Parent and Patient Expecations

APPOINTMENT SCHEDULING

At your child’s appointment, we look forward to ensuring that your child’s needs are addressed thoroughly and thoughtfully. Given time constraints, this means that we are generally able to either address “well child” concerns (such as growth, nutrition, educational progress, safety and vaccination) or “problems” (such as follow up care for chronic conditions, significant behavioral concerns, or new conditions). Please share your goals for your visit when you speak with our schedulers to ensure the proper visit type is scheduled.

 

Please be aware that if a patient is seen for both a Well Child Check and management of another significant problem (new or chronic), insurance contracts require that we charge for all services provided. This may result in an additional co-pay or charges toward your deductible as determined by your insurance company.

 

Well Child Visits (typically starting at 2 weeks of age once an infant’s lab work and weight is stable) are usually not subject to your deductible.

 

Broken appointments represents a cost to us, to you and other patients who could have been seen in the time set aside for you. Cancellations are requested 24 hours prior to the appointment. We reserve the right to charge a $25.00 fee for missed or late-cancelled appointment. Excessive cancellation of scheduled appointments may result in discharge from the practice.

 

We understand that changes to provider schedules affect families who have arranged for childcare changes or time off work to make their appointment time. We agree to limit our provider schedule changes to medical and family emergencies.

 

Patients who are late for Well Child Checks or Routine Follow Up visits will need to be rescheduled unless the provider has an open appointment. Patients who are late for Sick Appointments will be seen but will be worked into the first available provider’s schedule. Patients who are late should expect to wait. We will accommodate them as quickly as possible.

NURSE AND PROVIDER MESSAGES

The Pediatric Center will return all nurse triage calls within 4 hours, or by 10 a.m. the next day if the message is left after 4 p.m.

 

So that our physicians can focus on the patients in the office and remain on time for appointments, patient messages for physicians and nurse practitioners are directed to that provider’s nurse. Please understand that many discussions are best held in the context of an office appointment, face to face.

MEDICATION AND REFILLS

Medication refills should be directed to your pharmacy of choice. Routinely, refills for chronic conditions require office visits every 3-12 months (3 months for ADHD medications and asthma, 6-12 months for other well controlled chronic medical conditions.) For ADHD medications, patients should call the office for a paper prescription at least 3 business days prior to the medication being needed.

FORMS

The Pediatric Center can only complete forms on children with up to date Well Child Checks.

 

Forms completed at the time of Well Child Checks or at the time of a relevant medical visit will be completed free of charge to the family. Beginning November 1, 2012, forms not requested at the time of a patient’s visit for a relevant problem will be charged a fee, due at the time the forms are provided to the office. Parents must provide at least 3 full business days for The Pediatric Center to complete any standard patient forms.

 

Because of the complexity of information required for FMLA paperwork, please provide at least 7 business days for us to complete these forms. Beginning November 1, 2012, the charge for FMLA form completion will be $25, due at the time the forms are provided to the office.

 

All forms should be completed with demographic information to the best of the family’s ability to help reduce errors and misinformation. Front office staff can not accept forms when this basic information is left incomplete.

 

For patients with up to date Well Child Checks completed after the school mandated date of May 1 for the following school year, the Sports Participation form must be turned into the office with the medical screening questions completed. There will be a charge for completing these forms if not brought to the Well Child Check appointment. For patients whose Well Child Checks were completed before May 1, the schools will not allow us to use that physical exam to document readiness to participate in sports during the following school year. In those cases, we will schedule a Sports Physical exam and complete the Sports Participation form for a flat fee of $40. Since most insurances do not cover this exam if a Well Child Check has been completed during that year, the cost for this exam must be paid for up front. Some patients will require an additional appointment and examination or testing based on the results of the Sports Participation form’s screening questions . Families should submit these forms or schedule these appointments several weeks prior to try-outs to allow for this possibility. For parent and patient convenience, in order to ensure that Sports Participation forms can be completed at the time of Well Child Checks, we encourage our parents of school age children to have their Well Child Checks scheduled during the summer months.

REFERRALS

If you are enrolled in a managed care insurance plan, you must receive a referral from our office before seeing a specialist. Please call 3 business days in advance to allow us time to complete the referral. No retroactive referrals will be given.

CHILD-FRIENDLY ENVIRONMENT

We look forward to providing a child-friendly environment during your office visit. Please notify our staff if you notice anything that needs attention. We strive to provide a clean seating area, magazines, books and enjoyable videos.

 

The Pediatric Center is happy to provide family focused, child centered care. As such, rude language will not be tolerated, either in our waiting rooms or directed at our staff members. Such behavior will result in termination of the doctor-patient relationship.

TRANSITION TO ADULT MEDICAL CARE

Most of our patients stay with us through high school and into college. As pediatric providers, we are able and eager to see patients through the end of their undergraduate years and to support them as they move through that transition. After this time, we can help patients transfer to family practice or internal medicine providers.

CONSENT FOR TREATMENT

Patients may not be seen without a parent or guardian present to give consent unless they are adolescents seeking care for sexual health or mental health problems (Virginia state law grants adolescents the ability to consent for these issues) or unless they are accompanied by another adult who has written permission from a parent or guardian. Parents and guardians may also provide ongoing consent for named family members and friends to bring children and adolescents to the office. Without the proper documentation, appointments, including routine shots, will need to be rescheduled.

FINANCIAL

Payment is required at the time services are rendered unless other arrangements have been made in advance. This includes applicable coinsurance and co-payments for participating insurance companies. The Pediatric Center accepts cash, personal check, Visa and Master Card. There is a service charge for returned checks of $35.00.

 

Self pay patients are asked to pay a deposit of $100.00 at the time services are delivered.

 

We will bill your insurance company as a courtesy to you. If the insurance company denies payment to any portion of your bill for any reason you will be expected to pay the balance with in 45 days. We are not able to adjust off any portion of the balance that has been left to patient responsibility by the insurance company due to our contract with the insurance companies. Any disputes with how your insurance processed your claim must be taken up by you directly with your insurance company.

 

Patients with an outstanding balance of 90 days overdue must make arrangements of payments prior to scheduling appointments. We realize that people have financial difficulty. Therefore, we may advise that due to your financial situation you seek your child’s immunizations through a clinic or health department.

 

Patients who do not respond to mailed bills or phone calls may be sent to collections after 90 days and/or discharged from the practice. We encourage parents and guardians to call our business office to discuss payment arrangements.

FOR HIGH DEDUCTIBLE PLANS

Based on changes in health insurance policies, The Pediatric Center is requesting a down payment for all patients who have high dollar deductibles of $1000 or more.  (Your deductible is your yearly patient responsibility, the portion your insurance company requires you to pay your doctor directly.)

 

For most patients with high dollar deductibles, a typical remaining balance (after insurance has processed your claim) for your child’s sick visit is at least $70. We request patients with high dollar deductibles make this $70 down payment at the time of your visit.

 

Because we are sensitive to the costs of having a child who needs follow up care (for instance newborn weight checks or ear rechecks), we request you make a down payment of at least $35 for follow up visits.

 

If you cannot make this down payment and have a child that needs to be seen, please discuss payment options with our staff.   Our primary goal is to care for our patients and we are happy to work with families to help them meet their responsibilities to their insurance companies.

 

If your charges from your visit are more than your down payment, you’ll be billed for the remaining balance.  If your charges are less than your down payment, please notify us if you would like a refund.  Otherwise the balance will remain as a credit left on your account.

 

Well Child Visits (typically starting at 2 weeks of age once an infant’s lab work and weight is stable) are usually not subject to your deductible.

 

If your child is here for a Well Child Visit and has significant health concerns – anything that requires additional treatment – insurance companies require us list these as separate medical conditions. These may be subject to your plans deductible.   You will be billed for any remaining charges after your insurance has processed your claim.

 

We appreciate your working with us to ensure we meet the requirements set out by your insurance company.  Please let us know how we can help you!