Insurance and Billing Policy

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 us for assistance at (978) 635-8432, Monday – Friday from 7:30 am to 4:00 pm.

Please remember to bring your insurance card with you to every visit.

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.

For those with an HMO plan, it’s important to call your health plan before your first visit and select an Acton Medical provider as your primary care physician (PCP).

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, 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 must also approve these services. Please allow 4-5 business days for referral processing.

Adult Referral Department(978) 635-8915, Monday – Friday from 8:30 am to 5:00 pm.
Pediatric Referral Department(978) 635-8913, Monday – Friday from 8:30 am to 5:00 pm.

Billing Policy

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.

For questions regarding your statement, please call our Patient Accounts Department at
(978) 635-8432, Monday – Friday from 7:30 am to 4:00 pm.