Policies

At Beacon Pediatrics, our goal is to partner with parents to keep kids healthy! We appreciate that child(ren) with divorced or separated parents may present with unique challenges, and we require parents to work with us through those challenges. This policy was developed to avoid any misunderstandings going forward.

1. The providers, medical assistants, nurses, office, and billing staff will not be put in the middle of domestic issues or disagreements over the phone or in the office.
2. Please make decisions regarding appointments, vaccinations, and/or any office procedures prior to visiting our practice.
3. Only in situations where there is a documented court order will one parent be denied access to the minor’s health record or visits at the office. Beacon Pediatrics must have a copy of the court order on file in the minor’s electronic medical record.
4. It is both parents’ responsibility to communicate with each other about the patient’s care, office visit dates, and any other pertinent information relevant to the patient. It is not the responsibility of Beacon Pediatrics to communicate visit information to each custodial parent separately.
5. Our providers will not call the other parent prior to an appointment to gain consent regarding appointments scheduled, nor will they take a call from the other parent following an appointment. We will not restrict either parent’s involvement in the patient’s care unless authorized by law; however, we also will not duplicate information delivery unless directed by law.
6. We will send reminders of upcoming appointments by text and/or phone call. We can send this reminder to only the primary phone number listed on the patient’s account. The parent or guardian that completes and signs our new patient packet will be the chart guarantor and therefore receive these reminders.
7. All copays, deductibles, coinsurances, and any other fees are due at the time of the visit and are the responsibility of the parent accompanying the patient to the appointment.  If there is an arrangement between the parents about split payment, it is the responsibility of the parent attending the appointment to collect from the other parent.

Should the issues that come between parents become disruptive to our practice or there is non-compliance with this policy, we reserve the right to discharge the family from our practice.

Furthermore, we avoid prescribing antibiotics over the phone, as we believe in conducting proper assessments before doing so. Antibiotics are prescribed only when necessary and appropriate, ensuring patient well-being while mitigating the risks of antibiotic resistance and unnecessary side effects.

The following information explains our Financial Policy. A copy of this policy will be provided to you upon request.

1. Insurance: We participate in most insurance plans and are happy to file your insurance as long as we are provided with a copy of your card along with accurate information. It is very important to verify your insurance information at each visit. Any remaining balance after insurance pays will be billed to you and is due within 30 days of the statement.

2. Copayments: All co-payments must be paid at the time of service. This arrangement is part of your contract with your insurance company. We encourage you to become familiar with your policy.  Making your copayment at the time of service will ensure that you meet your contractual obligation. It is also our obligation through our contract with the insurance company to collect co-payments at time of service. Uncollected copayments will be billed within 30 days of your visit. Repeated failure to make your copayment may be reported to your insurance company for follow-up. Patients with Medicaid as secondary insurance are still responsible for the primary insurance copay. Medicaid DOES NOT always cover the copay for the primary insurance.

3. Copayments for yearly physicals: A “Well Visit” or “Well Check” does not require a co-payment under the Patient Protection and Affordable Care Act. For your convenience, your physician or provider may discuss or treat your child for a medical condition during your child’s well visit. This saves you from having to make several trips to our office. As a result, a co-payment or deductible may be required by your insurance company if discussions beyond your child’s preventive care occur. Some examples of this are as follows:

1. Your Provider manages a pre-existing/chronic problem (e.g., constipation, ADHD, anxiety, depression, asthma, eczema, or allergies) 
2. Your Provider treats your child for any new problems they are currently experiencing (e.g., fever, ear pain, sore throat, abdominal pain, cough, wart removal, acute joint pain, rash requiring a work-up, anxiety, ADHD).

For questions related to your benefits coverage and co-payments, please reach out directly to your insurance company. Our practice contracts with many health different insurance carriers and we do not know what benefits you may qualify for under your particular plan.

3. Proof of Insurance: All patients must complete our patient information form yearly. We must obtain a copy of your child’s current valid insurance card to provide proof of insurance.

4. Claims Submission: As stated above, we will submit your claims and assist you in any way we reasonably can to help get your claim paid. Your insurance may need you to supply certain information directly, and it is your responsibility to comply with their requests. Please be aware that the balance of your account is your responsibility whether your insurance company pays your claim or not.

5. Coverage Changes: If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay within 45 days, the balance may be billed to you.

6. PCP: If you have an HMO insurance product, you are required to elect a Primary Care Provider (PCP). It is your responsibility to elect a PCP with your insurance company, prior to attending any visits to that PCP office. 

7. Nonpayment: Patient balances are due within 30 days of the statement date. If no payment is made, reminder letters will be sent after 30 days and again after 60 days. Failure to contact us will result in referral to an outside collection agency and possible dismissal from our office. To avoid such action, you must contact our business office to set up a payment plan. We will extend credit for 90 days unless other arrangements are made.

8. No Shows: Failure to show up for a scheduled appointment will be tracked in our computer system, and letters will be sent via our portal notifying you of the missed appointments. The first missed appointment will be logged as a warning. A $50 fee may be charged for a second missed appointment. The third missed appointment in a calendar year may result in discharge from the practice. For new patients, a fee may be charged if the FIRST appointment is missed. A late cancellation or no show for a Medication Evaluation with our Psychiatric Nurse Practitioner will result in a $100 fee. Please see our No Show/Cancellation Policy for further information.

9. Payment Methods: We accept all major credit cards, debit cards, and checks. We also accept credit card payments over the phone. Checks returned for insufficient funds may be turned over to a third party for collection. You will be charged a $25 processing fee on all checks returned for insufficient funds.

The Health Insurance Portability and Accountability Act (better known as HIPAA) protects information about your child's health and medical record. At Beacon Pediarics, your privacy is our priority. You and your child will be able to discuss your child's health with a physician behind closed doors.

Beacon Pediatrics Privacy Policy

(This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.)

If you have any questions about this notice, please contact our Privacy Officer at the number listed at the end of this notice.

Each time you visit a healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This notice applies to all of the records of your care generated by your health care provider.

Our Responsibilities

Beacon Pediatrics is required by law to maintain the privacy of your health information and to provide you with a description of our legal duties and privacy practices regarding your health information. The current notice will be posted in the main reception area. The notice will include the effective date. In addition, we will make our best effort to provide you with a copy of this notice that we request you acknowledge with your signature.

We are required by law to abide by the terms of this notice and notify you if we make changes to this notice, which may be at any time. Changes to the notice will apply to your medical information that we already maintain as well as new information received after the change occurs. If we change our notice, it will be posted in the main reception area. You may also request that a revised notice be sent to you in the mail or you may ask for one at your next appointment or appropriate visit. This notice will also serve to advise you as to your rights with regard to your medical information.

How We May Use and Disclose Medical Information About You

The following categories describe examples of the way we use and disclose medical information:

1.     For Treatment: We may use medical information about you to provide, coordinate and manage your treatment or services. We may disclose medical information about you to other doctors, nurses, technicians (e.g., clinical laboratories or imaging companies), medical students, or other personnel who are involved in your care. We may communicate your information either orally or in writing by mail or facsimile.

We may also provide a subsequent healthcare provider with copies of various reports that should assist him or her in treating you. For example, your medical information may be provided to a physician to whom you have been referred so as to ensure that the physician has appropriate information regarding your previous treatment and diagnosis.

2.     For Payment: We may use and disclose medical information about your treatment and services to bill and collect payment from you, your insurance company or a third-party payer. For example, we may need to give your insurance company information before it approves or pays for the health care services, we recommend for you.

3.     For Health Care Operations: We may use or disclose, as needed, your health information in order to support our business activities. These activities may include, but are not limited to quality assessment activities, employee review activities, licensing, legal advice, accounting support, information systems support and conducting or arranging for other business activities. In addition, we may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment by telephone or reminder card.

4.     Business Associates: There are some services provided in our organization through contracts with business associates. Examples include software support. If these services are contracted, we may disclose your health information to our business associate so that they can perform the job that we have asked them to do and bill you or your third-party for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information through a written contract.

Other Permitted and Required Uses and Disclosures That May Be Made with Your Consent, Authorization or Opportunity to Object

We may also use or disclose your health information as set forth below. You have the opportunity to agree or object to the use or disclosure of all or part of your health information in these instances. If you are not present or able to agree or object to the use or disclosure of the health information (such as in an emergency situation), then your clinician may, using professional judgment, determine whether the disclosure is in your best interest. In this case, only the information that is relevant to your health care will be disclosed.

1.     Individuals Involved in Your Care or Payment for Your Care: Unless you object, we may release medical information about you to a friend or family member who is involved in your medical care or who helps to pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

2.     Future Communications: We may communicate to you via newsletters, mailings or other means regarding treatment options, information on health-related benefits or services; to remind you that you have an appointment for medical care; or other community-based initiatives or activities in which our facility is participating. If you are not interested in receiving these materials, please contact our Privacy Officer.

Other Permitted and Required Uses and Disclosures That May Be Made without Your Authorization or Opportunity to Object

We may use or disclose your health information in the following situations without your authorization or without providing you with an opportunity to object. These situations include:

1) As required by law. We may use and disclose health information to the following types of entities, including but not limited to:

• Food and Drug Administration
• Public Health or Legal Authorities charged with preventing or controlling disease, injury or disability
• Correctional Institutions
• Workers Compensation Agents
• Organ and Tissue Donation Organizations
• Military Command Authorities
• Health Oversight Agencies
• Funeral Directors, Coroners, and Medical Directors
• National Security and Intelligence Agencies
• Protective Services for the President and Others
• Authority that receives reports on abuse and neglect

2) Law Enforcement/Legal Proceedings: We may disclose health information for enforcement purposes as required by law or in response to a valid subpoena.

3) State-Specific Requirements: Many states have requirements for reporting including population-based activities relating to improving health or reducing health care costs.

Your Health Information Rights

Although your health record is the physical property of the Beacon Pediatrics that compiled it, you have the right to:

1.     Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. We ask that you submit these requests in writing. Usually, this includes medical and billing records, but does not include psychotherapy notes or information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review. Requests for access to and copies of your medical information must be submitted to Beacon Pediatrics in writing. No cost at this time.

2.     Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information by submitting a request in writing. You have the right to request an amendment for as long as we keep the information. We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial.

3.     An Accounting of Disclosures: You have the right to request an accounting of our disclosures of medical information about you except for certain circumstances, including disclosures for treatment, payment, health care operations or where you specifically authorized a disclosure. Beacon Pediatrics will provide the first accounting to you in any 12-month period without charge. The cost for subsequent requests for an accounting within the 12-month period will be $0.00. We ask that you submit these requests in writing.

4.     Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or for the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a procedure that you had. We ask that you submit these requests in writing.

We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

5.     Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We will agree to the request to the extent that it is reasonable for us to do so. For example, you can ask that we use an alternative address for billing purposes. We ask that you submit these requests in writing.

6.     A Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

To exercise any of your rights, please obtain the required forms from the Privacy Officer and submit your request in writing.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us by calling (781) 745-3322 and asking for the Privacy Officer or by contacting the Secretary of the Federal Department of Health and Human Services. All complaints must be also submitted in writing. You will not be penalized for filing a complaint.

Other Uses of Medical Information

Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. However, we are unable to take back any disclosures we have already made with your permission and we are required to retain our records of the care that we provided to you.

• Privacy Officer:  TBD
• Telephone Number:  781-745-3322

Beacon Pediatrics Vaccine Statement

As medical professionals, we feel very strongly that vaccinating children on schedule with currently available vaccines is absolutely the right thing to do for all children and young adults. We are making you aware of these facts not to scare you or coerce you, but to emphasize the importance of vaccinating your child. We are more than willing to discuss any questions you may have about vaccines, but do require all new patients to our practice to adhere to the vaccination schedule endorsed by the American Academy of Pediatrics (AAP)

• We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives.

• We firmly believe in the safety of our vaccines.

• We firmly believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the  American Academy of Pediatrics (AAP).

• We firmly believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities.

• We firmly believe that thimerosal, a preservative that has been in vaccines for decades and remains in some vaccines, does not cause autism or other developmental disabilities.

• We firmly believe that vaccinating children and young adults may be the single most important health promoting intervention we perform as health care providers, and that you can support as parents/caregivers.

The recommended vaccines and the schedule of administration are the results of years and years of scientific study and data-gathering on millions of children by thousands of our brightest scientists and physicians.

The vaccine campaign is truly a victim of its own success. It is precisely because vaccines are so effective at preventing illness that we are even discussing whether or not they should be given. Because of vaccines, many of you have never seen a child with polio, tetanus, whooping cough, bacterial meningitis, or even chickenpox, or known a friend or family member whose child died of one of these diseases. Such success can make us complacent or even lazy about vaccinating. But such an attitude, if it becomes widespread, can only lead to tragic results.

Over the past several years, many people in Europe have chosen not to vaccinate their children with the MMR (measles, mumps, rubella) vaccine after publication of an unfounded suspicion (later retracted) that the vaccine caused autism. As a result of under-immunization, there have been small outbreaks of measles and several deaths from complications of measles in Europe over the past several years. The United States experienced a record number of measles cases during 2019, with 1282 cases from 31 states reported to CDC's National Center for Immunization and Respiratory Diseases (NCIRD). This is the greatest number of cases since measles elimination was documented in the U.S. in 2000.

Furthermore, we firmly believe that by not vaccinating your child, you are taking selfish advantage of thousands of others who do vaccinate their children, which decreases the likelihood that a child will contract one of these diseases. We feel such an attitude to be self-centered and unacceptable. Even delaying or “breaking up the vaccines” to give one or two at a time over additional visits goes against expert recommendations, is not supported by any scientific data, can lead to unnecessary delays and errors, and can put your child, other children, and adults at risk for serious illness (or even death). It is therefore against our medical advice as professionals at Beacon Pediatrics.

Beacon Pediatrics Vaccine Policy

1. Because we are committed to protecting the health of your children through vaccination, we require all of our patients to be vaccinated in accordance with the schedule set forth in this policy. All school required vaccines must be received according to the schedule recommended.  All vaccines are strongly encouraged by the entire Beacon Pediatrics team. New, incoming families will be required to vaccinate according to the schedule recommended by the American Academy of Pediatrics, including HPV.  Influenza and Covid will not fall under this vaccine policy for new or current families.

2. If you have doubts regarding vaccination, please discuss these with your healthcare provider in advance of your visit. We are committed to engaging in discussion to explain the benefits of vaccination.

3. In some cases, we may alter the vaccination schedule to accommodate parental concerns or reservations. Please be advised, however, that delaying vaccines to give one or two at a time over two or more visits goes against expert recommendations, can put your child at risk for serious illness (or even death) and goes against our medical advice. Additional visits for vaccinations will also require additional co-pays on your part. Please realize that you will also be required to sign a “Refusal to Vaccinate” acknowledgement in the event of lengthy delays. Delayed immunization schedules leave an infant or child at risk for preventable infections and also present opportunity for errors. It is the responsibility of the parent to track the vaccine schedule and to inform any caregiver if a child is incompletely immunized. The fever work up for an under-immunized child may differ from that of a child immunized according to schedule.

4. Finally, if you should refuse to vaccinate your child despite all our efforts, we will ask you to find another health-care provider who shares your views.

Thank you for taking the time to read this policy. Please feel free to discuss any questions or concerns you may have about vaccines with any one of us.

Time Specific Guidelines:

NEW patients to the practice must have up to date immunizations for age according to the CDC and ACIP schedule OR be working toward catch up.

Children by 20 months are required to have the following:

• 4th DTaP
• 4th PCV 13
• 1 MMR (measles, mumps, rubella)
• 1 VZV (chicken pox)

Children by FIVE years are required to have the following:

• 5th DtaP
• 2nd MMR
• 2nd VZV
• 4th Polio

Newborns must be:

• Vaccinated according to schedule at 2, 4 & 6 months

Our practice makes every effort to run on time with appointments, as we believe everyone’s time is equally valuable.

As a courtesy, we will remind you of your upcoming appointments via phone/text message/email.

We ask that you arrive 15 minutes before your scheduled appointment time to complete any paperwork, screening forms, review insurance information and to start the check-in and rooming process so that your appointment can start on-time with your provider. We understand sometimes things happen beyond your control that may cause you to be late. However, we reserve the right to ask you to reschedule if you arrive late for your appointment.

Missed Appointments: Broken appointments represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you. We reserve the right to charge a fee for canceled or missed appointments. We request 24 hours notice for cancellation of Well Visit and Office Visit appointments.  We request a 2 hours notice for cancellation of a Same Day Sick or MyChart Same day appointment. Please call ahead if you know that you will not be able to make a scheduled appointment.  Missed appointments that do not meet the above cancellation notice timelines will be subject to the following fee schedule:

• The first missed appointment (per family) will be logged as a warning.

• A $50 fee may be charged for a second missed appointment.

• The third missed appointment in a calendar year may result in discharge from the practice.

• For new patients, a fee may be charged if the FIRST appointment is missed.

Beacon Pediatrics Adolescent Confidentiality and Transition Policy

Trust is an essential aspect of medical care and we at Beacon Pediatrics seek trust in all of our health care encounters. Parents and their children are both entitled to this trust. One way that physicians maintain trust is by keeping communications with patients and their families confidential.

Under Massachusetts state law, however, adolescents who are 12-17 years of age have special statutory rights that entitle them to confidential communications with their physicians. This means that they can discuss things with physicians they do not wish to tell their parents or other adults, and the physician is required to keep those things confidential. The only exception to this right of confidentiality is when the physician determines that the adolescent is in danger of hurting himself or herself, hurting other people, or being hurt by someone else.

At Beacon Pediatrics, we want to recognize and support our teenage patients’ evolving maturity and independence. Adolescence is a time of transition toward adulthood, and we believe that we should support this healthy transition in our office. Some teenagers may have health concerns that warrant professional advice and/or treatment, and they may not feel comfortable discussing this with their family and friends. In surveys, many adolescents say that concerns about confidentiality are a big reason they may avoid seeking medical care. We strive to provide the best care possible for our adolescent patients. To that end, we want our teens and parents to be aware of the following:

• Beginning at age 13, we will conduct part of each visit alone with our teens. This time alone with the provider gives the patient a chance to address any concerns or issues.
• When teens share something with us that they ask to remain confidential, we will honor that request, unless they plan to harm themselves or someone else. Although we always encourage patients to be open and honest with their parents, we also want them to have a safe place to go with any health concerns, and sometimes we can be that safe place. We hope that parents will trust us to take the best care of our teens in these situations.
• We are also happy to speak privately with parents during the visit, at their request, about any concerns that they may want to share with us about their teen. We will maintain our patient’s confidentiality in these discussions.
• These confidentiality parameters also extend to any telephone calls that we may have with our teen patients about their healthcare, including discussions about appropriate lab/imaging evaluations and results.
• When our patients turn 18 years old, we follow federal guidelines mandating that they make decisions as legal adults about with whom and how their medical information is shared.  They are now in charge of all medical decision making (including consent for treatment and immunizations), and we will require their consent to discuss any information about prescriptions, appointments, referrals and visits.

As such, upon turning 18 years old, they will be provided with an Authorized Representative form in which they will have an opportunity to grant permission for us to share medical information with their parents.  It is up to the young adult whether or not we have permission to speak with their parents or other individuals.  If the patient does not fill out this form or if they choose to withhold this permission, we will be unable to share any medical information (including with parents). 

Please note that this permission can be granted or retracted by the young adult patient at any time. 

We believe that it is important for young adults to take responsibility for their health care.  This includes scheduling their appointments, calling/e-messaging for refills of medication, and calling the office themselves when they are sick or have a question for our team.  Encouraging young adults to do this is an important part of the transition process and one more area where parents can help their children become functioning and healthy adults.

Turning 21 Years Old:

Beacon Pediatrics pledges to care for children and their families from birth through young adulthood.  To that end, we are able to treat young adults up to their 21st birthday. 

At the 21-year-check-up, patients will be provided with a “graduation” letter that details the following:

1. The patient will be unable to book a 22-year-old-check-up at Beacon Pediatrics
2. The patient will have a 12 month “grace” period for sick visits and medication management (for chronic issues including asthma, ADHD, anxiety/depression, etc)
3. Instructions will be given about how to find an adult provider

It is an honor and privilege to care for our patients.  Graduation to adulthood is always bittersweet.  We are sad to see you go, but happy to have served you along the way!

• We will collaborate with patients and families regarding the age for transferring to an adult provider and recommend that this transfer occurs on or before age 21. We will assist with this transfer of care including helping to identify an adult provider, sending medical records, and communicating with the adult provider about the unique needs of our patients if deemed necessary.

This policy is consistent with Massachusetts State Law surrounding adolescent confidentiality, and it is also consistent with the policies of the Society for Adolescent Medicine and the American Academy of Pediatrics. Please let us know if you have any questions.

Sick Visit During Well Visit Policy

A “Well Visit” or “Well Check” does not require a co-payment under the Patient Protection and Affordable Care Act. For your convenience, your physician or provider may discuss or treat your child for a medical condition during your child’s well visit. This saves you from having to make several trips to our office. As a result, a co-payment or deductible may be required by your insurance company if discussions beyond your child’s preventive care occur. 

Some examples of this are as follows:

1. Your Provider manages a pre-existing/chronic problem (e.g., constipation, ADHD, anxiety, depression, asthma, eczema, or allergies) 
2. Your Provider treats your child for any new problems they are currently experiencing (e.g., fever, ear pain, sore throat, abdominal pain, cough, wart removal, acute joint pain, rash requiring a work-up, anxiety, ADHD).

For questions related to your benefits coverage and co-payments, please reach out directly to your insurance company. Our practice collaborates with many health insurance carriers and do not know what benefits you may qualify for under your particular plan.

There are some complaints/illnesses that we may not be able to address during a Well Visit due to the time required to adequately assess these complaints. Your Provider may therefore suggest that you schedule a separate appointment to discuss the problem or complaints.

Beacon Pediatrics MyChart Billing Policy

When you have a medical question, sending your healthcare provider a message through MyChart is one of the most convenient ways to receive your care. It doesn’t matter what time it is — or if you’re in your office or the grocery store parking lot — you can still reach out with a MyChart message to start a conversation with your provider.

Over the last few years, virtual options have played a bigger role in our lives. And since 2019, the amount of messages providers have been answering has doubled.

Staying connected is important, and your provider is committed to responding to your needs in a timely way — within 5-7 business days. Most of these messages are free. However, MyChart responses that require your provider’s clinical time and expertise to answer may be billed to your insurance. There may be a co-pay based on your insurance company’s guidelines. This will allow us to continue to provide the high level of care you have come to expect from Beacon Pediatrics.

What to expect if your message is billed to insurance

The highest amount that you could be responsible for paying is $50. However, if your message is billed to your insurance, you may not be charged at all or you may see a low out-of-pocket cost. 

The dollar amount a provider bills to insurance is based on the amount of time spent reviewing the medical record and providing advice. Providers may only bill for messages that require 5 minutes or more.

Different insurance plans cover different things. Here are a few examples of what you can expect:

• Have Medicare? There’s no out-of-pocket cost for most people. Some might have a small fee of $3 to $8. If you’re a Medicare patient with secondary insurance, you’ll owe $0.
• Have private insurance? Most insurance providers cover these messages at little to no cost to the patient. If you have a deductible, or this isn’t a covered benefit on your plan, you could owe $33 to $50.

Reach out to your insurance provider to learn the specific out-of-pocket costs for your plan. 

What messages will be billed to my insurance?

Messages that will be billed usually require your provider’s medical expertise and take longer for your provider to answer — typically taking five or more minutes for your provider to answer.

But what kinds of messages could get billed? Messages about:

• Changes to your medications.
• New symptoms.
• Changes to a long-term condition.
• Check-ups on your long-term condition care.
• Infant feeding and new baby advice.
• Requests to complete medical forms.
• Rashes that require pictures to be reviewed by the MD to diagnose.

The provider looking at your message might be reviewing the information you sent over and changing part of your treatment plan, or recommending you get a test to learn more. They might need to look at your medical history and do an in-depth review of your records to make sure they give you the best possible advice.

What messages will be free?

It’s important to know that not every message you send to your provider will be billed to your insurance. The quick rule of thumb is to think of time and expertise. Does your provider need to spend a lot of time to fully answer your question? Does it require them to dig into your medical history to respond to your question?

Your provider won’t bill for messages about:

• Scheduling an appointment.
• Getting a prescription refill.
• Asking a question that leads to an appointment.
• Asking a question about an issue you saw your provider for in the last seven days.
• Checking in as a part of your follow-up care after a procedure.
• Giving a quick update to your provider.

What parts of telehealth does insurance cover?

Telehealth has made connecting with your provider easy and convenient. You don’t need to leave home and travel to a doctor’s office to chat with your provider on MyChart. As this option for care is getting more popular, you might wonder what your insurance covers when it comes to virtual options. Many insurance plans now cover:

• Virtual Visits
• Phone call visits.
• Medical advice via MyChart.

Most of the messages you send to your provider through MyChart are handled quickly and won’t be billed to your insurance. But requests that take extra time and expertise are considered telehealth, so those services will go to your insurance plan for payment.

Want to send a message? How to get started with MyChart messaging

Getting in touch with your healthcare provider through MyChart is easy. Simply log in using a web browser or the MyChart app to get started. Then select “Messages” and follow the prompts. You’ll see a list of your providers who use messaging. Click on the provider you want to reach, write your message and hit send.

If you don’t have a MyChart account, please contact a member of the Beacon Pediatrics front desk team for assistance.

Beacon Pediatrics Prescription Policy

Beacon Pediatrics will do our best to get your prescription refills sent to the pharmacy in a timely manner.  Prescription refill requests can be called in to our office refill voicemail which is monitored by our nursing team Monday through Friday during business hours.  Please allow up to 2 business days for routine refills.  Some refills may take longer depending on pharmacy stock/availability and/or need for prior authorization.  Urgent refills for asthma medications need to be called in to our nursing triage line to assess your child's condition and potential need for in-office evaluation.

For patients refilling prescriptions for Adderall, Concerta, Daytrana, Dexedrine, Focalin, Metadate, Methylin, Ritalin, Vyvanse, and other stimulants:

• We are able to electronically prescribe these medications and send them to your pharmacy.  Please contact our refill line 1 week prior to completion of your prescripion.  See below for current stimulant medication shortage issues and fixes.

• Please make sure you bring a photo I.D. with you to pick up the prescription.

• Missing an Adderall, Concerta, Daytrana, Dexedrine, Focalin, Metadate, Methylin, Ritalin, Vyvanse, or other stimulant dose does not constitute a medical emergency. These medications do not build up in the system and no harm will come to the patient other than the distress of being less attentive and/or self-controlled.

• Please note that the on-call and weekend providers will not refill these prescriptions.

• We require medication re-checks at least every 6 months (or sooner at the recommendation of the prescribing provider) for controlled substances and mental health medications for behavior, anxiety, depression, etc.

Please remember that refills can only be given to patients who have been seen within the past year. If your child has not been seen for more than a year, you will need to schedule an appointment.

Stimulant Medication Shortages

The shortage of stimulant medications is affecting many people with ADHD and their families!

It will take planning and persistence to fill these prescriptions.

1.   Ask pharmacist what the next earliest fill date will be and put it on your calendar with a reminder.  Call for your next pick-up THAT DAY, regardless of how many pills are left.  This gives a little more time for them to fill it.

2.   If your pharmacist can't get your medication, ask if they know of another local branch that has it.

3.   If your pharmacist doesn't know where it is in stock, call other pharmacies to see if they have the exact type and strength you need.  Read your prescription label to them to get it right.  If they have it, call your prescriber and ask them to send a script there and void previous scripts.

4.  Ask if there are combinations of other pill sizes that they can substitute.  For example, if you are on 30mg, see if there are 15mg tablets available to take two of the 15mg tablets rather than one of the 30mg - or three 10mg tablets.

5. If you try all of the above measures and you are still unable to locate your current prescription, you may ask your prescriber about changing to another medication if at all possible.

And finally. . .

This is frustrating for everyone. For you. For your pharmacy staff. For your office staff and Pediatricians. Please remain calm when talking to pharmacy or office staff.  It is not their fault and it's easy for your frustration to come out as anger towards them. It is not their fault and they are doing their best to help you.

 Be kind. . . we will get through this!

Beacon Pediatrics Patient Dismissal Policy

Beacon Pediatrics believes the provider/patient relationship to be a professional one, based upon mutual trust and understanding.  If a breakdown in this relationship occurs, we reserve the right to refuse treatment. 

Reasons for dismissal include, but are not limited to:

• Dishonesty
• Abusive, inappropriate, or aggressive behavior (actual or implied)
• Persistent non-compliance with treatment plans
• Refusing to see and/or be treated by members of our staff
• Refusal to vaccinate in accordance with our vaccination policy
• Illegal activity by a patient or their caregivers
• Patients or caregivers felt to be dangerous to self or others
• Requests for services beyond our scope of care
• Failure of payment
• Multiple missed/cancelled appointments
• Transfer to another primary care provider

Scope:  This policy applies to all established patients of Beacon Pediatrics.

Procedure:  In the event that a patient is dismissed, the following procedure will be followed.

1. A member of management will attempt to notify the parent or legal guardian in writing via certified mail of our decision to terminate the provider/patient relationship. The termination letter will be addressed to the address on file in the patient's medical record. The termination letter will clearly state:

• The date the termination becomes effective
• The reason(s) for the termination
• The time period during which we will continue to provide urgent care services to the patient
• A summary of this practice's record release policy

1. The patient's health insurance provider will be notified by management of the patient's dismissal from this practice, and all necessary paperwork will be forwarded to the appropriate contact.
2. We will continue to see the patient for urgent care services only for 30 days from the date of the termination letter.
3. This practice's record release policy applies to any release of records, including in the case of a termination of the provider/patient relationship.
4. Once the 30 day period from the date of the termination letter has passed, management will inactivate the patient's chart and enter an alert stating the reason why the chart is inactivated.
5. Any further contact by a parent or guardian of a dismissed patient to this office will be referred to management.

Beacon Pediatrics Appointment and After-Hours Policy

It is our intention to provide your children the best care possible at all times and to accommodate as many requests as is realistic and feasible. It is within this context that we ask you to take a few moments to review policies that affect the way services are provided.

In the Office:

 Arrive early. Please remember that all insurance requires that your insurance data be updated prior to each encounter. This usually takes a few minutes. If this is not done, your insurance may deny your claim. We do not want time spent on administrative requirements to limit your time with the doctor.

 Schedule an appointment by calling 781-745-3322 or through your MyChart portal. We are not a walk-in clinic. If available, walk-in patients may offered the first available appointment. 

 Schedule same-day appointments for sick visits. Appointments are used on a first-available appointment basis.

 Patients who arrive on time are seen at their appointment time. Patients who have arrived on time will be seen ahead of those who arrive late. If you arrive late, we may need to abbreviate or reschedule your child’s visit.

 Call ahead if you are late or unable to make your appointment time. We will do all that we can to accommodate your child’s appointment and to minimize the need to reschedule your appointment.

 Late arrivals (>15 minutes after scheduled appointment) will be offered the next available appointment. In these cases, a no-show charge for the lost appointment will apply. While we will do all that is possible to accommodate requests, the first-available appointment may or may not be on the day the appointment was missed.

 Please call the office if you are unable to make a scheduled appointment.  We request 24 hours notice for cancellation of Well Visit and Office Visit appointments.  We request a 2 hours notice for cancellation of a Same Day Sick or MyChart Same day appointment.

Please call ahead if you know that you will not be able to make a scheduled appointment.  Missed appointments that do not meet the above cancellation notice timelines will be subject to the following fee schedule:

The first missed appointment (per family) will be logged as a warning.

A $50 fee may be charged for a second missed appointment.

The third missed appointment in a calendar year may result in discharge from the practice.

For new patients, a fee may be charged if the FIRST appointment is missed.If you call to cancel the appointment, the no show fee may be waived.

Please see our No-Show Policy for complete details. 

 Appointments for additional children should be made by phone prior to coming to the office. A copay charge is applied for the add-on appointments. If you would like another child to be seen, please schedule appointments for both children by phone prior to coming to the office.

 Turn off cell phones in the office and examination rooms.

After-hours Call Service

 Please limit after-hour calls to urgent issues and emergencies. Please refer to our website Symptom Checker  for answers to common illness questions. For refills, appointment requests, and other nonurgent matters, you may leave a message or call the office during regular hours. 

Please also do the following when using this service:

 When leaving a message, please speak slowly.

 Be sure to leave a callback number.

 Disable your call block feature.

 Follow the Nurse Triage or On Call Doctor/NP's instructions.

If the on-call provider is contacted after hours, your insurance may be billed for the service.

We are here to provide the best care we can to your children should the need arise. As always, we welcome the opportunity to care for your children and appreciate your trust in the services we provide.

Beacon Pediatrics Family Behavior Policy

Beacon Pediatrics is a family-friendly pediatric office caring for impressionable young children, adolescents, and their families.  Although occurrences are rare, Beacon Pediatrics feels strongly that our patients, their families, and our staff deserve to be protected from verbal abuse and aggressive behavior.  We are very aware that families under physical and emotional stress might not be always at their best behavior. However, we all need to respect each other and be kind.  We understand that disagreements may occasionally occur, and we encourage you to discuss these matters with us in a civil, nonconfrontational manner.  We encourage constructive criticism as we can only improve when we discover that we could be doing things better. 

However, when discussions/conversations become overheated or rude, they will be reported to our practice manager for review.  We have a ZERO TOLERANCE POLICY if any member of our staff feels that a family’s behavior becomes abusive, threatening, or aggressive.  This behavior will be documented in the family’s chart and will result in the immediate dismissal of the family from the practice.  Depending on the degree of infraction, we reserve the right to involve child protective services, law enforcement, and other appropriate agencies should we deem them necessary.

Beacon Pediatrics No Firearms and Weapons Policy

At Beacon Pediatrics, our highest priority is the safety and well-being of our patients, families, and staff. To maintain a secure and welcoming environment for everyone, firearms and other weapons are not permitted on our premises at any time.

This policy applies to all individuals entering our facilities, including patients, parents, caregivers, visitors, vendors, and staff members—regardless of whether a person is licensed to carry a firearm or weapon.

Weapons include, but are not limited to:

• Firearms (handguns, rifles, shotguns)

• Knives or blades not used for medical or office purposes

• Explosives or ammunition

• Any item designed or used to inflict harm or intimidate

Exceptions:

• On-duty law enforcement officers acting in their official capacity are exempt from this policy.

Anyone found in violation of this policy may be asked to safely remove the weapon from the premises or leave the facility. Failure to comply may result in notification of law enforcement and/or termination of the patient’s relationship with the practice.

We appreciate your cooperation in helping us maintain a safe, calm, and healing environment for all children and families in our care.

Acknowledgment for Patients & Visitors

Beacon Pediatrics No Firearms and Weapons Policy Acknowledgment

I acknowledge that I have read and understand that weapons (as defined in this policy) are not permitted on the premises of Beacon Pediatrics. I agree to comply with any request by staff to remove or not bring a weapon onto the property. I understand that refusal may result in being denied entry or in termination of services.

Name (or parent/guardian)__________________________

Signature________________________________________

Date: ______________________