Financial Policy - North Shore Pediatrics, PC participates with most insurance plans with the exception of Neighborhood Health Plan. It is your responsibility to insure that you have active health insurance and that one of our pediatricians is listed as your Primary Care Physician (for those plans that require you to have a PCP).
- "Self Pay" patients are responsible for payment of all charges at the time of service. We may require you to post a deposit on your account prior to being seen by a provider. All accounts must be settled before any future appointments will be scheduled. North Shore Pediatrics, PC accepts cash, checks, credit cards and money orders.
- Co-Payments are due at the time of service. Failure to pay your co-payment at the time of service will result in an additional $20.00 charge to your account.
- Payment Plans are only available in extreme financial hardship. North Shore Pediatrics PC requires a 50% down payment on all payment plans and then 4 equal monthly installment payments for the balance. Payment plans are offered at the sole discretion of North Shore Pediatrics, PC and may require you to provide financial data to prove financial hardship. Failure to meet all requirements and payment deadlines in a payment plan will result in the balance being due, in full, immediately and we will not allow any future appointments until the balance is paid in full.
Insurance - Insurance is a contract between you and your insurance company. We are not a party to this contract. We file insurance claims on behalf of our patients. We will not become involved in disputes between you and your insurance company regarding deductibles, co-payments, covered charges, secondary insurance, "usual and customary" charges, etc. other than to supply factual information as necessary. You are responsible for the timely payment of your portion of your account with North Shore Pediatrics, PC.
Certain services and procedures provided by North Shore Pediatrics, PC (such as wart treatment, for example) may be your responsibility through your deductible. There is no way for North Shore Pediatrics, PC to know what services and procedures your particular policy covers until we file the claim and receive a response from your insurance company. It is your responsibility to know what services and procedures are covered under your policy and which services and procedure may be applied to your deductible. Any questions on whether a particular service or procedure will be covered or applied to your deductible should be directed to your insurance carrier prior to your visit in our office. We are unable to answer these questions for you.
It is your responsibility to provide timely and correct insurance information and to verify that all information contained in the "Patient Profile Form" is accurate. Most insurance policies have a timely filing period of 60 or 90 days after which claims cannot be submitted for payment. You must insure that you have provided our office with the correct insurance information at the time of service. Any claims denied due to incorrectly provided insurance information will be your responsibility.
Returned Checks - A fee of $20.00 will be charged to your account for any/all/each returned checks. All future payments must be made by way of cash or credit card.
Outstanding Balances - All past due balances are expected to be paid in full prior to any future appointments unless you have a previously established payment plan. North Shore Pediatrics, PC will not get involved in disputes between separated or divorced parents on responsibility for payment on an outstanding balance. North Shore Pediatrics, PC expects all account to be kept in good standing and reserves the right to refuse service due to outstanding balances on account.
Cancellation Policy - We require 24-hour notice for any appointment cancellations. A fee of $25.00 will be charged to your account for any appointments that are not cancelled within a 24 hour period. Repeated cancellations or no shows for appointments could result in discharge from the practice.
Billing Statements - North Shore Pediatrics, PC mails patient account statements monthly. If you believe that there is an error on your account or if you believe that another insurance company should be responsible for payment, it is your responsibility to notify us as soon as possible. North Shore Pediatrics, PC will not be able to assist you once the "timely filing" period of your insurance company has expired.
Appointments - Appointments for physical and non-emergent routine care can be booked as much as 6 months in advance. To book an appointment of this type, please call our office in Danvers at 978-406-4234.
Appointments for Sick Visits and Emergencies can be booked on the day of service. Our telephone lines are open at 8:00 AM and the staff will be happy to arrange an appointment for your child to be seen as soon as possible. It is our goal to see all sick children on a same day basis. Our offices are also open for sick and emergency visits from 8:00 AM until 12:00 PM on Saturday and Sunday. There may be an extra charge to your insurance/account for appointments on Saturday, Sunday or Holidays.
Calls for appointments and Sick Visits after hours will be referred to our answering service and a triage nurse. In emergency situations after hours, please utilize the 911 system or report to your nearest Emergency Room.
We request that you provide our office with 24 hours notice if you need to cancel an appointment. Appointments that are not cancelled 24 hours in advance and "No-Shows," may result in you being billed a fee for the visit.
Referrals - In order to expedite your care, NSP has set up a Referral Line and Coordinator to assist you. You can reach our Referral Line at 978-777-3908.
Nurse Triage - Because we understand that you may have questions that do not need a visit, NSP has a nurse triage system where you can get advice from one of our experienced nurses. If you would like to speak to a triage nurse, please contact our office. Our nurses will let you know if they determine an appointment should be made with one of our providers.
Patient Accounts - Medical Offices and hospitals are two of only a very few business that provider services to customers without requiring payment at the time of service. For example, you cannot go to the grocery store, dry cleaners or a restaurant and leave without paying for your purchases or the service you received.
In our business, we must rely on accurate health insurance information from parents to bill insurance carriers and often that is not enough to get a claim paid. We work very hard to make sure that each claim that should be paid by an insurance carrier is paid by that carrier. However, there are times when claims are not paid by insurance, such as when a deductible is involved, or it is a non-covered service. In those cases, the parents become responsible for the bill for services and should receive an Explanation of Benefits from their insurance carrier informing them about the insurance company’s decision.
Our office sends our monthly statements to each patient with a balance on their account. We greatly appreciate your timely attention to those statements. If a balance goes unpaid for more than 90 days, the account goes into collections. For us, this means that we will not provide prescriptions or routine care until the balance is paid. While this rarely happens, and we are happy to work out payment plans when needed, there are times when we are forced to take this action since, unlike a grocery store or dry cleaners; we cannot take back the services we provided.
If you have any questions about our Patient Accounts policies, please contact Kristen or David.
Wart Treatment Information - Warts are a common complaint in the pediatric population. Most children will likely have at least one wart before they turn 18. There are several types of warts that we encounter in the office. Most people are familiar with the plantar wart, which occurs on the bottom of the foot, but warts can occur on any part of the body. There are also flat warts, known as molluscum contagiosum, which are smaller warts that often come in clusters. Lastly, there are also genital warts, which are less common.
Warts can be painful, itchy and unsightly. Many people seek treatment for warts in the office for the aforementioned reasons, as well as the fact that they can spread and are contagious. Warts are viral, thus there is no oral medication that has been guaranteed to eradicate them. We treat warts frequently in the office. Outlined below are the most frequent methods used.
- Liquid Nitrogen: also known as "freezing" or "burning." The liquid nitrogen freezes the skin and the wart in hopes of causing a blister and killing the wart.
- Cantharide: "blister beetle-juice," a liquid compound that it is painted on the wart and left on for 4 hours in hopes of causing a local chemical burn which also may lead to a blister. There is a lower strength cantharide for the body and a higher strength for the sole of the foot.
- Curettage: using a scalpel to shave off the dead skin and possible removal of the wart. This is not always an option when treating a wart; it is most often performed on plantar warts when appropriate.
There are always possible side effects when treating a wart. With the first two options, we expect a blister, but sometimes the blister is larger and more painful than anticipated. Untreated warts can cause scarring, but treatment may also cause scarring. There is also the risk of warts spreading or lack of resolution with appropriate treatment.
Treating a wart is considered a "surgical procedure" when billed to insurance and in many instances your insurance will transfer responsibility for payment to you under your deductible or co-insurance. Warts take time and money to treat. The medications that we use are expensive. We bill the same way that the dermatologist or the podiatrist bills. As there are thousands of different insurance plans, our office has no advance knowledge of what is covered by your insurance when we bill for this procedure. If you are considering wart treatment, please consult your insurance plan beforehand, as we can not be responsible for procedures that are not covered by your insurance. Your insurance plan will be the best place to consult, as our office will not be able to supply you with accurate answers to coverage questions. On average, you can expect wart treatment to result in a bill of approximately $350.00
Lastly, we are always happy to discuss over the counter options for wart treatment. As we treat warts in the office, unless otherwise directed by your physician or nurse practitioner, we do not refer to dermatology or podiatry for wart treatment.
Thank you in advance for your understanding.