Billing & Insurance
Billing Office: hours 9-4pm M-F
Manager: Josie Stewart 339-201-4123
We at South Shore Women's Health value our patients and want to assist in making your medical bills more manageable. We understand with the increasing medical costs it can be difficult to keep up with out of pocket expenses.
We accept monthly payments for patients with financial difficulty. Our billing staff is available to assist you in setting up a plan.
SSWH participates in most managed care plans. However, some major insurance carriers listed have independent plans that we do not participate with so be sure to check your plan details. Claims are submitted to your insurance company at the end of your visit. Your insurance is a contract between you and your insurer. All insurance co-pays are due at the time of service. All deductibles, co-insurance and payments for non-covered services will be due upon receipt of your first statement unless other arrangements have been made with the billing office. If you do not see your plan listed please feel free to call our billing department to find out if we participate.
Aetna, Blue Cross / Blue Shield, Cigna, MassHealth, Fallon Community Health Plan, BMC Healthnet Plan, First Health, Medicare, MultiPlan / PHCS, UnitedHealthCare, Tricare, Harvard Pilgrim HeathCare, Neighborhood Health Plan, Tufts Health Plan, Some Tufts Public Plans (Not all plans are accepted, please be sure to check your plan details).
Some insurance companies require a referral from your Primary Care Physician to be seen by an OB/GYN. Please check with your provider and insurance carrier before scheduling an appointment.
What is a deductible?
A deductible is a fixed amount of money you have to pay before most, if not all, of the policy's benefits can be. These services will vary with each type of plan. A deductible amount is calculated yearly, so you have to meet a new deductible for each year of the policy. Before you meet this amount, you are required to pay for health care. Once you meet this deductible, however, the health insurance benefits kick in, and you're then responsible only for paying co-payments and co-insurance if applicable.
What is a co-insurance?
Also known as cost-sharing, co-insurance is the portion of eligible expenses that plan members are responsible for paying, typically after the deductible is met. Co-insurance is usually a percentage of the provider's actual charge, or the allowed amount.
Why are there two charges (bills) for my ultrasound?
Premier Diagnostic Services is an on-site ultrasound provider and is not part of South Shore Women's Health. They and their employees are here as a convenience to our patients who otherwise would have to go to the hospital or to some other facility for their ultrasound.
Premier will bill you for conducting the ultrasound which is the technical component of the service. Questions regarding their services or bills should be directed to their billing office at 800-346-2111.
South Shore Women's Health will bill you for the physician reading and interpreting the ultrasound and explaining the results to you. This is the professional component of the service. Questions regarding their services or billing should be directed to our billing office at 339-201-4127.
Why am I getting a bill from GenPath?
GenPath is an on-site laboratory provider and is not part of South Shore Women's Health. They and their employees are here as a convenience to our patients who otherwise would have to go to the hospital or to some other facility for their lab testing.
GenPath bills separately for their services. If you have any questions regarding your billing, you should discuss it with the lab technician at SSWH or call GenPath's billing office at 800-633-4522, prompt #2.
How often will Medicare pay for a physical exam?
Medicare will cover one physical every 24 months and will include pelvic exam, a breast exam, and a PAP smear.
What is included in the Global maternity charge?
The global charge will include all routine OB office visits, the delivery charge, and post-partum visits and will be billed after delivery. Any non-routine visits, i.e., problem visits, will be billed separately as they occur.
What is a problem visit?
A problem visit is any visit that is not considered to be routine. Examples are pelvic pain, UTI, missed period, yeast infection, etc.
Annual Exam vs. Office Visit
On occasion, one appointment can meet the requirements of both an Office Visit and an Annual Exam. If this is the case, your Provider will submit a charge for both a yearly preventative physical exam and an office visit. If your Annual Exam includes consultation or treatment for an additional specific condition, your provider is legally required to report additional medical services on your bill.
How Does This Affect You?
While combining a preventative physical and an office visit will save you time by eliminating an extra appointment, it may also affect your costs. Providers must bill for your visit based on both the reason you initially scheduled the appointment and what is done during the appointment. For this reason, it's important to remember that when you see your provider for a physical, something more than a general evaluation could cost more and you may be responsible for any copay, coinsurance or deductible that applies. If you have any questions please contact our billing office or your insurance company.