Policies

We welcome you to our practice and thank you for selecting us for your child's healthcare needs.

PHONE CALLS/APPOINTMENTS/AFTER HOURS CALLS
VACCINATION POLICY
TRAVEL IMMUNIZATIONS
NEWBORN CARE
BILLING/FINANCIAL RESPONSIBILITIES
PRESCRIPTION REFILLS
SCHOOL FORMS
RECORD TRANSFER POLICY

PHONE CALLS

In case of a life-threatening emergency or very serious accident, call 911 for immediate help. For other urgent problems during regular office hours, please notify the receptionist that it is an emergency, and your phone call will be handled promptly. Our skilled nursing staff is available from 9am to 5pm Monday through Friday, and 9am to 12pm on Saturday. If you have a sick child, please be prepared to give the nurse the following information: your child’s first and last name, date of birth, symptoms, temperature, length of illness, and primary care physician. For non-emergent advice or information, call mid to late-morning or early to mid-afternoon when our phone lines are less busy.

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APPOINTMENTS

We reserve time in our doctors’ schedules every day to accommodate sick children on the same day an appointment is needed. Your child will be scheduled with his/her primary care doctor whenever possible. To help us best accommodate you, please call as early as possible; inform the nurse if you have multiple concerns or you think you may require extra time with the physician; call ahead if you need to “add on” another child to be seen.

In general, well appointments should be scheduled 3-4 weeks in advance. If your child plays a sport through school, state law requires a yearly physical exam/well visit. Please plan ahead when scheduling a physical in the summer, as this is our busiest time of year for this type of appointment. Well appointments are always scheduled with your child’s primary doctor.

Please arrive on time for your child’s appointment. Our doctors make every effort to remain on time; arriving late not only affects the doctor’s schedule, but is inconsiderate to the patients who have appointments following yours. If you arrive more than 10 minutes late for your appointment, you may be asked to reschedule. Appointments that are 30 minutes or more in length that are missed or cancelled with less than 24 hours notice, will be charged a $20 fee.

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AFTER HOURS CALLS

Our After Hours Phone Service is provided for your benefit, however, Montgomery Pediatrics is charged a significant fee for every phone call made to TeamHealth. Recently this fee has significantly increased. Therefore, due to increasing administrative and staffing costs, any after hours calls that are received by the triage nursing service will incur a $8 fee. Calls received during regular office hours will not incur a charge. When possible, please allow our staff to help you during regular business hours.  By seeking assistance from our daytime staff who have access to your child’s medical history and records, you will help us limit the expense of the after-hours service both to you and to Montgomery Pediatrics. The TeamHealth service can be reached at 855-865-6972. Poison Control can be reached at 1-800-222-1222

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VACCINATION POLICY

As medical professionals, we feel very strongly that vaccinating children on schedule with currently available vaccines is absolutely the right thing to do for all children and young adults. We firmly believe that vaccinating children and young adults may be the single most important health-promoting intervention we perform as health care providers, and that you can perform as parents/caregivers. Because we feel so strongly about vaccinating children, we will ask you to sign an agreement that states that you are willing to vaccinate your child according to AAP guidelines and your child’s physician’s recommendations. This agreement can be found on the FORMS PAGE.

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TRAVEL IMMUNIZATIONS

If your family/child is planning a trip abroad/oversees and your child is in need of less common travel vaccines, in most cases we will refer you to a facility that routinely administers these vaccines and has them readily accessible. If you are not sure what vaccines are required, please visit CDC website (http://wwwnc.cdc.gov/travel/content/vaccinations.aspx) for information. Passport Health in Blue Ash, OH is most frequently utilized by our patients for travel vaccines. Visit their website for more information on the services and vaccines they provide (http://passporthealthusa.com/cincinnati/vaccines.html).

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NEWBORN CARE

Our physicians do not visit local hospitals to see newborns, as there are neonatologists on staff. The hospital will fax us information regarding your baby’s birth.
We generally see newborns at 1 week of age. Please call our office when you have been home for 24 hours so that we may get an update on your baby, and schedule your baby’s first appointment. It is helpful if you can add the baby to your insurance policy prior to your first visit.

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FINANCIAL RESPONSIBILITIES

  • Co-pays are the responsibility of the patient and must be paid at the time of service.  You, and our office, signed a contract with your insurance company that requires that we collect the co-pay at each visit.  Some insurance carriers will cancel your coverage if it is discovered that you are not paying your appropriate co-pay at the time of your office visits.
  • It is your responsibility to know the details and limitations of your plan, the benefits it provides, and the amount of your copayment, deductible, and coinsurance requirements.  It is your responsibility to find out before your visit if we participate with your insurance carrier, as well as to inform us immediately if there are any changes to your insurance information.  Most insurance carriers have a “filing deadline” and will deny claims not received in the allowable timeframe.  If a claim is denied because you failed to inform us of changes, you will be held responsible for the balance due on your account.
  • If your account has a balance due at the time of your scheduled appointment, you will be asked to make a payment.  Please be prepared to do so to keep your account current and avoid collection proceedings.  If you cannot make payment in full, a payment plan can be arranged.
  •  Most insurance companies no longer require a referral to see a specialist, but it is your responsibility to confirm whether or not a referral is necessary on your policy.  If a referral is needed, call our office after the appointment has been made. We ask for 48 hours notice to process referrals, with the exception of emergency room/urgent care center referrals. For your convenience, you may leave us a message on our referral line. Please be sure to leave all requested information, including your child’s full name, DOB, and the date of the appointment with the specialist.
  • We do not participate with any Medicaid carriers, including Caresource and Amerigroup.

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NON-COVERED SERVICES

Routine services, immunizations, well visits, and pre-existing diagnoses may not be covered by your insurance plan.  If your claim is denied for a non-covered service, you are financially responsible. Many insurance companies no longer cover vision and hearing services and will make the charges for these services the patient’s responsibility.

RETURNED CHECKS

Returned checks are subject to a $30 fee. Multiple returned checks warrant all future balances to be paid by cash or credit card. If the balance of a returned check is not paid before your child’s next appointment, payment will be expected at the time of your next office visit.

BILLING

  • CLAIMS FILING: We will file claims to your insurance company on your behalf. If there is any patient financial obligation as a result of your visit, you will receive a billing statement from us within 30 days. If your insurance company does not process your claim within 60 days, we will notify you and the balance of the unpaid claim will become your responsibility. It will also be your responsibility to contact the insurance company to resolve the issue of the unpaid claim. Our billing office will be happy to assist you if needed.
  • COORDINATION OF BENEFITS: Insurance companies routinely send questionnaires to their insured to confirm whether you have secondary insurance coverage. These forms must be returned, regardless of whether you have ever carried secondary coverage. If you receive such questionnaire, IT MUST BE RETURNED OR ALL FUTURE CLAIMS WILL BE DENIED. Claims denied because you failed to return the Coordination of Benefits form (“COB”) will result in you becoming financially responsible for these unpaid claims. Please call our office if you have any questions. We will be happy to assist you!
  • STATEMENTS:  Payment in full is due upon receiving your first billing statement.  If you are unable to pay in full, we ask that you contact our billing office promptly after receiving your first statement to set up a payment plan. If your account becomes 60 days past due, we may begin collection proceedings. If you fail make a payment or arrange a payment plan, your account may be sent to collections.  If your account is sent to collections, your child can no longer be seen at our office.  We will provide emergent care only for 30 days to allow you time to find another physician for your child.  Accounts forwarded to our collection agency will be reported to the credit bureau.
  • DIVORCE SITUATIONS: In cases of divorce or separation, the parent carrying the insurance coverage most often receives the statement for balances due.  A copy of the statement may be sent to the other parent if payment is not received. In situations where each parent is responsible for a portion of the bill, we do not “split” account balances. Making payment arrangements is your responsibility.
  • Payments are accepted by phone. We accept VISA, MASTERCARD, DISCOVER, and AMERICAN EXPRESS. Receipts for payments made by phone are mailed by request only.

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PRESCRIPTION REFILLS

In general, we ask for 2-3 business days to fulfill prescription refill requests. You may call our office and speak to one of our nurses to request a refill, or you may leave a message on our refill line. Please do not leave messages regarding any other issue on our refill line, as these messages are not checked frequently.

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SCHOOL FORMS

We are happy to complete school, camp, and daycare forms for your child. Please allow at least 48 hours for forms to be completed. Forms can be dropped off, faxed, or mailed. If you would like the form returned to you by mail, please include a stamped, self-addressed envelope. Health history portions of any form must be completed by the parent before a physician can sign the form. Please see the FORMS PAGE for available forms for download.

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RECORD TRANSFER POLICY

Montgomery Pediatrics provides medical care for children from birth to age 18 or graduation from high school, whichever comes last. In general, we ask for 2 weeks to complete record copying, and to help cover the cost of transferring patient records, we charge a fee. This fee is as follows:
$25 for the first child
$10 for each additional child (requested at the same time) with a maximum charge of $50
$5 postage- records are sent “Priority Mail with Delivery Confirmation” so that we can guarantee your child(ren)’s records are received. The postage fee is waived if records are picked up.
We require a written authorization to release records; this can be hand-written by the parent (include the child(ren)’s full name and DOB), or we have a Record Release Form that can be completed. See the FORMS PAGE to download and print one of our forms. Requests can be dropped off, mailed or faxed to our office. Payment for the record transfer must be received before records can be mailed, and we do accept payment by phone.

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