Policies and Procedures

Appointments:

All office visits are by appointment only. We have extended office hours during the week for your convenience. On weekends, both offices are open for sick visits only. On holidays and on weekends during the summer, we are available to see sick patients at the Manhattan office.

When scheduling your appointment, please let us know the reason for the visit so that we can allow the appropriate amount of time for your child. We value your time and attempt to keep to our schedule but hospital responsibilities, emergencies, and phone calls can derail us.  We would appreciate the courtesy of your calling to cancel if you cannot keep an appointment of if you will be late.  We do require a 24 hour cancellation call to avoid a missed appointment charge.  If it is necessary to bring additional children to an appointment, please call so that we can determine the best way to accommodate your needs. Asking for additional children to be seen during a scheduled visit without having advised us ahead of time puts the physician in the uncomfortable position of either having to refuse or "run late".

We ask that you arrive at the office 10 minutes prior to your scheduled appointment. Upon arrival, please notify the receptionist if your child is ill, we do have a separate waiting are and ask that you wait there to prevent contagious diseases from children who are well.

Please keep us informed of changes in your address, health insurance, or home/work telephone numbers.

Telephone Calls:

Routine questions, appointments, billing information, requests for referrals, and prescription renewals are handled during regular office hours. Our phones are busiest between 9 AM and 10 AM. If you are calling to schedule a well visit or for non-urgent advice, it would be helpful if you placed your call later in the day. Please understand that patient care and emergencies take priority over non-urgent phone calls, but we will return your phone call as soon as possible. If you are calling from work, please give us your home number as well.  We are available for emergencies 24 hours a day, 7 days a week. In the presence of a true life-threatening emergency, call 911 to be brought to the nearest Emergency Room.

After-hours calls are made to the same office numbers but are handled by a a voicemail answering service. Please listen to the details of the outgoing message and leave a detailed message for the on call physician. There often is a large volume of calls and only when we have the appropriate information can we better serve our patients by getting back to those in greatest need first. If you have placed an after-hours call to us, please disarm any Caller-ID feature you may have on your phone or you may make it impossible for us to return your call.
When possible, please call us prior to taking you child to an emergency room or urgent care center. We can then assess whether your child's problem could be better handled in our office. We do not communicate with families by email of text.

Payments and Insurance:

We appreciate that you have entrusted us with the healthcare of your children. As a commitment to our patients and to accommodate their healthcare needs, we participate with the majority of managed care plans and at least one of our offices is open 365 days a year.

As you may be aware, the current economic downturn has resulted in employers selecting healthcare insurance policies that have increasingly transferred costs to the employee. In addition to rising copays, there are now deductibles, co-insurance charges, and also the loss of some in- network benefits. Some employers have selected policies that limit the number of well visits. Deductibles and co-insurance mean that the patient is now responsible for a portion or percentage of the covered charges.

It is cost prohibitive for us to participate in managed care and have to bill both the insurance company and you, the patient, for each visit. In order to continue our participation in managed care and accept your insurance, we are phasing out patient billing. We are requiring patients to leave a valid, open credit card with a signature on file, authorizing PEDIATRIC ASSOCIATES OF NYC to bill that card for the “patient responsibility” amount. This is clearly listed on the Explanation of Benefits (EOB) form which is sent to you by the insurer after each office visit.

Be assured that our billing department will continue to be aggressive in their attempts to collect appropriate payments from your health plan, however, the ultimate financial responsibility for your child’s health care rest with you.

Payment, including that for insurance copays and for non-covered services, is expected at the time of the visit. For your convenience, we also accept Visa, MasterCard, American Express credit cards and checks ONLY. We do not accept cash.  Your insurance plan may restrict you to specific diagnostic facilities and/or hospitals. Please become familiar with the provisions of your plan as we do not have access to that information.

We participate in many Managed Care Health Plans. For a complete list go to the "Insurance" tab at the top of the page.

Referrals:

We are proud of providing comprehensive care to our patients but there are times when it is necessary to refer to specialists for further evaluation and treatment. Many insurers, through their HMO products, create a "gatekeeper" model which requires the primary care physician to authorize referrals to specialists. We will provide referrals to physicians participating in your insurance plan after evaluating the clinical complaint. When a referral is required, we request at least 48 hours to process the request. We cannot give retroactive referrals for consultations not initially recommended by one of our pediatricians.

Laboratory Tests:

There are a number of laboratory tests ordered in conjunction with well child care, such as hemoglobin, hematocrit and lead screening. In addition, hearing and vision screening are ordered at appropriate well visits or when clinically indicated. Most childhood illnesses can be diagnosed by a complete history and thorough physical examination, but occasionally laboratory tests are necessary. The laboratory testing for the well or sick patient may be performed in our office or ordered at a commercial laboratory, as dictated by the requirements of your health insurer.

Hospitals:

Tisch Hospital of the NYU Medical Center is our principal hospital affiliation.