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Financial and billing matters

Boston Children's Orthopaedic Surgical Foundation (COSF) bills to a wide variety of health insurance companies. Since each of these companies may have several different plans, options and coverage for each plan can vary considerably.

For this reason, we urge you to become familiar with your insurance so that you understand your plan’s rules and coverage. This will help you know whether your visits, x-ray, laboratory charges, and physical therapy will be covered.

It is important that you bring your child's insurance card with you to each appointment. This will help reduce any billing errors.


Insurance companies require that patients pay their co-pay at the time of their visit; therefore, we do not bill patients for their co-pays. We appreciate your cooperation in paying your co-pay at the time of registration. Please check your insurance card for your co-pay amount. We accept cash, check, MasterCard or VISA. ATMs are conveniently located on the first floor of the hospital. We will gladly provide you with your payment receipt during the registration process.

Waiver fee

If you do not have a referral from your primary care provider (PCP), you will be asked to sign a waiver assuming all payment responsibility for the visit. You will be asked to pay a $50 waiver deposit. If you are able to obtain a referral from your physician before noon the following business day, we are able to refund your waiver deposit. After 12:00 pm, the daily bank deposit is complete, and we are unable to refund your money until the insurance company has paid for your visit.

Insurance card

We will ask to see your insurance card (or your child's card if your company issues one in your child's name) so that we can verify that we have the correct information. Please remember to bring your card or your child's card to the office for each visit. If you change insurance companies, please contact us immediately so we may update our records.

Missed visits

If you are unable to make your appointment, we ask that you contact us to cancel at least one business day (24 hours) in advance. We have a high demand for appointments, and this will allow us to see other patients during this time.

Monthly statements

We will send you a monthly statement only if you have a balance due. Usually, this means that your insurance company has transferred the responsibility to you for either our entire charges or for part of the charges. If you do not agree with the transfer of charges to you by your insurance company, please call your company right away to resolve the situation.

What is a referral?

A referral is a form and/or code number from your child's primary care physician. It is an approval required for the office visit with most HMO insurance plans. Referrals can vary in the number of visits they cover, the length of time that visits can be used, and the services covered.

  • Verify with your insurance company that you need a referral. If you have an HMO plan, chances are that you need a referral from your child's primary care physician for the visit. If you have a PPO plan, chances are that you will not need a referral, but you should always check with your insurance plan.
  • Check with your insurance company before you begin the referral process to verify the requirements.
  • Speak with your pediatrician, referring MD or nurse practitioner about the need for a referral. Receive medical approval for that referral before you schedule the appointment.
  • When you make an appointment for your child with one of our specialists, be sure to ask for the specialist provider ID number for your specific insurance. At that time, please confirm that the specialist is a member of your health insurance network. Otherwise, you may be subject to "out of network" costs.

Billing problems and questions

  • If your child was seen in the Cerebral Palsy and Spasticity Center or the casting room, please call 617-355-3397.
  • If your child was seen by Dr. Christian Sampson, please call 617-582-1122.
  • All other billing questions, please call our billing department at 888-244-5316.