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.
No-Shows
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
Vaccine Policy
Vaccines protect children and their families and friends from dangerous, life-threatening illnesses. Each childhood recommended vaccine has been thoroughly studied, approved and recommended by the Food and Drug Administration and Center for Disease Control. We recommend the following website to assist you as you learn about the benefits of vaccination: www.chop.edu/vaccine-education-center.
It is important for you to understand our office policy regarding vaccination as you consider our practice. We follow the AAP-recommended vaccination schedule and do not recommend any other unproven vaccination practice. Our policy is based on the HEDIS guidelines that promote maximum protection when children are most susceptible to these diseases. The standards are supported by scientists and physicians worldwide and are required by most insurance companies in an effort to save lives.
The vaccines required by our practice to remain a patient of the practice are listed below. Vaccines must be started by age 4 months. If you cannot comply with the vaccination schedule listed below, we will regretfully ask you to seek medical care with another physician whose philosophy meets your needs better.
| VACCINE | DOSE REQUIREMENTS |
|---|---|
| Hepatitis B | 3 doses by age 24 months |
| DTaP-HIB-IPV | 3 doses under age 12 months; initial dose no later than 4 months and one dose between age 12–21 months |
| Pneumococcus | 3 doses under age 12 months and one dose between age 12–21 months |
| MMR #1 | One dose by age 15 months |
| Varicella | One dose by age 18 months |
| DTaP-IPV | One dose at age 4 years |
| MMR #2 | Prior to school entry |
| Varicella #2 | Prior to school entry |
| Tdap | One dose prior to 7th grade entry |
We understand that there are times when a guardian decides against a vaccine after it has been discussed with a provider and ordered by the provider. If the vaccine has been drawn up, the providers at Carithers Group will make every effort to utilize that vaccine for another patient following all guidelines regarding safe storage and handling. If the vaccine is unable to be used, the patient will be responsible to pay for the unused, discarded vaccines. The cost of the vaccine will be shared prior to checking out.
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.
