Insurance and
Billing Policies
Insurance and Billing Policies
We Accept Most Insurance Plans
Acton Medical Associates accepts health plans from most insurance carriers, including Blue Cross/Blue Shield, Harvard Pilgrim Healthcare, Medicare, Tufts HMO and Tufts Medicare Preferred.
If you have questions regarding your specific plan, please contact your insurance carrier directly or call our Registration Department at (978) 635-8735 for assistance, Monday through Friday from 8:00 am to 4:00 pm.
Patients are responsible for knowing the specifics of their insurance coverage. Acton Medical will bill your insurance carrier for your medical services. The amount a patient owes depends on their specific health insurance plan, co-payment and deductible amounts. If you have any questions, please call the number on your insurance card to learn more about your coverage.
Patients who have an HMO plan must call their insurance carrier and select Acton Medical Associates as their primary care physician (PCP) before their first visit to our practice.
Referrals
If you need specialized services not available at Acton Medical, your PCP will refer you to the appropriate specialist. If you have a managed care product (most HMO plans), an approved referral will be needed prior to your visit, or you may be financially responsible for any services rendered. If you are referred to a specialist who orders additional tests or labs, your PCP may also need to approve these services. Please allow 5-7 business days for referral processing.
Learn more about obtaining a specialist referral
Referral Department
(978) 635-8964
Monday – Friday
8:30am – 4:00pm
Acton Medical Associates partners with vendors to provide clinical services for our patients. Depending on their insurance benefits, our partners may contact patients directly and bill them for services rendered. This includes VaxCare for vaccine administration, Premier for Ultrasound services, and Quest for laboratory services.
Preventative Care Billing
In accordance with the Patient Protection and Affordable Care Act enacted in September 2010, co-payments are not collected at the time of service for physical examinations. This law benefits patients because most insurance plans are no longer allowed to charge co-payments or deductibles for preventive screenings, such as an annual physical.
Acton Medical follows national standards established for medical billing. Services which are not considered part of your annual physical exam will be billed separately to your insurance company. A co-payment or deductible may apply if, during your annual physical, your physician treats you for any problems you are experiencing, including but not limited to:
- Changes to your medication
- Multiple services or tests for a pre-existing or acute medical condition
- Diagnostic and surgical procedures
- Your insurance plan does not fall under the Patient Protection and Affordable Care Act
Coverage guidelines vary by insurance. Your insurance company will determine what services are covered under your policy and will notify us of your financial responsibility. All questions related to your benefit coverage and co-payment requirements will need to be directed to your insurance company.
Understanding Your Medicare Preventative Services Benefits – Annual Wellness Visits and Physicals
Learn about your rights and protections against Surprise Medical Billing
Questions about a statement?
Send a message through Healow any time or call Patient Accounts, at (978) 635-8432, Monday – Friday from 7:30 am to 4:00 pm.