Medical Record / HIPAA
We document all visits and always respect your privacy. Records requested for transfer to another physician, personal use, or sent directly to you will incur a charge, which must be paid before the records are processed. To request records, a medical record release must be submitted. Turn around time is between 7 -30 days. Urgent request will incur an additional fee.
Insurance / Financial Policy
We are contracted with many insurance companies. Claims will be submitted to all insurance companies we are contracted with. In the event that the insurance carrier pends the claim while requesting information from the insured, we will provide a maximum of 30 days to resolve issues with your insurance company. If you are unable to resolve the issue, or you do not respond to your insurance carrier, then the charges will be transferred to your responsibility for payment.
Copays and a minimum of 50% of all deductibles/coinsurances are due at the time of service. If you need to arrange a payment plan, please contact our billing department prior to your visit to the office. Please be aware of your plans benefits and limitations. Although we will file many insurance carriers, you are responsible for any portion not covered by your plan. Statements are mailed monthly and payment is due upon receipt. Extended payments require contacting our billing manager. Please bring a copy of your insurance card to every visit. Payment is due at the time of service for patients without insurance. Ask us about the VFC program for immunizations. We accept cash, money orders, Visa, Mastercard, Discover, and Amex. (We may make exceptions for personal checks, however, they generally are not accepted)
All children receiving vaccines will be given an updated 3231 immunization form on the day of their visit. The office provides this 3231 form free of charge on the day that the patient receives immunizations or a Well Child Check. Any request for 3231 (immunization) or 3300 (hearing, vision, dental) forms beyond the time of service will be subject to a fee. Sports, school, medication, camp forms, and letters are all subject to a fee. Most forms require a physical exam within 6 months to 1 year. If your child has not had an exam, please schedule one before asking us to fill out the form. Due to the increased volume and enormous amount of staff time, beginning January 1, 2009 we charge a fee of $2-$40 for every form, including sports, school, camp, 3231, 3300, medication forms, utility letters and insurance forms (this list is not exhaustive). The fee is due at the time of the request. Turn around time varies by form. An additional fee up to $25.00 will be charged for all urgent requests. When completed, forms can be faxed, mailed, emailed or picked up.
Well checkups, follow-up and consultations are scheduled in advance. Sick appointments can be made the day your child is ill by calling as early as 8:00 AM. We accept sick walk-ins Monday - Friday when we can accommodate them but we suggest that you call first. For life threatening emergencies call 911. Please help us stay on time by arriving 5-10 minutes earlier than your appointment. If you are more than 15 minutes late you may be rescheduled for the next available appointment. If you need to cancel/reschedule an appointment, please be sure to call 24 hours ahead of time for one child and 48 hours for multiple children. If you do not give advance notice, it will be considered a Missed Appointment and may accrue a fee of $25.00 per missed appointment.
We often refer to a variety of talented, mostly pediatric specialists in the area for things that need specialty care. We will almost always suggest you start with an appointment with us, although at times and for certain conditions we will make suggestions by phone. It is your responsibility to check with your insurance company and with the specialist to be sure your visit will be covered. If a referral is needed, call our office and leave all the required information. Please be sure you call in advance of your appointment to allow time to process the referral. Other than for emergencies, there is a 2-3 day turn around time for referrals.
A provider is available after hours for urgent and emergent medical needs by calling the main number 770-621-0245. For calls that are not urgent, please call during regular office hours. We recommend that all parents learn CPR and keep emergency numbers handy.
We refill prescriptions during regular office hours. Call or Text 770-621-0245 with your refill information or have your pharmacy call or fax a request. Refills are completed within 48 ours, unless authorization is required. We will notify you if there are any problems. You may be asked to leave this information on voice mail of the clinical staff.
Please help us keep our office clean so each visit can be an enjoyable experience for all:
- No Food Allowed, other than breastfeeding and formula for infants
- No cell phone use in exam rooms and hallways except for emergencies
- No smoking on the premises
- Dirty diapers must be taken out of the office
THANK YOU FOR YOUR COOPERATION