Office & Billing
Policies
Get to know our:
The following policies help us to provide the very best care for your family. Scroll down for records, insurance, appointments, and more!
If you have any questions or concerns about privacy, please contact our main number at 781-772-1527
Have Questions?
The Health Information Portability and Accountability Act (better known as HIPAA) protects information about your child's health and medical record. At Lower Falls Pediatrics your privacy is our priority. You and your child will be able to discuss your child's health with a physician behind closed doors. We try to keep hallways clear in order to facilitate the privacy of conversations.
Due to HIPAA laws, we are unable to fax or mail to any third party; we can only mail them to your home or they can be picked up at either office.
Paperwork with medical information cannot be faxed from our office. Completed forms with health information must be mailed to you (not faxed) or picked up in person. Email must be communicated through a secure server. We are currently using Patient Gateway for such communication.
Privacy Policy
Privacy for Minors
Trust is an essential aspect of medical care and we at Lower Falls 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 Mass 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.
For questions related to your benefits coverage and co-payments, please reach out directly to your insurance company. Our practices collaborate with many health insurance carriers and do not know what benefits you may qualify for under your particular plan.
Copayments for Preventive Visits
Payment for services is expected at the time of your child's visit. This includes co-pays, deductibles and payment in full when we are not contracted with your insurance carrier. We accept cash, check and credit card (Visa and MasterCard). The accompanying parent or other adult is responsible for full payment and providing current insurance information. You may elect to keep credit card information on file to speed the check-out process.
Payments
- Your Pediatrician needs to change your child’s medication or order tests for a pre-existing/chronic problem
- Your Pediatrician treats your child for any new problems he or she is currently experiencing.
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:
United Health Care
Tufts HMO Health Plan
Tricare
MultiPlan
Aetna
Insurance
Unicare
mass health
(with exceptions)*
FALLON (with exceptions)*
Cigna (with exceptions)*
Blue Cross/Blue Shield
Harvard Pilgrim Health Plan (with exceptions)*
Managed Care
If you are enrolled in a managed care insurance plan you must receive an authorization or referral from our office before seeing a specialist. NO retroactive referral will be given. You should allow 5 to 7 business days for the processing of authorizations/referrals. You will be notified by mail when the authorization has been approved. In general, we will not agree to a referral for a problem we have not been consulted about first.
A records release form must be completed or a signed note from the parent, with your name, complete address, the names of each patient whose records are to be released and the Practice name and complete address to whom the records are to be released. There is a fee for sending records out to a new practice.
Medical Records
We make reminder calls, as a courtesy, beginning 2 days in advance of your scheduled appointment. Regardless of whether you get this call or not, it is your responsibility to come at your scheduled appointment time. Please keep us informed of any changes to your contact information. If you change your cell phone as your primary phone number, please provide us with an alternate phone number or email address so that we may make every effort to remind you of your appointment.
Reminder Calls
We do not accept walk-ins except in cases of emergencies. If a parent walks-in for a non-emergency visit and we happen to have an available opening, we will do our best to fit you in. If you must have a specific provider who does not have an opening at that moment, or if there is no opening at all, we will schedule you in the next available spot. If you have to wait for more than 30 minutes for that scheduled spot, we ask that you leave and come back. Walk-ins can increase wait times for everyone, so please be respectful.
Walk Ins
Appointments
We provide same day sick appointments. To make certain we have a majority of our appointment slots open on any given morning, we ask that you call the day you need the appointment and not earlier. This has helped us reduce our no-show rate since some parents forget about appointments because the child is doing better. We avoid filling up our schedule days in advance so that we can ensure access for everyone when they truly need us.
Sick Appointments
Sick
Appointments
Please plan on arriving 10 minutes BEFORE you scheduled appointment so our staff may check you in and prepare your chart.
If you are unable to keep your regularly scheduled appointment, please call 24 hours prior to cancel or reschedule. Please be advised of the following no show fees for cancellation less than 24 hours prior (we will allow one cancellation within 24 hours prior to charging) or not showing for appointment:
Well visit ~ $50
Medication Follow up ~ $50
Travel Visit ~ $50
Developmental Visit ~ $200
Sick Visit ~ $50
No Show Policy
Lower Falls Pediatrics wants you to feel like family. We are committed to giving the best possible service, which includes time with your provider. A no-show is an appointment for which you do not show up. It also includes when you cancel an appointment less than 30 minutes before your scheduled time. We understand last minute problems can’t be helped, but families who no-show more than 3 times may be asked to leave the practice. Not only do your child’s needs go unmet, but a missed appointment prevents another child from being treated. We also do not overbook our schedule to accommodate no-shows. Overbooking means long-wait times and unhappy parents! We don’t overbook so we ask that you don’t no-show. Families who no-show double-well visits for siblings, will not be allowed to schedule double well appointments again. Families who no-show on Saturdays and holidays when we have shortened hours, will also not be allowed to schedule on those days again.
