Practice Policies

PRIVACY POLICY

The Health Insurance Portability and Accountability Act (better known as HIPAA) protects information about your child's health and medical record. At Pediatric Professional Associates, PC your privacy is our priority. You and your child will be able to discuss your child's health with a physician behind closed doors.

Please see our HIPAA form for more descriptive details under the “FORMS” tab.

 

PRIVACY FOR MINORS

Trust is an essential aspect of medical care and we at Pediatric Professional Associates, PC seek trust in all of our health care encounters. Parents and their children are both entitled to this trust. One way that physicians maintain trust is by keeping communications with patients and their families confidential.

Under Mass law, however, adolescents who are 12-17 years of age have special statutory rights that entitle them to confidential communications with their physicians. This means that they can discuss things with physicians they do not wish to tell their parents or other adults, and the physician is required to keep those things confidential. The only exception to this right of confidentiality is when the physician determines that the adolescent is in danger of hurting himself or herself, hurting other people, or being hurt by someone else.

                            

 APPOINTMENTS

We schedule appointments in a way so that your child can be examined, treated and leave in a timely manner.  Although this cannot always be done, we strive to accomplish this and we have several policies in place in an effort to accommodate your family’s needs:

  1.  Appointment Tardiness:  Parents who are 15-20 minutes late for their appointment will be rescheduled.  We will make every effort to reschedule your appointment as soon as possible, but it is important to keep in mind that some well-visit time slots can be filled as far as 2 months out.  Also, to avoid delaying your child’s vaccines, we may need to you back on the schedule as soon as possible.  This means you may not get the provider or time you prefer, this is the importance of being on time.
  2. Sibling Add Ons:  If you arrive with your child for a visit and need to add on a sibling, we count that as a walk-in.  If we do not have the space to accommodate a walk-in, we will ask that you schedule the sibling at a later time that day.  All we ask is for a phone call ahead of time to let us know. 
  3. Walk-Ins:  We do not accept walk-ins.  If a parent walks-in for a non-emergency visit and we happen to have an available opening, we will do our best to fit you in.  If we do not have an opening, you will be asked to return when there is availability.
  4. Saturday/Sunday Appointments:  We have weekend hours available for acute, same day sick.  Please call us when the office opens at 8:00 am to schedule your sick child.

 

Immunizations

The providers of Pediatric Professional Associates, PC firmly believe in the safety and effectiveness of vaccines to prevent serious illness and to save lives. We believe that all children and adolescents should receive the recommended vaccines on time and accordance with the schedule published by the CDC and the American Academy of Pediatrics. To ensure the best care and to protect all patients from vaccine-preventable illnesses, we require full immunizations, on time for children seen in our office. New patients who are not up-to-date on their immunizations will be provided with a schedule to get the vaccinations caught up, as part of our care.

 

CANCELLATION/NO SHOW POLICY

Thank you for trusting your child/children’s medical care to Pediatric Professional Associates.  When you schedule an appointment with Pediatric Professional Associates we set aside enough time to provide you with the highest quality care.  Should you need to cancel or reschedule an appointment please contact our office as soon as possible.  This gives us time to schedule other patients who may be waiting for an appointment.  Please see our Appointment Cancellation/No Show Policy below:

  • Any established patient who fails to show for an appointment and has not contacted our office prior to the appointment will be considered a no show and charged a $50 fee
  • If there are 3 no show occurrences the patient may be dismissed from Pediatric Professional Associates.
  • Any new patient who fails to show for their initial visit will not be rescheduled.
  • The no show fee is charged to the patients account and is due at the time of the patient’s next office visit.
  • As a courtesy we send emails and text messages with appointment reminders.  If you do not receive a reminder message the above policy will remain in effect.

We understand that there may be times when an unforeseen emergency occurs and you may not be able to keep your scheduled appointment.  If you should experience extenuating circumstances please contact our office.  You may contact Pediatric Professional Associates 24 hours a day 7 days a week at 978-683-1974.  Should it be after regular business hours or a weekend you may leave a message with our answering service.  Messages left with our office or the answering service prior to the appointment time are acceptable.

 

REFILLS

If you child needs a prescription refill, we ask that you call up to 2-3 days before he/she will run out.  This will allow us time to promptly get your request off to the pharmacy so that you will have it on time.

Children taking chronic medication may require an office visit every few months for continued prescriptions to be filled.

 

FORMS

We currently do not charge for the following forms.  However, we do require that your account be in good standing with us.

  1. Immunization Records:  We require 24 hours’ notice to prepare copy of your child’s immunizations.  We do not mail/email these records.  They must be picked up by hand at our office.  If you need it to be faxed, a signed release of information must be sent to us ahead of time.  If you child is at our office, we will be able to provide this for you while you are in the office.
  2. Sports/Camp Forms:  Please bring your sports or camp forms with you to your well visit.  The provider will fill it out for you at that time.  However, if you are bringing us the form after your child was seen, we will have your form completed within 5 business days, provided the well visit was completed within the last 12 months.
  3. School Notes/Excuse:  We will be happy to provide you with a school/work note if your child was seen at our office or if you called and consulted about their illness.  We cannot provide excuses for dates we did not see or speak to you about his/her illness.

 

Medical Records

Your medical records are strictly confidential. The Health Insurance Portability and Accountability Act (HIPAA) restricts us from releasing any information without your written permission. There may be times when you may need to request a copy of your medical records or should you transfer out of our practice. Legally we have 30 days after we receive written authorization from the patient to release the records.  However, we do our best to get these ready for you within 10 business days. We incur an expense to provide you with this service and that cost is $25.00 for the 1st record and any siblings will be $5.00 to add on to the request.  Payment will be expected before the Medical records can be released.

 

FINANCIAL POLICY

 

The following information explains our Financial Policy. A copy of this policy will be provided to you upon request.

1. Insurance: We participate in most insurance plans and are happy to file your insurance as long as we are provided with a copy of your card along with accurate information. It is very important to verify your insurance information at each visit. Any remaining balance after insurance pays will be billed to you and is due within 30 days of the statement.

2. Copayments: All co-payments must be paid at the time of service. This arrangement is part of your contract with your insurance company.  Making your copayment at the time of service will ensure that you meet your contractual obligation. It is also our obligation through our contract with the insurance company to collect co-payments at time of service.  Uncollected copayments will be billed within 30 days of your visit. Repeated failure to make your copayment may be reported to your insurance company for follow-up. Patients with Medicaid as secondary insurance are still responsible for the primary insurance copay. Medicaid DOES NOT cover the copay for the primary insurance.

3. Copayments for yearly Physicals:  A “Well Visit” or “Well Check” does not require a co-payment under the Patient Protection and Affordable Care Act. For your convenience, your physician or provider may discuss or treat your child for a medical condition during your child’s well visit. This saves you from having to make several trips to our office. As a result, a co-payment or deductible may be required by your insurance company if discussions beyond your child’s preventive care occur. Some examples of this are as follows:

                                        a) Your Provider needs to change your child’s medication or order tests for a pre-existing/chronic                                             problem                           

                                        b) Your Providers treats your child for any new problems he or she is currently experiencing.

Your questions related to your benefits coverage and co-payments, please reach out directly to your insurance company. Our practices collaborate with many health insurance carriers and do not know what benefits you may qualify for under your particular plan.

3. Proof of Insurance: All patients must complete our patient information form yearly. We must obtain a copy of your child’s current valid insurance card to provide proof of insurance.

4. Claims Submission: As stated above, we will submit your claims and assist you in any way we reasonably can to help get your claim paid. Your insurance may need you to supply certain information directly, and it is your responsibility to comply with their requests. Please be aware that the balance of your account is your responsibility whether your insurance company pays your claim or not.

5. Coverage Changes: If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay within 45 days, the balance may be billed to you. 6. Nonpayment: Patient balances are due within 30 days of the statement date. If no payment is made, reminder letters will be sent after 30 days and again after 60 days. Failure to contact us will result in referral to an outside collection agency and possible dismissal from our office. To avoid such action, you must contact our business office to set up a payment plan. We will extend credit for 90 days unless other arrangements are made.

7. No Shows: Failure to show up for a scheduled appointment will be tracked in our computer system, and letters will be sent via our portal notifying you of the missed appointments. Multiple “no shows” will result in dismissal from our practice. Please see our No Show/Cancellation Policy above.

8. Payment Methods: We accept all major credit cards, debit cards, cash, checks, and money orders. We also accept credit card payments over the phone. Checks returned for insufficient funds may be turned over to a third party for collection. You will be charged a $25 processing fee on all checks returned for insufficient funds.