Policy Information for New & Existing Pediatric
Center Patients

Part of our unwavering quality of pediatric medicine comes from our commitment to policies that are clear, concise and easy to follow for our patients and Doctors and Nurse Practitioners alike. While we do our best to address any questions or issues you may have, it’s possible that situations not addressed below will come up before, during or after your scheduled or walk-in appointment.

Click on the links below to learn more about our pediatric clinic policies, or please contact us today at (919) 787-9555 or online with any additional questions or comments on special needs or special health care needs:

Appointments
Financial Policies
Prescription Refills
ADHD
Asthma
Hospital Affiliations

Appointments
If your child is sick, in most situations we will see him the day you call. Please call early in the day to make acute care same-day appointments. Well child visits/sports physicals will be scheduled with your choice of provider. After school time slots are limited, so you will need to call several weeks in advance for these coveted slots. If you are more than 15 minutes late for your well visit appointment, you may be asked to reschedule. If you are late for a sick visit, you may need to wait until the next appointment slot is available since others have scheduled appointments.

Walk In Clinic
Have a long night with a sick child? Bring him/her in without an appointment at 8:25 am on any week day except Wednesday, when the walk-in clinic starts at 9:20am. This walk-in clinic is for acute problems only, such as a child with a new fever, or one who was up at night crying with an ear infection. An ongoing or more complicated problem is better evaluated during a scheduled, longer appointmentt.

Weekend and Holiday Hours:
Our pediatric clinic is open 7 days a week, 362 days a year.

We’re closed on the following holidays Thanksgiving day, Christmas day and New Year’s day.

On most other holidays we are in the office for sick visits from 9:00 am until 11:00 am. On Sundays we are open from 1:30 pm – 3:30 pm.

If you would like to be seen on a Saturday or holiday, call at 9:00 am. On Sundays, call at 1:30 pm. You can also call and leave a message before these times and we’ll call you back upon opening the office.

Financial Policies
Over the last several years medical practices such as ours have experienced a steady increase in the time our staff is required to spend on services that are not reimbursed by insurance or Medicaid. These services require a careful review of your chart and often require physician involvement. Because office charges and payments are largely determined by managed care organizations, we cannot build in adjustments to cover the time required to complete these services for you. Rather than requiring an office visit to complete these services, and causing inconvenience to our patients and parents, we have certain charges for these services. These fees will not be billed to your insurance company and will be your responsibility.

Additionally, there are many different types of insurance plans offered now. Many insurance policies have high deductibles so in order to have lower premiums we have made a few changes to account for these plans.

1. Co-payments and deductibles: Co-payments will be collected at the time of service. If you have not met your deductible, we will collect the entire cost of the visit. Because each insurance policy has a different allowable per type of office visit, we will estimate what your insurance will allow and collect that amount. If we overestimate, we will apply that amount toward your next visit or write you a refund check after all insurance has cleared. If we underestimate, you will be billed for the balance. We accept cash, check, Visa and MasterCard. There will be a $30 charge for returned checks.
2. Insurance: In order to avoid being responsible for payment in full, you will be required to present a current insurance card at each visit. We need to be the provider listed on your Carolina Access card in order to provide service to your child. If we are not listed, you are responsible for calling 855-4000 to have that changed.
3. Missed appointments: Please notify us as soon as possible if you need to cancel an appointment since someone else may want the time slot reserved for you. A $25 charge will be billed to your account for missed appointments not cancelled 24 hours in advance. We will attempt to notify you of an appointment within 48 hours of your scheduled visit but ultimately, it is your responsibility to call us to cancel if you cannot show up at your scheduled time.
4. Phone calls: We are glad to answer brief questions for you over the phone. However, when phone advice becomes extended, it often takes the place of an office visit. There will be a charge of $10-$25 for extended phone advice with an MD or PNP during office hours.
5. Prescriptions: There will be a $10 charge for calling in prescriptions that are not associated with an office visit. This does not include prescription refills for chronic problems if that problem has been addressed at an office visit within the last 6-12 months. There will be a $10 charge for prescription refills needed on the same day of the request. There will also be a $10 fee for prescription pre-authorizations.
6. Stimulant prescriptions cannot be called or faxed into drug stores, nor can we write for automatic refills. You will need to physically hand the pharmacist a written prescription.
   Most insurance companies will only pay for a 30 day supply so you will need a new prescription monthly. As a courtesy to you, we can mail these monthly prescriptions to you if you provide us with a supply of self addressed, stamped envelopes. You may also pick up prescriptions at the office, but please call at least 24 hours prior to the time you plan to pick up. We will write you a prescription in less than 24 hours, but you will be charged $10 at the time of pick up for rush services.
7. After hours phone calls: For non-emergency issues of prescriptions we ask that you please call during regular office hours, otherwise a charge of $10 may be billed to you.
8. Forms and letters: We are happy to fill out school, camp and day-care forms at the time of the well child visit. It saves us time to fill out these forms as the visit is being completed and the chart is open. Please give these forms to the nurse at the beginning of the visit. There will be a $10 charge for forms filled out at other times, payable when the form is picked up. We will, of course, be glad to issue excused absence slips at the time of the visit, but there will be a $10 charge for letters needed at other times.
9. Records: The charge for record transfer will be $10 plus 5 cents for each page. There is no charge for records faxed to specialists. Five dollars will be charged to print year-end financial summaries of payments. We issue receipts at each office visit to help you avoid this charge.
10. Billing Administration Fee: A $5 charge  will be assessed if more than one bill, for the same balance, has to be generated and sent.

We appreciate your compliance with these policies. We strive to provide excellent, cost effective medicine in an ever-changing health care environment. We are happy to discuss any questions you have about these policies.

Asthma Management Guidelines
In order to best work with you to manage your child’s asthma, we have established the following guidelines. It is important to continue close monitoring and treatment of asthma even when it is under control.
A month after the initial diagnosis of asthma, your child will need a follow-up visit for continued asthma education and to monitor symptoms and assess progress.
If your child’s asthma is being treated using only Albuterol or Xopenex, they will need to be seen yearly for assessments. If these medications are needed more than twice a week or if we feel too many refills are being needed, we will need to see your child again to decide if further treatment is needed.
If your child’s asthma is being treated using inhaled steroids or Singulair, he or she will need to be seen every six months.
Exercise-induced asthma treatment and follow-up will be based on the doctor’s discretion.

ADHD Polcies
We both diagnose and treat Attention Deficit and/or Hyperactivity Disorder. This diagnosis can be straightforward or quite complex, requiring collaboration among parents, teachers and us. At times, additional help from a pediatric psychologist is necessary.

For initial diagnosis we have questionnaires that teachers and parents need to fill out – click here to download forms. Ideally, we would like to review these before your office visit, so try to get them to us several days before your appointment.

If medications are prescribed, we see these patients in the office at least every 6 months. The main purpose is to assess your child’s response to the medication, to look for any adverse side effects, and to see if anything else needs to be done to improve your child’s quality of life (e.g., evaluation for learning disability, consultation with psychologist, etc.). In addition, the Federal Government/FDA expects close follow-up of individuals on these controlled medications and may revoke a physician’s prescribing license if scripts are written without follow-up visits.

Hospital Affiliations
We have admitting privileges at Rex Hospital and WakeMed. These are the only two hospitals in Raleigh with inpatient services for sick children. If you plan to deliver a newborn at a different hospital, there are Nurse Practitioners and neonatologists that will see your baby while you are in the hospital.