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Frequently Asked Questions

What is the recommended well child exam schedule?

  • 5-10 DAYS Weight & Feeding Check, Hep B if not given at birth

  • 1 MONTH  PEDS Form

  • 2 MONTHS Pediarix (DTaP, Hep B, IPV), HIB, PCV-13, Rotateq, PEDS Form

  • 4 MONTHS Pediarix (DTaP, Hep B, IPV), HIB, PCV-13, Rotateq, PEDS Form

  • 6 MONTHS Pediarix (DTaP, Hep B, IPV), HIB, PCV-13, Rotateq. PEDS Form

  • 9 MONTHS Hep B, Hgb/Pb, PEDS Form

  • ​12 MONTHS MMR, Varivax, Hep A, PEDS Form

  • 15 MONTHS DTaP, HIB, PCV-13, PEDS Form

  • 18 MONTHS Hep A, M-CHAT Form

  • ​​24 MONTHS Hep A, Hgb/Pb, M-CHAT Form

  • 3 YEAR Hgb/Pb, Vision, PEDS Form

  • 4 YEAR Hgb/Pb (high risk), A/V, PEDS Form

  • 5 YEAR DTaP, MMR, Varivax, IPV, A/V if needed, PEDS Form

  • 6, 7, 8, 9 & 10 YEARS Catch up on Vaccines as needed, PSC Form,cholesterol

  • 11-12 YEARS TdaP, Menactra, Gardasil, PSC Form, cholesterol

  • 13 YEARS & BEYOND Catch up on Vaccines, Hgb, PSC-Y Form

  • 18 YEARS-PRE COLLEGE Menactra, PPD, A/V, Hgb , PSC-Y Form, PHQ-9, cholesterol

Individual vaccine needs or blood testing may vary from the above schedule

YEARLY FLU VACCINE IS RECOMMENDED FOR ALL CHILDREN BEGINNING AT SIX MONTHS OF AGE. 

INSURANCE COVERAGE VARIES BY POLICY, PLEASE CHECK WITH YOUR INSURANCE COMPANY TO VERIFY COVERAGE FOR ALL WELL CHILD EXAMS

How do I get a referral?

If your insurance policy requires that you obtain a referral to see a specialist, please call our main office number at 781-344-3791 and follow the prompt for our referral line.  This line is monitored Monday, Wednesday and Thursday.
           

Please note that referrals may take up to 48 hours to process; please plan accordingly.  Although your physician has referred your child to see a specialist, you must call our referral line to obtain a referral if your insurance plan requires one.

Referrals may only be completed after you have made an appointment with a specific doctor.  We cannot obtain a referral for a group, clinic or specialty.  Please have the following information available when you contact our office:

 

Child's Name and Date of Birth

Specialist's Name

Phone Number for the Physician

Date of the Appointment

Reason for the Visit

If you require an urgent referral for an appointment on a day on which our referral line is not monitored, please call our main office number at 781-344-3791 and follow the prompt for the well-child line and one of our staff members will be available to assist you.


 
Please note that most insurance companies will only back date referrals for a specific period of time.  If you fail to obtain a referral on time, you will be responsible for all charges.  Please consult your insurance company for their referral requirements.  If your insurance plan changes, do take the time to familiarize yourself with the rules of your new plan and contact our office as soon as possible to inform us of your new insurance.  Insurance referrals are specific to the insurance company. If your insurance changes after you have obtained a referral, a new referral must be issued under your new plan.

With what hospitals are you affiliated?

     If a member of your family requires hospitalization, we are affiliated with:

South Shore Hospital

55 Fogg Road
South Weymouth, MA 02190 

PH: 781-624-8000

Newton Wellesley Hospital

2014 Washington Street

Newton, MA 02462

PH: 617-243-6000

Massachusetts General Hospital

55 Fruit Street

Boston, MA 02114

PH: 617-726-2000

After the admission, please follow your insurance company requirements to reduce your risk of payment problems.

What insurance do you accept?

Tri-County Pediatrics accepts most major insurance including:

Blue Cross Blue Shield

Tufts Health Plan

Harvard Pilgrim Health Plan

United Health Care

Aetna

Cigna

Fallon Community Health Plan

Private Health Care Systems

MassHealth MGB-ACO plan only

Children's Medical Security Plan

Please check with your insurance company to verify that your child's physician is listed as a provider for your specific policy with any of these carriers.

 

Please be aware that it is your responsibility to know the details of your insurance coverage including co-pays, deductibles, and coinsurance.

Co-pays are payable at the time of the visit regardless of who brings the patient in to the office.  In the case of divorced or separated parents, we do not bill co-pays.   A receipt for payment may be obtained for your records at each visit.

Deductibles are expected to be paid within 30 days of billing.  Well Child Exams, School/Camp/Sports Forms will not be completed if the account has a balance over 60 days old.  We realize that payment of medical bills can represent a hardship for many of our families.  Please contact our billing department to set up a budget plan at 781-344-3791 if you are unable to meet your financial obligation at the the time of your child's office visit.

Tri-County Pediatrics does not bill auto insurance companies in the case of an auto accident.  Massachusetts is a no-fault automobile insurance state.  The automobile insurance company rather than the health insurance company has primary responsibility for payment for the evaluation and treatment of injuries received in an automobile accident.  If your child is seen as a result of an auto accident, the visit must be paid in full at the time of the visit.  You will then be given a statement that can be submitted by you to your auto insurance carrier.

If you child is injured at work, please contact his or her employer to obtain information as to where your child should seek medical care.  Tri-County Pediatrics is not credentialed to provide workman's compensation care.

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