ATTENTION:

Billing & Financial Services

Learn about our billing policies

Billing, Insurance and Payment Resources

Understanding how finances work at New England Baptist Hospital (NEBH) can ensure a smooth visit for everyone.

We provide a range of financial information and services to help you understand what to expect when it comes time to pay your bill and what options are available if you can’t.

Bill Pay

We make it easy for patients to see, manage and pay their bills. Discover our online and over-the-phone bill pay options.

Financial Assistance

As part of our mission to provide high-quality musculoskeletal services to our patients, we offer financial assistance to patients who are unable to pay for services due to their financial circumstances.

Role of Your Primary Care Physician

Your primary care physician (PCP) plays an important role managing your care. They may issue referrals and coordinate your care with your New England Baptist Hospital physician.

Be sure to let your PCP know that you are coming to New England Baptist Hospital.

Insurance Referrals

A referral is a specific instruction from your primary care physician (PCP), which directs you to a participating provider for care considered medically necessary. A referral can be issued electronically or as a paper document.

Most of the physicians at New England Baptist Hospital are considered specialists and may require a referral from your PCP.

Some referrals allow for multiple visits, some for a single visit and others for a specified time period.

Your insurance plan will have this information. As the patient, you are responsible for getting referrals when needed.

If your insurance plan is a Health Maintenance Organization (HMO), you are usually required to:

  • Select and contact/visit your primary care physician to obtain written referrals for New England Baptist Hospital physicians.
  • Bring copies of your referrals when you come to New England Baptist Hospital for your appointment.
  • Obtain referrals for all scheduled follow-up procedures and physician visits as necessary.
  • Check with your insurance carrier to make sure you understand how to manage your referrals.

If you do not have the necessary referrals when you come for your appointment, you may need to reschedule. You could also be responsible paying for your visit and/or any prescribed procedures. 

Primary & Secondary Insurance Coverage

If you are covered by more than one insurance program, we will need information about both to coordinate your benefits.

Remember to bring all of your insurance identification cards when coming for your visit.

Co-Insurance

When your insurance company pays a percentage of your medical bills and you pay the other percentage, this is known as co-insurance.

For example, your insurance may pay 80 percent and you would be responsible for the remaining 20 percent.

If you are unsure if you have co-insurance, contact your insurance company.

Managed Care Plans

Managed care plans often require you to use specific physicians, facilities and/or ancillary services.

They frequently require you to make co-payments and obtain referrals from your PCP before receiving health care services.

Co-Payments

Some insurance plans have per visit co-payments, annual deductibles, or lifetime or annual limits. Separate co-payments may be required for your doctor or professional services and for technical services such as laboratory tests, x-rays or MRIs.

If any portion of your bill is payable at the time of service, come prepared to pay with cash, check or major credit card. Co-pays are expected to be made at the time of service.

For your convenience we accept MasterCard, VISA and American Express. All costs not covered by your insurance company are your responsibility.

Preadmission Screening Visit & Rehabilitation Service

Part of our clinical excellence and patient assessment process includes a physical therapy (PT) evaluation performed during Pre-Admission Screening.

This is to assess your present mobility and will provide a base-line to establish post-surgery goals.

Please understand your insurance carrier may indicate you have a co-payment for that evaluation.

Observation Status vs. Inpatient Status

Did you know that even if you stay in a hospital overnight, you might still be considered an outpatient?

“Observation Status” is a hospital outpatient service provided to help doctors decide if the patient needs to be admitted as an inpatient or can be discharged.

A patient under observation may remain in a bed within the hospital while test results are reviewed by a physician, while still being considered an outpatient.

The decision for inpatient hospital admission is a complex medical decision based on your doctor’s judgment and your need for medically necessary hospital care.

An inpatient admission is generally appropriate when you’re expected to need two or more nights of medically necessary hospital care.

Your doctor must order admission and the hospital must formally admit you in order for you to become an inpatient.

Your hospital status (whether the hospital considers you an “inpatient” or “outpatient”) affects how much you pay for hospital services (like x-rays, drugs and lab tests).

If you have Medicare, this may also affect whether Medicare will cover care you get in a skilled nursing facility (SNF) following your hospital stay.

Please consult the Observation vs. Inpatient guidelines for your insurance plan. 

Outpatient Radiology Procedures

Some procedures performed in radiology are considered surgical procedures and billed accordingly following the payor requirements. Depending on the insurance plan, a surgical co-pay may apply.

These procedures may include steroid injection, joint injection and arthrogram. To verify, please contact customer service with your insurance carrier.

Durable Medical Equipment

When you are discharged, your provider, in consultation with your physical and/or occupational therapists, may order or recommend the use of durable medical equipment (DME), such as crutches, canes, walkers and commodes.

You have the right to obtain supplies from any durable medical equipment provider. Please contact your insurer to confirm participating durable medical equipment providers and coverage of durable medical equipment.

If you have any questions, please contact the New England Baptist Hospital Durable Medical Equipment Coordinator at 617-754-5789.

Surprise/Balance Billing Protection

At New England Baptist Hospital (NEBH), we make sure you have the financial resources you need to understand your rights and protect yourself from surprise bills.

BILH Find Help

Find free/low-cost services near you. Get help with bills, rent, buying food, transportation and more.

Patients & Visitors

Find helpful details on patient portal access and billing information about medical care for your inpatient or outpatient visit.