We know that navigating the complexities of health insurance and billing can often be confusing and frustrating. Our support staff and case coordinators are available to answer all of your questions and help you sort through the financial matters associated with your child’s care. Here are some of the most common questions families ask:
My child has health insurance. How much do I owe?
Co-insurance, co-payments, and deductibles are determined by your insurance plan, and we strongly encourage you to contact your plan directly to gain a full understanding of what you may owe. Your case coordinators will verify your insurance and is available to assist you in determining what your out-of-pocket expenses may be.
Should I inform my insurance company that my child is going to be in the hospital?
It is always beneficial for you to contact your insurer before receiving medical services, so you understand your benefits and coverage limitations. Your case coordinators will verify your insurance and attempt to secure authorizations and referrals where necessary.
Do I need to have my insurance card or my child’s insurance card with me at the hospital or clinic?
Yes. It is very important that you bring your insurance card with you to ensure that we have accurate billing information to correctly file your claim. You will be asked to present your card each time you register.
How do I know if my insurance is accepted?
We accept most insurance plans, provided that eligibility has been confirmed and/or verified and that the services anticipated are in fact covered under your plan. In some cases, you may be subject to increased out-of-pocket expenses if Boston Children’s Hospital is considered to be an out-of-network provider or in a tiered network. You should always verify your benefits and coverage limitations directly with your insurer beforehand.
How do I know if my insurance company will cover my child’s hospital visit?
Health benefits vary with each insurance plan or employer group. Although your case coordinator will verify your benefits and seek referrals and authorization where necessary, we encourage you to call your insurer directly with questions regarding coverage for specific services.
Who is responsible for getting an authorization or pre-approval for a particular service?
Your case coordinator will make every effort to obtain an authorization from your insurer when required. If your insurance denies the authorization request, or if there are delays, we may contact you and ask you to contact your insurer directly to assist us. Otherwise you may be responsible for payment.
Will the hospital bill the insurance company for my child’s visit?
We will bill claims for services directly to your insurer, provided that we have sufficient information to do so and that your insurer has confirmed eligibility. It is very important that you provide us with all of the necessary information — prior to your appointment or admission, if possible.
Will the hospital bill both my primary and secondary insurances?
We will bill all insurers directly.
Understanding Your Bill
Will I receive an itemized statement?
Your initial statement or bill will provide a summary of charges and payments. If you require a detailed and itemized bill, you may obtain one by contacting the International Center at 1-617-355-5209 or email@example.com.
What is the difference between hospital and physician billing statements?
For each admission or outpatient service, the hospital will bill for room and board and most ancillary services, which include (but are not limited to) operating room and recovery room stays, lab work, X-rays, and other diagnostic or therapeutic services. Physicians will bill directly for their professional fees, which include (but are not limited to) office consultations, test interpretations, and surgical fees.
I made a payment, but I still received a billing statement. Why?
The statement could have been sent prior to posting of your payment, or you may have received a bill for a different service date. If you made a payment and still received a bill, please call the International Center at 1-617-355-5209. We’ll be happy to confirm your payment(s) and any remaining balance(s).
Also note that the hospital and physicians bill separately (see above). Please verify the provider name that appears on your bill and view the list of physician billing contacts if needed.
I have been contacted by a collection agency. Why did this happen and what should I do?
Before an account is placed with a collection agency, you will typically receive a minimum of three billing statements from Boston Children’s Hospital advising you of your account balance and responsibility, and you may also receive letters or phone calls from billing office personnel.
After these steps have been taken and payment or satisfactory payment arrangements have not been made, the account is then referred to a collection agency. You may resolve the account balance by contacting the agency directly. If you are unable to do so, case coordinators are available to answer your questions.
Paying Your Bill
How can I pay my balance?
We offer several payment options. You can pay your bill online. You can pay over the phone with a credit card (1-617-355-3397). Or you can pay by check or money order.
Make the check or money order payable to Boston Children’s Hospital, include your patient account number, and mail to: Boston Children’s Hospital, P.O. Box D-3053, Boston, MA 02241-3053.
Can I pay my bill online?
Yes. You can pay your bill online here. You may also update your address, insurance information, or submit a question about your bill or an upcoming service.
When do I pay my co-pay, co-insurance, or deductible?
Your out-of-pocket responsibility is due when you register. If you’re unsure of your financial liability, please refer to your insurance card, or contact your insurer directly. Case coordinators are also available to assist you in determining your costs.
What if I can’t pay my bill in full?
Your case coordinator can help you identify assistance programs that may cover your medical expenses. The coordinator can also work with you to arrange an affordable payment plan.
Online Second Opinion
What is the cost of an online second opinion?
An online second opinion from Boston Children’s costs $650. Learn more about our online second opinion process here.