not a provider for your insurance, if you are not insured, or if we do not file with your insurance company, you may be responsible for the entire charge at the time of service.


CPT Codes for the most common in-office tests:


We recognize that having a sick child can be a stressful experience. We have selected our testing kits and molecular testing platforms because they are highly sensitive and accurate. This allows us to diagnose disease faster and earlier than with the older technology testing platforms.

 

We do not want you to be surprised by a bill. We must always bill your insurance plan based on federal guidelines and the actual services provided in a visit. We encourage families to review their coverage of benefits for these tests:

  • COVID - 87635
  • Influenza A/B - 87502
  • RSV - 87634
  • Strep - 87651