HOLLY CITY
PEDIATRICS, PAWalking you through the years.
Pediatric & Adolescent Care
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HOLLY CITY
PEDIATRICS, PA Walking you through the years. Pediatric & Adolescent Care |
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Welcome! We are glad that you have chosen to receive your health care needs with our practice. OFFICE HOURS: Monday through Wednesday 8am - 7pm Thursday & Friday 8am - 6pm *Most Saturdays 8am - 1pm 10 E. Main Street, Suite A
OFFICE GUIDE: for your information The following information is for your benefit. Our providers make every effort to stay on time, and we expect our patients to be on time too. We also try very hard to work out insurance problems for you, but we need your cooperation, patience, and any information that may help us help you. 1. No Call/No Shows: It is very important that you keep all your appointments or call the day before if you need to cancel your appointment. Three documented No Call/No Shows will result in a discharge procedure from our practice. 2. Insurance: Please bring your insurance cards and your Medicaid card if you have one to EVERY appointment, or you will be required to pay at the time of visit. *Especially for well checks/physicals/ and/or any immunizations. 3. Lateness: You must show up on time. We do not guarantee that your time slot will be held past 15 minutes, you may be asked to reschedule. 4. Emergencies: If you have a TRUE EMERGENCY after office hours or on the weekend, you may call our office 856/825-5932, you will be provided with the number to our answering service who will page our physician on call. *If you do not receive a return call within 30 minutes, please call our answering service again. Non-emergency situations include prescription refills, cough, throat pain, earache, or fever (under 102) for less than 24 hours. Non-emergencies can wait until the next business day when the office is open. 5. Referrals: Patients must be seen by our physician prior to the issuance of any referrals excluding Emergency Room referral requests for follow up fracture care. Please give our office 48 hours notice for each referral (prior to appointment) so that appropriate pre-certification may be obtained. *Note: If ample time is not provided, your referral may not be guaranteed for that visit and you may either be financially responsible for the visit or rescheduled by the specialist. 6. Doctor Preference: We will make every effort if you request to see a particular doctor in our office. But, if your child is sick or in the event of any emergency, your child will be seen by the first available doctor. 7. Account Updates: It is your responsibility to provide our office with your current phone number, address, and insurance information. You MUST have an insurance card with our doctors/office name on it, or we must be able to verify eligibility before we see the patient. 8. Courtesy: Please do not bring a second child to be seen by the doctor when you only have an appointment for one child. *Inform our receptionist when checking in and we will assist you in scheduling an appointment. Failure to do so will back up the doctor’s schedule, and it is not fair to the next patient waiting to see the doctor with a scheduled appointment. 9. Siblings: Please do not discuss another child’s medical problem with the doctor. This causes confusion and the doctor may not be able to give you the best possible medical advice without having the child’s health history available to him/her at the time. 10. Guardianship: If the natural parents are not bringing in the child, you need to provide our office with legal guardianship papers and/or court documents as well as any previous medical records prior to your establishment with our practice. 11. Authorized Representatives: If you are authorizing a childcare provider, friend or relative in the event you cannot bring the child in for a scheduled appointment, please provide written consent stating authorization. 12. Interpreter: For your benefit, we recommend that you bring an interpreter with you for your child’s visits. We may not at all times have someone available to provide this service to you. 13. Financial Responsibility: If your insurance has a copay due, it is payable at the time of registration. Or if your insurance does not provide coverage for well exams, physicals or immunizations and/or if you have no insurance you must speak with our financial representative prior to your appointment for payment arrangements. NOTE: If you have no insurance (SELF PAY) our office does provide a discount for services rendered. In the event of split financial responsibility due to divorce/separation, it is the responsibility of the party who is bringing the child in. We will not balance bill. 14. Age Restriction: NOTE: Your child must be accompanied by an adult until the age of 18. Our practice will continue to see your child up to the age of 18 years or upon high school graduation. But as a courtesy, we will continue to see your child if he/she attends college. In the event that your child (16 years & up) develops adult complications or is pregnant and decides to carry, our practice will recommend that you seek an “adult” physician that can address your medical condition(s). 15. Fee for Forms: Please note that we charge a fee for forms that require completion for school, camp, work, deferrals, FMLA, etc. These fees vary depending on the form & their complexity. Please ask our front desk for assistance. FOR YOUR BENEFIT, WE HAVE PROVIDED TWO SEPARATE WAITING ROOMS, ONE FOR SICK CHILDREN AND THE OTHER FOR WELL CHILDREN. THIS WAY THEY WON’T BE EXPOSED TO VIRAL INFECTIONS OR COLD GERMS. AGAIN, WE ARE VERY GLAD THAT YOU HAVE CHOSEN TO RECEIVE YOUR CHILD’S CARE WITH US. WE WILL WORK WITH YOU TO PROVIDE YOUR CHILD WITH THE BEST MEDICAL CARE POSSIBLE. PLEASE CALL OUR OFFICE WITH ANY QUESTIONS OR CONCERNS YOU MAY HAVE. rev. 8/2005 |
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