Office Policies

HIPAA Notification

Our practice has implemented the Health Information Portability and Accountability Act to protect the privacy of the patient’s health information. In your absence, we will request from the person with your child some form of photo ID for comparison to your child’s patient profile that you have completed giving specific persons permission for Consent for Treatment and Patient Health information. If the person with your child is not listed on the Patient Profile, our office will be contacting you. Also, anyone other than the parent picking up prescriptions, forms, or any other information on your child will also need to present a photo ID.

Current Information

As a patient at The Carithers Pediatric Group you are required to notify our staff of any changes in your patient information, such as insurance, benefits, employer, patient name, home address, and/or contact numbers. You will be asked to present your current insurance cards at each appointment.

Payment at Time of Service: If your insurance plan requires you to pay a co-payment, it will be collected during check-in. Patients that fail to bring their co-pay on two or more occasions may be required to reschedule their non-urgent appointment. If you are a self-pay patient or your insurance information cannot be verified prior to your appointment, you will be required to pay in full at the time of service. If your insurance plan requires payment of an annual deductible and/or co-insurance (i.e. 80/20 plans), payment will be calculated and due at check out. We accept cash, personal checks, MasterCard, Visa, and American Express. Patient payment plans are also available if needed. Payment plans are available by contacting our billing office prior to your appointment. INSURANCE CARD MUST BE PRESENTED AT EACH VISIT.

Claims Filing

As a courtesy to our patients, we file claims with your insurance company. You will be responsible for timely payment of any patient balances as directed by your insurance. You will also be responsible in the event that the claim is disputed or unpaid. Our office does not file secondary insurance.

Patient Billing and Collections

Patients that receive a statement from our office are expected to remit a full payment upon receipt unless previous payment arrangements were made with our billing office. If your account must be referred to an outside collection agency for non-payment, a fee will be added to your account to cover the expense incurred from the agency. The percentage varies based on the age of the outstanding balance. Patients in the collection process must make payment arrangements prior to scheduling another appointment with our office. If you receive a billing statement that you do not understand, please contact our office for assistance so that the account can be resolved.


For patients that fail to come to their scheduled appointment and do not notify our office 24 hours in advance of the need to cancel the appointment, a missed appointment fee will be added to their account. This charge will be the patient’s responsibility; insurance companies will not pay this charge. Please notify our office if you cannot keep your appointment, so other patients in need of medical care can be seen.

Late Policy

  • Missed Physical Appointment – $75.00
  • Missed Sick Appointment – $50.00
  • Late Cancellation – $50.00

Letter/ Forms Completion

We will gladly fill out the required forms for your child at his or her well checkup at no charge. However, if you need any forms/ letter completed outside of your scheduled well-child appointment, there will be a fee per child. The Carithers Pediatric Group reserves the right to modify these charges from time to time at our discretion. If a type of form presented for completion is not included in this list, we reserve the right to apply a fee that we deem appropriate.

  • FMLA/ Disability Forms: $30.00
  • Typed Letters: $20.00
  • Shot Records- $10.00
  • College Forms- $10.00
  • Camp Forms: $10.00
  • Physical Forms: $10.00
  • Sports Forms: $10.00
  • Overseas/ Travel Forms: $10.00
  • Notarized Forms: $15.00

Immunization Policy

It is our practice’s philosophy that it is incumbent upon us as pediatricians to protect both the individual patient, as well as our patient population as a whole, from contagious disease. We advocate following the American Academy of Pediatrics’ recommendations for the immunization of children. Unimmunized children are at risk for contracting contagious diseases which can be debilitating and life-threatening. These unimmunized children may expose our patients to serious diseases such as measles, whooping cough, and bacterial meningitis. It is our office policy that parents who have concerns about immunizations be allowed to consider the benefits of immunizations. We do not recommend delaying or refusing these vaccines. Vaccines required by the state of Florida for daycare/ preschool/ school entry must be started by age 4 months. Vaccines required by the state of Florida for daycare/ preschool/ school must be completed by age 24 months (2 years old) with the exception of the 4-year-old, 5-year-old and 7th-grade immunizations, which much be completed at those appropriate ages. We do not require vaccines the state does not require, although we recommend all vaccines approved by the AAP and CDC. If you cannot comply with these standards, we will regretfully ask you to seek medical care with another physician whose philosophy better meets your needs.

Policy For Transition to Adulthood

Carithers Pediatrics is committed to helping our patients make a smooth transition from pediatric to adult health care. This process involves working with youth, beginning at ages 16 to 17, and their families to prepare for the change from a “pediatric” model of care where parents make most decisions to an “adult” model of care where youth take full responsibility for decision-making. This means that we may spend time during the visit with the teen without the parent present in order to assist them in setting health priorities and supporting them in becoming more independent with their own health care.

At age 18, youth legally become adults. We respect that many of our young adult patients choose to continue to involve their families in health care decisions. Only with the young adult’s consent will we be able to discuss any personal health information with family members. If the youth has a condition that prevents him/her from making health care decisions, we encourage parents/caregivers to consider options for supported decision-making.

We will collaborate with youth and families regarding the age for transferring to an adult provider and require that this transfer occurs by the 22nd birthday. (There may be some occasions where it is in the best interest of the patient to transfer earlier, should he/she need adult subspecialists and experts in adult medicine.) We will assist with this transfer process, including helping to identify an adult provider, sending medical records, and communicating with the adult provider about the unique needs of our patients. As always, if you have any questions or concerns, please feel free to contact us.

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