Parent and Patient Expectations

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.

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 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.

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.

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.

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.

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.

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.

The Pediatric Center recommends all patients get yearly Well Child Checks. Some services routinely performed at these visits may not be covered by the insurance carrier – or are left to deductible/coinsurance.

We offer these screenings because we find these evidence-based tools help us provide the best care for your child and family.

Developmental Screening  $10

Performed at all checkups 1mo to 6 yr (except the 3 mo visit).

This checklist used to assist in the early identification of developmental delays. It helps to identify developmental areas that may need extra attention and to plan intervention strategies, including referrals to qualified professionals, if required.

Autism Screening  $10

Performed at the 18 mo, 24 mo and 30 mo visits.

This questionnaire is used to identify Autism and helps to identify if a referral to Early Intervention or specialist is needed.

Maternal Postpartum Depression Screening  $10

Performed at the 1mo, 2 mo, 6 mo, and 12 mo visits.

This screening identifies mothers who may be having unusual levels of depression or anxiety following childbirth.

Vision Screening  $15

Performed annually starting at the 4 yr visit.

The eye chart is used to measure visual acuity and allows providers to detect problems early.

Vision Photo Screening  $15

This camera takes images of a child’s eyes and can estimate refractive error and determine if a child is at risk of amblyopia (lazy eye). Early detection, referral and treatment can be vision saving.

Hearing Screening  $15

Performed annually starting at the 4 yr visit.

This hand held device is used to screen for hearing loss and allows for early identification of hearing loss.

Dental Fluoride Treatment  $5

Performed every 6 mo, starting at 9 mo, based on provider assessment.

Fluoride varnish is a dental treatment that can help prevent tooth decay, slow it down, and stop it from getting worse.

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!

• Co-Payments: Co-payments are due at the time of service. If you are unable to remit your co-payment amount, the office reserves the right to reschedule your appointment for another day/time that is convenient for you. If it is determined the patient needs to be seen regardless of the ability to pay the copay, the practice will bill an additional $20.00 fee if the copay is not remitted by the end of the business day.

• High Deductible Health Plans and Prior Balances: Due to the recent increase in high deductible plans, it is now the policy of the Pediatric Center to require a $50.00 minimum payment towards any balances greater than $50 on the account. If you are unable to make the payment at the time of the scheduled appointment, we will require that you start a payment plan at the office that day for the current balance on the account. If you do not address the balance, the office reserves the right to reschedule your appointment for another day/time that is convenient for you.
  • Any remaining balances, as determined by the insurance carrier will be billed to the responsible party on the account. Balances are expected to be paid promptly, within the first 30 days of receiving your statement.

• Self-pay: Patients/parents/guardians that present at the office without health insurance will be asked to pay a deposit of $100.00 at the time services are delivered. You are very likely to have a remaining balance above the $100 payment, for which you will receive a statement. Pediatric Center expects account balances to be paid at the next appointment, or within 30 days of the bill, whichever is sooner.

• Significant Health Concerns at Well Child Visits: 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.

• Insurance Changes: It is the responsibility of the patient/parent/guardian to notify the office of any changes to your insurance, so that we can correctly file claims, and accurately determine out of pocket costs. It is expected that all information you provide on primary and secondary insurance(s) is accurate. Any missing or incorrect information could result in a bill being left to your responsibility.

• Billing: The Pediatric Center bills insurance as a courtesy to our patients. If we receive denial information from your insurance payer, you may receive a bill from our office. It is the responsibility of the patient/parent/guardian to reach out to our billing office and/or the insurance company to discuss the balance.

• Phone Calls: Any phone number provided, at which I may be contacted, I consent to receive calls or text messages, included but not restricted to communications regarding billing and payment for items and services, unless I notify the office to the contrary in writing. Calls and text messages include but are not restricted to pre-recorded messages, artificial voice messages, automatic telephone dialing devices, or other computer assisted technology, or by electronic mail, text messaging or by any other form of electronic communication for the office, affiliates, contractors, servicers, clinical providers, attorneys or its agents including collections agencies.

• Collections Activity: If the Pediatric Center does not receive prompt payment; we reserve the right to transfer your balance to outside collections after 90 days. If an account is referred to outside collections, we reserve the right to dismiss the patient from the practice. The account is subject to additional fees related to the collections activity.

• Payment Methods: 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.  Pediatric Center accepts cash, personal check, and all major credit cards.  There is a service charge for returned checks of $35.00.

• Missed Appointments/ Late Cancellations: Broken appointments represent 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 abuse of scheduled appointments may result in discharge from the practice.