Information For New Patients

Insurance information:

Please bring your insurance card with you to your appointment. If you have an HMO plan or a plan that requires a referral, please make sure we receive this before your appointment, otherwise, your visit is considered as if you are out-of-network.

If you don’t have medical insurance or are out of network, it’s not a problem!

We see out-of-network patients every day. We charge $350 for a typical consultation which is payable by check or credit card when you arrive.

Our practice contracts with the following insurance companies*:

Aetna*, Blue Cross Blue Shield, Harvard Pilgrim, MGB Health Plan, MassHealth MGB ACO, Medicare*, Multiplan/PCHS, Tufts, Unicare, United

BUT, each individual plan is different and some plans are very restrictive, so please call the number on the back of your insurance card to verify that we are in network – you can use the NPI numbers listed below to ensure we are in your specific network.

Boston Hernia NPI – 1407333511
Michael Reinhorn NPI – 1306837356
Nora Fullington NPI – 1306073010

 

As of April 1, 2023, we are no longer contracted with Cigna. If you have Cigna, you can pay our self pay rates for consultation and surgery, and Cigna may reimburse you if you submit these claims. The facility and anesthesia fees will likely be covered by your insurance, but the surgeon fee will no longer be covered as of April 1, 2023.

*not all providers in the practice participate with all insurance products. If you are using insurance to pay for some of your care, please let us know when you call.

 

What to expect on the day of your appointment:

  • After arrival, you will be asked to sign saying that you read our Financial Policy and HIPAA privacy notice policy – you can read these below.
  • If you have a primary care doctor outside of the MGB system, you will need to fill out a brief medical history form.
  • Your appointment is scheduled for 30 minutes. We typically run on time.
  • Most patients are first seen by one of our PAs, Kortney or Lauren, who are experts in hernia. Either Dr. Fullington or Dr. Reinhorn will then come in for an examination to confirm the diagnosis and plan.
  • In consideration of our other patients, if you are late for your appointment or require additional time, we are happy to schedule a follow up appointment to provide you the time you need.

 

Financial Policy and HIPAA Privacy Policy:

Please review the following forms. When you come in for your appointment you will be required to sign a form agreeing to our policies.

HIPAA privacy notice

Financial Policy

Please plan to arrive 15 minutes prior to your appointment to allow time for any paperwork.  

While our office is typically on schedule, on occasion, surgical emergencies or other unanticipated situations may impact your scheduled appointment time. We appreciate your understanding.

 

Please call us if you have any questions:

(617) 466-3373

 

 

Important insurance information for patients from Vermont, Maine, Rhode Island and Connecticut:

We are contracted with similar insurance plans as Newton-Wellesley Hospital with the exceptions of Cigna and Wellsense. You can find a list here. Please reference this list to check if we are within your insurance network. We also accept Medicare and MassHealth within the MGB ACO. 

If you have any questions, please call the phone number on the back of your insurance card and provide the NPI (see below) for our practice to see if your care with us will be covered. As a small private practice, we are unable to call your insurance provider on your behalf. The majority of our patients are from Massachusetts and New Hampshire where we are participating providers for more than 90% of our patients. If you live outside of MA or NH, it is your responsibility check with your insurance company before your appointment.

If we are not in your network, we would be happy to evaluate you for a 30 minute consultation. Costs for surgery can be discussed AFTER the consult, not before. Surgical fees have a large range and will depend on many factors that will be discussed at this appointment.

Boston Hernia NPI – 1407333511
Michael Reinhorn NPI – 1306837356
Nora Fullington NPI – 1306073010

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