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Frequently Asked Questions

Do I need to have my insurance card with me when I arrive for my appointment at Joslin?

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 check-in for your appointment.

How do I know if my insurance is accepted?

Joslin Diabetes Center accepts most insurance plans. However, please review our current list of insurances. In some cases, we are considered out-of-network or in a tiered network and you may be subjected to increased out of pocket expenses. Please verify your benefits and coverage limitations directly with your insurance beforehand.

What does “in-network” and “out-of-network” mean, and how does it apply to me?

In Network

This means that your insurance company has contracted a negotiated rate, with a wide range of doctors, hospitals, labs, pharmacies and other providers, for your health care services. These providers have agreed to accept the contracted rate as payment in full – that rate includes both your insurer’s share and your share of the cost. Your share may include a co-payment, a co-insurance and/or a deductible.

Out of Network

Providers who have not agreed to a contracted rate are considered “out of network”. If you are seen or receive services from an out of network provider your portion of the cost of your care will be higher.Also a provider maybe part of the Network, but out of your Network area

Please contact your insurance company directly to confirm if Joslin Diabetes Center is part of your network. If you are scheduled for an eye appointment, please also confirm your coverage for Mass Eye and Ear services.

What is the difference between an HMO and PPO?

HMO

If you are enrolled in an HMO (Health Maintenance Organization) you will need to select a primary care physician (PCP) and receive most or all of your services from a network provider. If you need to see a specialist or receive specialist services, that provider must also be in your HMO network, AND, your PCP will need to provide you with a referral for that specialist service.

If you do not obtain a referral or if you choose to see a doctor outside of your network, you will be responsible for most or all of the cost of your care.

PPO

A PPO (Preferred Provider Organization) contracts with a network of “preferred” providers from which you can choose. This type of plan does not require a PCP and you do not need to obtain referrals to see other providers in the network.

If your care is from a provider within the preferred network you will only be responsible for your deductible and copayments. If you receive services from a provider that is not in the “preferred” network – which is commonly known as going “out of network” – you will be responsible for a higher balance.

When do I pay my co-pay, co-insurance, or deductible?

Your co-pay is due when you check-in. If you are unsure of your financial liability, please refer to your insurance card, or contact your insurance directly. Our Patient Financial Counselors are also available to assist you in determining your cost.

How do I pay my bill?

Bills can either be paid by phone or mail:

Pay by Phone The phone number for the billing department is 617-309-5725. Please have your credit card information available when you call.

Pay by Mail Make the check, money order, or credit card payable to Joslin Clinic and include your patient account number. Mail to:

Joslin Diabetes Center
PO Box 414633
Boston, MA 02241

What if I can’t pay my bill in full and need financial assistance?

Joslin has financial counselors available to assist you with applying for Local, State or Federal programs, as well as working with you to establish affordable payment plans or applying for Joslin free care. Please call 617-309-5725 to discuss your options.

What are the billing department office hours?

The billing office is open 8:30am-5:00p.m., Monday through Friday.

Will you bill my primary, secondary and tertiary insurances?

We will bill all insurances directly. Please inform us of any changes to your insurance coverage by calling our Centralized Appointments Office at 617-309-2440 for your next visit or Patient Accounts office at 617-309-5725 for any current charges.

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, please contact our billing office at 617-309-5725.

I recently was seen in the eye clinic and received two bills. What is the difference between the MEEI and BEI billing statements?

The Beetham Eye Institute (BEI) ophthalmologists have recently become affiliated with Massachusetts Eye and Ear Infirmary (MEEI), which is a licensed hospital. As a result of this affiliation, the ophthalmology practice at One Joslin Place is now designated as a Mass. Eye and Ear hospital outpatient site.

When a patient is treated in a hospital outpatient site, the patient receives two separate bills – one bill for the physician services and another for the technical/facility charge.


If you would like to learn more about the MEEI/BEI affiliation, please click here.

To review the MEEI/BEI billing brochure, please click here.

I have been contacted by a collection agency. Why was this done and what should I do?


Before your account is placed with our collection agency, you will receive four billing statements from Joslin Diabetes Center. These statements will advise you of your account balance and payment responsibility. Our patient financial counselors will also attempt to reach you by phone before sending the account to collections. After this has been done and the account remains unpaid, the bill will be forwarded to our collection agency for further action.

Who is responsible for getting an authorization or referral for a particular service?

You are responsible for obtaining all necessary pre-authorizations or referrals prior to your appointment. We will call you using the phone number on your account to inform you if these are needed.

Please note that patients who are covered by Fallon, BMC HealthNet, and Celtic Care who do not have a referral or pre-authorization in place at least 2 days before their appointment will need to reschedule their appointment. Once pre-authorization is in place an appointment can then be scheduled.

What if I need a referral but don’t have it by the day of my visit?

If you need a referral and we have not received it yet, you will be asked to sign a waiver during the check-in process which states that you assume financial responsibility for the cost of the visit in the event that you are unable to obtain a referral. It is your responsibility to contact your primary care physician and have him/her fax the referral to fax# 617-309-2444.

Page last updated: April 17, 2014