We are committed to providing you and your children with the highest quality of care. As part of your relationship with Pediatric Associates, a clear understanding of our financial policies is important so you will know what actions Pediatric Associates will be undertaking on your behalf as well as what your financial responsibilities are to Pediatric Associates.

INSURANCE BENEFITS

You must know your insurance benefits. Your insurance policy is a contract between you and your insurance company even if your employer provides the policy. You are responsible for knowing the coverage provided by your policy or communicating with your insurance provider as needed. You will be responsible for any part of the visit cost that your insurance does not cover including deductibles and co-payments.

INSURANCE CARD

You must show your current insurance card at every visit. We will attempt to validate your insurance benefits at the time of service and alert you to any problems.

CO-PAYMENTS

You must pay your co-payment at the time of the office visit. This is predetermined by your insurance company and our contracts with insurance companies require us to collect your co-payment at the time of service.

SECURE AND CONVENIENT ONLINE PAYMENTS

Pediatric Associates offers Online Bill Pay through InstaMed to enable our patients to securely pay their bill online through our website.

FINANCIAL AND PRIVACY POLICIES

Please review these important policies.

For your convenience, we have provided various forms below that you may directly access and complete through our website.

New Patient Forms

Please review and complete these forms in preparation for your first visit.

• New Patient Registration - English

• New Patient Registration - Spanish

• Insurance Card Upload Form

Release, Consent, and Privacy Forms

• Release of Medical Records to Pediatric Associates

• Release of Medical Records from Pediatric Associates

• Parental Authorization for Patients 18+ Years

• Notice of Privacy Practices

Well Check Forms

• 2 Week Well Child Check

• 2 Month Well Child Check

• 4 Month Well Child Check

• 6 Month Well Child Check

• 9 Month Well Child Check

• 12 Month Well Child Check

• 15 Month Well Child Check

• 18 Month Well Child Check

• 24 Month Well Child Check

• 30 Month Well Child Check

• 3 Year Old Well Child Check

• 4 Year Old Well Child Check

• 5-6 Year Old Well Child Check

• 7 Year Old Well Child Check

• 8 Year Old Well Child Check

• 9 Year Old Well Child Check

• 10 Year Old Well Child Check

• 11 Year Old Well Child Check

• 12 Year Old Well Child Check

• 13-14 Year Old Well Child Check

• 15-17 Year Old Well Child Check

• 18-21 Year Old Well Child Check

Established Patient Forms

• Established Patient Demographic Update Form

• ADHD Teacher Questionnaire

• ADHD Parent Questionnaire

Form Requests

• If you have an upcoming wellness exam, please bring your forms to the appointment so that your physician may complete them the same-day.

• Any physical examination forms (including but not limited to GHSA sports physical forms, Georgia form #3300, school examination forms, etc.) cannot be processed if the patient has not had a wellness exam within the last 12 months from the date of form submission.

• Patients 18 years of age or older will need to submit their own requests or submit a parental authorization form to allow parental access to medical records on behalf of the patient. Without prior parental authorization, access to these patient’s records will be denied.

• Form request turnaround time is five to seven business days from the date of submission. We make every effort to complete forms as quickly as possible, but the heavy volume of requests may cause delays– so please plan ahead.

• Parents must complete all information on the forms that they have knowledge of (such as patient demographics & signatures , health history, allergies, medications etc.) Blank forms will not be accepted for physician review, and forms missing any of these fields may cause delay in the request.

An appointment is required for your child to be seen. If you are going to be late for an appointment or need to cancel, please call our office.

There are typically 5-7 doctors in the office on weekdays. Every attempt will be made for you to see the doctor of your choice. Saturday morning office hours are shared by the physicians in the group on a rotating basis.

MISSED APPOINTMENTS

We request at least 24-hour notice for any cancellations or rescheduling of a previously scheduled appointment.

Missed appointments and late cancelations represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you.  

SATURDAY MORNING OFFICE HOURS

Pediatric Associates has visits on Saturday mornings for urgent care/sick children only. Pediatric Associates charges an additional fee for Saturday services. This fee may or may not be covered by your insurance carrier.

Pediatric Associates has carefully reviewed our approach to vaccinations within our practice. We want to ensure that all our patients, as well as our patient community, are as healthy as possible. One of the most important advancements in public health has been the development of vaccinations, by which many diseases have been eliminated or become uncommon. Scientific research has consistently and overwhelmingly shown that vaccines are effective and safe. 

Effective March 19, 2018, the Physicians at Pediatric Associates have revised our vaccine policy.  Pediatric Associates follows the recommended immunization schedule of the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). 

1. Pediatric Associates will allow alternate vaccine schedules under the following guidelines:
 • Vaccinations are started by age 12 months and there is a definitive vaccine plan in place.
 • Mandatory vaccinations for public school attendance are completed by age 5.

2. Families with questions and concerns regarding vaccinations are encouraged to speak with their primary pediatrician/provider. We anticipate that all our families will adhere to our above guidelines.

3. If vaccines are refused or they are not completed by age 5, you can anticipate having to find a new practice for your family.

As pediatricians, we partner with parents to make the best decisions for their children and their health. We understand that the choice to vaccinate can be an emotional one for some families. We will do everything we can to provide education and information on all the vaccines we offer. 

If your child’s illness or injury is life threatening, call 911.

AFTER-HOURS NURSE LINE

For urgent medical issues that cannot wait until business hours, call our office at (770)534 5255. We partner with the Chrildren’s Healthcare of Atlanta after-hours nurse line to ensure someone is always available to answer your questions.

One of our physicians is always on call for further questions or emergencies and to provide important continuity of care for you and your family.

After hours calls should deal only with illness or injury requiring immediate attention. Other calls involving routine issues, and prescription refills should be dealt with during normal business hours.

URGENT/EMERGENCY CARE

For patients whose problem is serious enough to be seen outside of routine hours, we encourage you to use Children’s Healthcare of Atlanta network of Urgent Care Facilities or if emergency care is needed: Arthur M. Blank Children’s Hospital or Scottish Rite Hospital.

REFILL INSTRUCTIONS

Prescription refill requests are processed through our nurse line or your pharmacy. To reach our nurse line please call (770)534 5255 and follow the prompts.

It is very important that you include:

• Patient name and date of birth

• The name of the medication

• The strength, dose, and the frequency with which it is taken

• Pharmacy name and phone number

• For asthma medicine, please specify the delivery method (such as nebulizer, metered dose inhaler, etc.)

Failure to provide this information may cause a delay in filling the prescription.

ADHD MEDICATIONS

ADD/ADHD medications are classified as schedule II controlled substances. These medications are federally controlled by the DEA and the FDA, which means you must call for a refill monthly so that prescription can be securely faxed to your pharmacy. The pharmacy cannot call your doctor to get approval for your ADD/ADHD medication refills.

As recommended by the American Academy of Pediatrics, in addition to a yearly physical exam, your child will need to have a medication check with one of our doctors every SIX MONTHS. The six-month follow-up visit will need to take place in our office so that we can obtain vital signs. In addition with the initial diagnosis of ADHD, medication rechecks at one month and three months are required and then every six months thereafter.

This visit schedule must be followed for your child to continue to receive medication refills, as it is important to make sure that your doctor is carefully monitoring the efficiency and side effects of these medications.

MENTAL HEALTH MEDICATIONS

When mental health prescriptions—such as medications for anxiety or depression—are prescribed, regular follow-up visits are necessary. These typically occur once a month at first, then every three to six months, to monitor your child’s progress and adjust medications as needed to maximize treatment effectiveness. This visit schedule must be followed for your child to continue receiving medication refills, as it is essential for the doctor to carefully monitor both the effectiveness and potential side effects of these medications.