Policies

Everyone's Time is Equally Valuable.

We ask that you arrive 15 minutes before your scheduled appointment time. We understand sometimes things happen beyond your control that may cause you to be late. However, we reserve the right to ask you to reschedule if you arrive late for your appointment.

Our practice makes every effort to run on time with appointments, as we believe everyone’s time is equally valuable.

Upcoming Appointments Via Phone/Text Message/Email

Missed Appointments: Broken appointments represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you.  We request 24 hours notice for cancellation of appointments.

The third consecutive missed appointment will result in a notification to your insurance company.

Payment Policy

Philosophy 

Our staff works hard to provide the highest quality medical care for your child. We understand that medical bills are often a significant expense for families. We do our best to keep your child’s medical bills as low as possible. Our fees are determined by our costs that we must pay in order to operate a pediatric office including staff salaries, medical supplies, office supplies, insurance and maintenance.

Medicaid, Peachcare and Private Insurance 

Our office accepts Georgia Medicaid and Peachcare. We also participate in several managed care programs. Our office files all claim forms for Georgia Medicaid,  Peachcare and  for the managed care programs in which we are participating providers.

Deductible and Co-Payments

Parents are responsible for co-payments and deductibles. We do ask that copayments be made at the time of the visit so that we can keep out billing cost to a minimum.

Single Parent Families

If the child’s father is responsible for the medical bills and does not pay, then the mother should make sure that the father is aware of the bill and balance amount. If he still does not pay, then the mother can seek legal assistance from a private attorney, or Georgia Legal Services at 1-888-408-1004

Willingness to see patients regardless of ability to pay

We understand that there are sometimes circumstances which occur that make it impossible for a family to make any payment toward their medical care. If this is the case, we ask that you submit to our office in writing a brief note explaining the circumstances which make it impossible to pay for your child’s medical care.  Upon receipt of this information, we will be happy to continue to see your child for medical care.

HIPAA Privacy Rule:

Receipt of Notice of Privacy Practices

Written Acknowledgement Form

Acknowledgment of receipt of Information Practices Notice (§164.520(a))

I  ___________________, understand that as part of my healthcare, this facility originates and maintains health records describing my health history, symptoms, examination and test results, diagnosis, treatment and any plans for future care or treatment. I acknowledge that I have been provided with and understand that this facility’s Notice of Privacy Practices provides a complete description of the uses and disclosures of my health information. I understand that:

I have the right to review this facility's Notice of Privacy Practices prior to signing this acknowledgement

This facility reserves the right to change their Notice of Privacy Practices and prior to implementation of this will mail a copy of any revised notice to the address I've provided if requested.

With the creation of smartphones, tablets, micro recorders, and other video and audio recording devices which capture and store video and audio files (collectively, “Recorders™), we wanted to make you aware of our office policy on the use of these Recorders within our practice and during your visit with a provider (our “Recording

Policy”). 

Please ask the provider or any staff member if you ever have any questions about our Recording Policy.

Please understand that the basis of our Recording Policy is to protect your personal health information, and that of other patients, from being accessed by non-authorized parties. 

As a medical office, we are subject to certain state and federal privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which require us to take reasonable measures to prevent the unauthorized access of our patients’ protected health information (PHI). 

Recorders used during an office visit may result in the unauthorized recording of another patient’s PHI, intentionally or inadvertently, or you may misplace or lose your Recorder once you leave the office, providing others with access to your PHI and potentially subjecting us to fines and penalties.

Therefore, we have developed the following Recording Policy, and we ask that you carefully read and sign where indicated to signify your (i) understanding of the Recording Policy, and (ii) agreement to adhere to same.

1. While in the office lobby, administration areas, receptionist area, billing office, hallways, and other common areas of the office:

The use of all Recorders is strictly prohibited in all areas of the office unless (1) the Recorder is needed for communication purposes in accordance with the Americans with Disabilities Act (ADA), OR (2) the Recorder is needed to help the patient remember what a staff member told him/her about billing questions, follow up instructions, future appointments, etc. If the latter, we ask that the patient first ask the staff member for permission to record the interaction. Under no circumstances, however, is a patient permitted to video record in the office area unless ADA required.

2. While in a patient room communicating with a provider or clinical staff (the “Patient Room”): 

The use of all Recorders is strictly prohibited in the Patient Room unless (1) the Recorder is needed for communication purposes in accordance with the Americans with Disabilities Act (ADA), OR (2) the Recorder is needed to help the patient remember what the provider told him/her at the time of the visit. If the latter, we ask that the patient first ask the provider for permission to record the interaction. Under no circumstances, however, is a patient permitted to video record a provider visit unless ADA required.

If a provider or staff member has a reasonable belief that a patient has used a Recorder in violation of this Recording Policy, the patient will be (i) asked to turn the Recorder off, (ii) reminded of the Recording Policy, (iii) asked to delete any audio/video recordings taken within the Common Areas or Patient Room, and (iv)

potentially, be terminated from the practice.

By signing below, I am confirming that I have been able to ask questions about the Recording Policy, that all of my questions (if any) have been answered, and I agree to abide by the Recording Policy.

For your safety, Peds Care, P.C. would like to e-Prescribe you medications. "E-Prescribe" is defined as a physician's ability to electronically send an accurate, error free, and understandable prescription directly to a pharmacy from the point of care. The benefits include:

• More accurate, error-free prescriptions
• Medication history information
• Fill status notification
• Access and update vaccination information in GRITS system

By signing this consent form you are agreeing that Peds Care, P.C. can request and use your prescription medication history and your medication history from other healthcare providers and/or third-party pharmacy benefits payers for treatment purposes.

I hereby provide informed consent to Peds Care, P.C. to enroll me in the e-Prescribe program. I have had the chance to ask questions and all of my questions have been answered to my satisfaction.

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 are making you aware of these facts not to scare you or coerce you, but to emphasize the importance of vaccinating your child. We are more than willing to discuss any questions you may have about vaccines, but do require all new patients to our practice to adhere to the vaccination schedule endorsed by the American Academy of Pediatrics (AAP).

• We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives.
• We firmly believe in the safety of our vaccines.
• We firmly believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP).
• We firmly believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities.
• We firmly believe that thimerosal, a preservative that has been in vaccines for decades and remains in some vaccines, does not cause autism or other developmental disabilities.
• 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 support as parents/caregivers.

The recommended vaccines and the schedule of administration are the results of years and years of scientific study and data-gathering on millions of children by thousands of our brightest scientists and physicians.

The vaccine campaign is truly a victim of its own success. It is precisely because vaccines are so effective at preventing illness that we are even discussing whether or not they should be given. Because of vaccines, many of you have never seen a child with polio, tetanus, whooping cough, bacterial meningitis, or even chickenpox, or known a friend or family member whose child died of one of these diseases. Such success can make us complacent or even lazy about vaccinating. But such an attitude, if it becomes widespread, can only lead to tragic results.

Over the past several years, many people in Europe have chosen not to vaccinate their children with the MMR (measles, mumps, rubella) vaccine after publication of an unfounded suspicion (later retracted) that the vaccine caused autism. As a result of under-immunization, there have been small outbreaks of measles and several deaths from complications of measles in Europe over the past several years. The United States experienced a record number of measles cases during 2019, with 1282 cases from 31 states reported to CDC's National Center for Immunization and Respiratory Diseases (NCIRD). This is the greatest number of cases since measles elimination was documented in the U.S. in 2000.

Furthermore, we firmly believe that by not vaccinating your child, you are taking selfish advantage of thousands of others who do vaccinate their children, which decreases the likelihood that a child will contract one of these diseases. We feel such an attitude to be self-centered and unacceptable. Even delaying or “breaking up the vaccines” to give one or two at a time over additional visits goes against expert recommendations, is not supported by any scientific data, can lead to unnecessary delays and errors, and can put your child, other children, and adults at risk for serious illness (or even death). It is therefore against our medical advice as professionals at Peds Care, P.C.