Policies in Brief
1. Appointments: If you have scheduled an appointment, please be here. Cancellations should occur at least 24 hours prior to the appointment time. Except in extraordinary circumstances, failure to do so will incur missed appointment charges. Repeat offenders may be dismissed from the practice at the discretion of The Children's Clinic management.
2. Timely arrival: We expect patients and their families to arrive with adequate spare time for check in prior to their appointment time. While we do not always find it possible to see patients exactly on time, your early arrival will facilitate our scheduling. Remember, many patients have complex problems that require a significant amount of time and attention. We always strive to provide the best in medical care for your child. If we are late in seeing you due to an extended visit with another patient, please remember that your child may need extra attention that we will be happy to provide.
3. Payments: All co payments are due at the time of service. Ultimately, the patient or the family is always responsible for payment. Our charges are based on prevailing standards, the "level of service" as determined by the diagnosis, and the amount of time we spend with the patient. We will bill your insurance company and accept assignment of payment in accordance with existing contracts. While we hold contracts with several hundred insurance companies, it is impossible for us to know the details of your individual plan. Knowing what services are covered is the responsibility of the patients and/or their family, not the doctors or staff of The Children's Clinic. Please do not ask us to change the reason for your visit if, for example, your plan does not cover well-child care. To do so constitutes insurance fraud. For prompt payment of services rendered, we are willing to negotiate further discounts on an individual basis. Accounts past due will be charged interest at the prevailing rate as allowable by state law. We cannot honor requests to collect co payments from divorced spouses or other third parties. Payment remains due at the time of service. We are not a collection agency. Again, co payments are due at the time of service.
4. Telephone advice: All calls for medical advice are considered a medical consultation, and they will be billed in accordance with the latest version of medical Current Procedural Terminology (CPT) Codes. Please do not substitute a telephone call for a proper medical examination and consultation. Calls to our nursing staff during the day will be treated in the same manner as after-hours telephone calls. We offer office hours that are more than adequate to deal with most problems encountered by children. If there is some question as to the severity of the problem, our nurses will make a determination as to the severity of the problem. If we do not have an opening on our schedule, one of several things will happen. We will a.) overbook our schedule, b.) delay the appointment to a time of better availability or c.) refer you for emergency services. Remember: you do not need our approval for emergency services, however, you will probably need to be able to justify the visit on the basis of severity of the symptoms. In general, emergency services are indicated for items such as: bleeding that won't stop, a bad burn, severe or intractable pain, broken bones, trouble breathing, convulsions (seizures), loss of consciousness. Non emergencies include complaints such as "bad cold", sore throat, upset stomach, cuts, bruises, and muscle strains. We always do our best to take into consideration your child's comfort, but it may not always be possible see your child on the same day. If you have scheduled an appointment for the same day please expect to wait, regardless of the circumstances. Unless the visit is emergent, we will always attempt to see our scheduled patients first.
5. Well visits: With the exception of infants with whom timely visits are necessary we will generally need between one and four weeks to accommodate your visit, depending on the time of the year. It is nearly impossible to schedule a well visit just before school starts. We sympathize if you need a well-child for tomorrow for daycare and we will do our best to help you whenever possible, but do not expect us to "just fit you in" for well care. Please plan ahead, especially for sports physicals and daycare.
6. Provider preference: Our providers see patients on a "first available" priority. One of the physician providers will generally try to see patients on the first visit with our practice, but this is not always possible due to our various schedules. Preferences will be honored only when it is not disruptive to other patients on the schedule. If you insist on seeing a particular provider, we reserve the right to see all other patients who are waiting before seeing your child. We consider all of our nursing staff and medical providers as completely qualified for the tasks they are assigned. Please treat every member of our staff with the respect they deserve.
7. Dismissal from the practice: We reserve the right to dismiss any patient or family from our practice at any time. Dismissal will be a.) based on failure of the patient or family to comply with prescribed therapies, or b.) failure to keep appointments or follow up appointments in a timely manor, or c.) displays of inappropriate, abusive or disruptive behavior in our office either in the presence of the staff or other families.
HIPAA Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment, or health care operations (TPO) and for other purposes that are permitted or required by the law. It also describes your rights to access and control your protected health information. "Protected health information" is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.
Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to pay your health care bills, to support the operation of the physician’s practice, and any other use required by law.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example we would disclose your protected health information, as necessary, to a home health agency that provides care to you. For Example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.
Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.
Healthcare Operations: We may use or disclose, as needed, you protected health information in order to support the business activities of your physicians practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, and conducting or arranging for other business activities. For example, we may disclose your protected health information to medical students that see patients at our office. In addition, we may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. We may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment.
We may use or disclose your protected health information in the following situations without your authorization. These situations include: as Required By Law, Public Health issues, Communicable Diseases, Health Oversight, Abuse or Neglect, Food and Drug administration requirements, Legal Proceedings, Law Enforcement, Coroners, Funeral Directors and Organ Donation, Research, Criminal Activity, Military Activity and National Security, Workers’ Compensation, Inmates, Required Uses and Disclosures. Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500.
Other Permitted and Required Uses and Disclosures Will Be Made Only With Your Consent, Authorization or Opportunity to Object unless required by law.
You may revoke this authorization, at any time, in writing, except to the extent that your physician or the physician’s practice has taken an action in reliance on the use or disclosure indicated in the authorization.
Your Rights
Following is a statement of your rights with respect to your protected health information
You have the right to inspect and copy your protected health information. Under federal law, however, you may not inspect or copy the following records; psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information
You have the right to request a restriction of your protected health information
This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
Your physician is not required to agree to a restriction that you may request. If physician believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. You then have the right to use another Healthcare Professional.
You have the right to request to receive confidential communications from us by alternative means or at an alternateive location. You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively i.e. electronically.
You may have the right to have your physician amend your protected health information. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information.
We reserve the right to change the terms of this notice and will inform you by mail of any changes. You then have the right to object or withdraw as provided in this notice.
Complaints
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact or your complaint. We will not retaliate against you for filing a complaint.
This notice was published and becomes effective on April 14, 2003.
We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information. If you have any objection of this form, please ask to speak with our HIPAA Compliance Officer in person or by phone at (913) 557-2482.
