Our Policies
North Shore Pediatrics, PC participates with most insurance plans and we are always adding new plans that we accept. With the on-going name changes and mergers of insurance companies, it is more important than ever to make sure we accept your insurance. While we are always happy to answer any questions, we have listed below all of the insurance carriers we currently accept. It is your responsibility to insure that you have active health insurance and that one of our pediatricians is listed as your Primary Care Physician (for those plans that require you to have a PCP).
- “Self Pay” patients are responsible for payment of all charges at the time of service. We may require you to post a deposit on your account prior to being seen by a provider. All accounts must be settled before any future appointments will be scheduled. North Shore Pediatrics, PC accepts cash, checks, credit cards and money orders.
- Co-Payments are due at the time of service. Failure to pay your co-payment at the time of service will result in an additional $20.00 charge to your account.
- Payment Plans are only available in extreme financial hardship. North Shore Pediatrics PC requires a 50% down payment on all payment plans and then 4 equal monthly installment payments for the balance. Payment plans are offered at the sole discretion of North Shore Pediatrics, PC and may require you to provide financial data to prove financial hardship. Failure to meet all requirements and payment deadlines in a payment plan will result in the balance being due, in full, immediately and we will not allow any future appointments until the balance is paid in full.
Insurance is a contract between you and your insurance company. We are not a party to this contract. We file insurance claims on behalf of our patients. We will not become involved in disputes between you and your insurance company regarding deductibles, co-payments, covered charges, secondary insurance, “usual and customary” charges, etc. other than to supply factual information as necessary. You are responsible for the timely payment of your portion of your account with North Shore Pediatrics, PC.
Certain services and procedures provided by North Shore Pediatrics, PC (such as wart treatment, for example) may be your responsibility through your deductible. There is no way for North Shore Pediatrics, PC to know what services and procedures your particular policy covers until we file the claim and receive a response from your insurance company.It is your responsibility to know what services and procedures are covered under your policy and which services and procedure may be applied to your deductible. Any questions on whether a particular service or procedure will be covered or applied to your deductible should be directed to your insurance carrier prior to your visit in our office. We are unable to answer these questions for you.
It is your responsibility to provide timely and correct insurance information and to verify that all information contained in the “Patient Profile Form” is accurate. Most insurance policies have a timely filing period of 60 or 90 days after which claims cannot be submitted for payment. You must insure that you have provided our office with the correct insurance information at the time of service. Any claims denied due to incorrectly provided insurance information will be your responsibility.
A fee of $20.00 will be charged to your account for any/all/each returned checks. All future payments must be made by way of cash or credit card. Outstanding Balances – All past due balances are expected to be paid in full prior to any future appointments unless you have a previously established payment plan. North Shore Pediatrics, PC will not get involved in disputes between separated or divorced parents on responsibility for payment on an outstanding balance. North Shore Pediatrics, PC expects all account to be kept in good standing and reserves the right to refuse service due to outstanding balances on account.
We require 24-hour notice for any appointment cancellations. A fee of $25.00 will be charged to your account for any appointments that are not cancelled within a 24 hour period. Repeated cancellations or no shows for appointments could result in discharge from the practice.
North Shore Pediatrics, PC mails patient account statements monthly. If you believe that there is an error on your account or if you believe that another insurance company should be responsible for payment, it is your responsibility to notify us as soon as possible. North Shore Pediatrics, PC will not be able to assist you once the “timely filing” period of your insurance company has expired.
Appointments for physicals and non-emergency care can be booked as much as 6 months in advance. To book an appointment of this type, please call our office in Danvers at 978-406-4234.
Appointments for sick visits are scheduled on the day of service. Our phone lines open at 8:00 AM, and our staff will be happy to arrange an appointment for your child as soon as possible. We strive to see all sick children on the same day. Our offices are also open for urgent care starting at 8:00 AM on Saturdays and Sundays. On weekends and holidays, we ask that you call as soon as we open to speak with a triage nurse. They will assess whether an appointment is needed or if at-home management is appropriate. Please note that there may be an additional charge to your insurance for appointments on Saturdays, Sundays, or holidays.
Calls for appointments and sick visits after hours will be referred to our answering service and a triage nurse. In emergency situations after hours, please utilize the 911 system or report to your nearest Emergency Room.
We request that you provide our office with 24 hours notice if you need to cancel an appointment. Appointments that are not cancelled 24 hours in advance and “No-Shows,” may result in you being billed a fee for the visit.
In order to expedite your care, NSP has set up a referral line and coordinator to assist you. You can reach our referral line at 978-777-3908.
Because we understand that you may have questions that do not need a visit, North Shore Pediatrics has a nurse triage system where you can get advice from one of our experienced nurses. If you would like to speak to a triage nurse, please contact our office.
Medical offices and hospitals are unique businesses that provide services to patients without requiring payment at the time of service. In our practice, we rely on accurate health insurance information from parents to bill insurance carriers, but this is often not sufficient to ensure timely claim payments. We work diligently to make sure that each claim is submitted correctly and that the insurance carrier fulfills its obligations. However, there are instances when claims are not paid by insurance. This can happen when a deductible applies or if the service is not covered by the policy. In such cases, the financial responsibility for the bill falls to the parents. They will receive an Explanation of Benefits from their insurance carrier, which outlines the insurance company’s decision.
Our office sends monthly statements to each patient with a balance on their account. We greatly appreciate your prompt attention to these statements. If a balance remains unpaid for more than 90 days, it will be sent to collections. This means that we will not be able to provide prescriptions or routine care until the balance is settled. While this situation is rare, we are willing to work out payment plans when necessary; however, we sometimes have to take this action.
If you have any questions about our patient account policies, please feel free to contact Takara.
To provide the best care for our patient population, North Shore Pediatrics, PC, offers 24/7 support to patients and their families through telephone triage.
During regular business hours, our telephone triage is managed by in-office nurses. You should receive a return call from one of our nurses within one hour of contacting us. However, during periods of high call volume, it may take longer than an hour to return your call. There is no charge for calling our office and speaking with a triage nurse.
After regular business hours, our telephone triage is handled by Night Nurse Pediatric Triage. To speak with the after-hours triage service, please call our office number, and you will be automatically routed through the answering service, which will forward your message to the triage service. You should receive a return call within one hour, except in times of high call volume. The triage service is supported by a North Shore Pediatrics physician who is on call for the evening. There is never any charge for calling and speaking to the after-hours triage service.
If you wish to speak with a physician or nurse practitioner, please call our office and leave a message for the specific provider you would like to talk with. You will receive a callback within 72 hours, except during times of extreme call volume. North Shore Pediatrics bills your insurance carrier for calls with physicians or nurse practitioners. Your insurance may transfer responsibility for payment to you as part of your copayment, deductible, or coinsurance. Calls made after hours to the on-call physician may also result in a bill being submitted to your insurance carrier. For the most accurate information regarding your financial responsibility under your insurance plan, please consult your Summary of Benefits or contact your insurance carrier using the number on your insurance card.
As always, if you have a medical emergency, please dial 911.
North Shore Pediatrics, PC, remains neutral in all divorce and separation disputes. Our primary responsibility is to provide quality pediatric care to our patients. We assume that children are in joint custody of their parents and that both parents have the right to access their child’s medical records and make medical decisions, unless we receive court documents stating otherwise. The parent accompanying the child to a visit will be considered to have the authority to make medical decisions on behalf of the child. We will not be responsible for informing the non-accompanying parent about the details of the visit.
Parents are expected to establish a communication system that does not require mediation by our office. All our communications will be directed to the parents; we will not engage with lawyers involved in custody disputes unless mandated by court order.
We are contractually obligated to collect a copay at the time of service. The person accompanying the child to the office is expected to pay this copay during the visit. In some cases, a child’s health insurance may be provided by a non-custodial parent. Because our provider-patient relationship is with the parent who is present, the ultimate responsibility for payment remains with the adult who brings the child to the office.
We reserve the right to ask families to leave our practice if a custody dispute interferes with our ability to provide care for a child or conduct our daily operations.
As a recipient of Federal assistance, including Mass Health, North Shore Pediatrics, PC does not exclude, deny benefits to, or otherwise discriminate against any person on the grounds of race, color, national origin, disability, age, sex, sexual orientation, gender identity, religion or creed in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, and in staff and employee assignments to patients, whether carried out by North Shore Pediatrics, PC directly or through a contractor or any other entity with which North Shore Pediatrics, PC arranges to carry out its programs and activities.
This statement is in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (nondiscrimination on the basis of race, color, national origin), Section 504 of the Rehabilitation Act of 1973 (nondiscrimination on the basis of disability), the Age Discrimination Act of 1975 (nondiscrimination on the basis of age), regulations of the U.S. Department of Health and Human Services issued pursuant to these three statues at Title 45 Code of Federal Regulations Parts 80, 84, and 91.
Additionally, in accordance with Section 1557 of the Patient Protection and Affordable Care Act of 2010, 42 U.S.C 18116, North Shore Pediatrics, PC does not exclude, deny benefits to, or otherwise discriminate against any person on the ground of sex (including gender identity) in admission to, participation in, or receipt of the services and benefits under any of its health programs and activities, and in staff and employee assignments, whether carried out by North Shore Pediatrics, PC directly or through a contractor or any other entity with which North Shore Pediatrics, PC arranges to carry out its programs and activities.
In case of questions, please contact:
North Shore Pediatrics, PC
480 Maple Street, Suite 3A
Danvers, MA 01923
Contact Person/Section 504 Coordinator: David L. Smith
Telephone: 978–406–4234
Whenever possible, North Shore Pediatrics, PC strives to resolve patient questions or concerns quickly and informally. If this is not possible, patients have the right to file a formal grievance. Since physicians and staff members are usually the first points of contact for patients, all employees at North Shore Pediatrics, PC are familiar with the organization’s grievance procedures.
The following is the formal process for addressing or resolving grievances. All grievances are reviewed by the Practice Administrator, Nurse Manager, Billing Manager, and/or the physician partners at North Shore Pediatrics, PC.
All grievances should be directed to the Practice Administrator at:
North Shore Pediatrics, PC
480 Maple Street, Suite 3A
Danvers, MA 01923
Attention: David L. Smith
Each grievance will be investigated by management members who are most knowledgeable about the area of concern. For instance, a complaint regarding quality of care will be reviewed by the Practice Administrator, Nurse Manager, and a physician partner. A complaint related to billing issues will engage the Practice Manager, Billing Manager, and a physician partner. Regardless of the nature of the complaint, the responsible managers will investigate and provide a written notice of the practice’s decision within 14 days of receiving the grievance.
If a patient is not satisfied with the response provided by the investigating manager, they may request a review of the complaint and its response by the Physician Partners at North Shore Pediatrics, PC. This request should be sent to:
North Shore Pediatrics, PC
480 Maple Street, Suite 3A
Danvers, MA 01923
The Physician Partners will investigate the escalated complaint and provide a written notice of the practice’s decision within 14 days.
To ensure a thorough investigation of any complaints, please provide the essential facts related to the issue. Specify which health plan services were not received, what was wrong with the service provided, and any billing issues. Be sure to include details such as who was involved, what occurred, when and where it happened, and how it unfolded. Please attach any supporting documentation relevant to your complaint.
Below is the Standard Fee Schedule for North Shore Pediatrics, PC. Because our entire fee schedule is over 280 pages with close to 20,000 procedure codes, many of which will never be performed in our office, we have listed below the most common procedures performed in our office. Should you wish to see the entire list, or have a question about a specific code not on the below list, please feel free to ask us and we will be more than happy to provide you with that information. We are also happy to provide you with a good faith estimate of the cost of your visit prior to your appointment. Please feel free to contact us at 978-406-4234 and ask for Billing.
Warts are a common complaint in the pediatric population. Most children will likely have at least one wart before they turn 18. There are several types of warts that we encounter in the office. Most people are familiar with the plantar wart, which occurs on the bottom of the foot, but warts can occur on any part of the body. There are also flat warts, known as molluscum contagiosum, which are smaller warts that often come in clusters. Lastly, there are also genital warts, which are less common.
Warts can be painful, itchy and unsightly. Many people seek treatment for warts in the office for the aforementioned reasons, as well as the fact that they can spread and are contagious. Warts are viral, thus there is no oral medication that has been guaranteed to eradicate them. We treat warts frequently in the office. Outlined below are the most frequent methods used.
- Liquid Nitrogen: also known as “freezing” or “burning.” The liquid nitrogen freezes the skin and the wart in hopes of causing a blister and killing the wart.
- Cantharide: “blister beetle-juice,” a liquid compound that it is painted on the wart and left on for 4 hours in hopes of causing a local chemical burn which also may lead to a blister. There is a lower strength cantharide for the body and a higher strength for the sole of the foot.
- Curettage: using a scalpel to shave off the dead skin and possible removal of the wart. This is not always an option when treating a wart; it is most often performed on plantar warts when appropriate.
There are always possible side effects when treating a wart. With the first two options, we expect a blister, but sometimes the blister is larger and more painful than anticipated. Untreated warts can cause scarring, but treatment may also cause scarring. There is also the risk of warts spreading or lack of resolution with appropriate treatment.
Treating a wart is considered a “surgical procedure” when billed to insurance and in many instances your insurance will transfer responsibility for payment to you under your deductible or co-insurance. Warts take time and money to treat. The medications that we use are expensive. We bill the same way that the dermatologist or the podiatrist bills. As there are thousands of different insurance plans, our office has no advance knowledge of what is covered by your insurance when we bill for this procedure. If you are considering wart treatment, please consult your insurance plan beforehand, as we can not be responsible for procedures that are not covered by your insurance. Your insurance plan will be the best place to consult, as our office will not be able to supply you with accurate answers to coverage questions. On average, you can expect wart treatment to result in a bill of approximately $350.00 You will be asked to sign a waiver in the office stating you understand that insurance may not cover the wart treatment. You can download and sign this waiver ahead of time here.
Lastly, we are always happy to discuss over the counter options for wart treatment. As we treat warts in the office, unless otherwise directed by your physician or nurse practitioner, we do not refer to dermatology or podiatry for wart treatment.
Thank you in advance for your understanding.
There are waivers due to different insurance plans for the following, all of which may be downloaded, printed and signed prior to your appointment. Feel free to check with your insurance coverage before coming:
Once our patients turn 18 years of age they are asked to read and sign a waiver form about their medical record. The patient can choose (or not) to give permission for each of the following:
- Allow a parent or caregiver to schedule or cancel appointments
- Allow a parent to speak to a triage nurse
- Give a parent access to ALL medical records including lab results, notes, discussions with their care providers
- Deny all access to medical records
Click here to view and print a copy of this waiver before your appointment.
Immunizations are a vital component of well-child care. At North Shore Pediatrics, we strongly believe in the effectiveness of vaccines for preventing serious illnesses and saving lives. We are confident in the safety of our vaccines and require that all children and young adults receive all recommended vaccinations, in accordance with the guidelines set by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP). Choosing not to vaccinate poses risks to our other patients, our staff, and the broader community. Based on our experiences with patients and families, if you are entirely opposed to routine immunizations or significantly disagree with our vaccination policy as outlined above, it may be challenging for us to establish a positive and productive relationship with you and your family. Our Vaccination Policy is as follows:
North Shore Pediatrics, PC Vaccination Policy 2025
North Shore Pediatrics, PC strictly adheres to our vaccine policy.
We reserve the right to make our office a vaccine preventable disease-free space to help maintain the health and safety of our staff and immunocompromised patients.
The only vaccines North Shore Pediatrics, PC will allow a family to decline, although we will still highly recommend, is the Rotavirus vaccine, Hepatitis A vaccine, Human Papilloma Virus vaccine, Influenza vaccine, Covid-19, and RSV vaccine.
All childhood immunizations must start by the age of 2 months (8 weeks), no later. If the below vaccines are not administered within the timeline set forth by North Shore Pediatrics, PC we reserve the right to discharge your family from our care.
Vaccines will be given as below in our office as a patient of North Shore Pediatrics, PC
Hepatitis B#1 will be given at birth in the Hospital
2 Month Physical: Vaxelis#1, PCV20#1, Rotavirus#1
4 Month Physical: Vaxelis#2, PCV20#2, Rotavirus#2
6 Month Physical: Vaxelis#3, PCV20#3
9 Month Physical: No regularly scheduled vaccines
12 Month Physical: PCV20#4, HepA#1, Lead and Hemoglobin Check (May also get MMRV vaccine or wait until 15-16mo physical)
15-16 Month Physical: MMRV vaccine
18-20 Month Physical: Pentacel Vaccine, HepA#2
2 Year Physical: Lead and Hemoglobin Check
3 Year Physical: Lead and Hemoglobin Check
4 Year Physical: Kinrix, MMRV #2
5 Year Physical: Vision and Hearing Exam, No regularly scheduled vaccines
11 Year Physical: TDaP#1, MCV4#1 (Meningitis A,C,W,Y), HPV #1 (6-12mo later HPV#2)
16 Year Physical: MCV4#2 (Meningitis A,C,W,Y)
17 or 18 Year Physical: Meningitis B #1. 4 weeks later Meningitis B#2.
Vaxelis= DTaP, HepB, HIB, IPV
Pentacel= DTaP, HIB, IPV
MMRV= Measles, Mumps, Rubella, Varicella
Kinrix= DTaP, IPV
PCV20= Pneumococcal conjugate 20-valent
Please note, we are unable to separate some, and it is not advised to separate combination vaccines.
Please note, we do not provide religious exemption.