| Telephone calls | Telephone calls after hours | On weekends and holidays |
| Prenatal meetings | Forms | Hospital affiliation | Referrals |
| Insurance participation | Insurance Facilitator | Payments |

Telephone calls:

Our staff is trained to answer most questions. If you have a question or problem with your child that cannot wait until a check-up or that may not require an office visit, please call the office to speak with your doctor’s nurse. If your call requires that the doctor speak with you, please leave a message with the nurse and the call will be returned to you at the earliest opportunity. You may find it easier to reach us for questions if you call mid-morning or early afternoon when other parents are generally not calling to schedule sick visits.

Telephone calls – After hours:

If an acute non-emergency medical condition arises while the office is closed, and you need medical assistance or advice, you may call our answering service at 585-327-3443 and a pediatric advice nurse will return your call. This nurse is not one of our daytime nurses and does not have access to your child’s chart. Refills and routine questions should be handled during the day. If the condition warrants it, or you expressly desire a provider to contact you, please inform the advice nurse and your call will be returned as quickly as possible. Please be sure to give an alternative number if you are leaving a cell phone number. If your child is experiencing a true medical emergency, please call 911.

On weekends and holidays:
One of our providers will be available in the AM only for emergency visits with the exception of Christmas. If your child is ill and you think he/she needs to be seen, please call the answering service between 8:00 am to 10:00 am. A member of our staff, who will be available to assist you, will return your call. If your child is experiencing a true medical emergency, please call 911 or take him / her immediately to a hospital emergency room. We recommend using either Rochester General or Golisano’s Children’s Hospital at Strong where there are pediatric doctors and facilities readily available. Always try to call us first so that we can call ahead to the hospital and authorize your Emergency Room visit with your insurance company.

Prenatal meetings:

Every 4 to 6 weeks we run a group prenatal evening meeting for prospective patients. Two doctors, our office manager and our nurse practitioner introduce our practice and review our general policies and some basic newborn care. We will give you a tour of the office and try to answer all questions. We also have some parenting books available for purchase. We find that these group meetings enable both parents to attend, and allow for a more relaxed time to see the office and speak with the doctors.

Forms:

• 1. Bringing your school, daycare, camp and sport form with you at the time of your physical. If your form needs to be completed at any other time than at the time of the actual physical exam, our office requires one week to complete this service.
  
• 2. Providing us with a self-addressed stamped envelope with which to return the form. Completed forms will be stored at the reception desk for you to pick up if an envelope is not furnished.
  
• 3. It is the parent/guardians’ responsibility to complete the personal and immunization information on each form.
  
• 4. If the form needs to be completed within 48 hours, a $5.00 fee per form will be collected. There are times when a 48 hour turn around time on forms is impossible because of the high volume of sick children that require our immediate attention. It is important that you give us adequate time to complete the forms.

Hospital Affiliation

We are affiliated with Rochester General Hospital and Golisano’s Children’s at Strong Hospital. Each provider has admitting privileges at both hospitals.

Referrals:

Should the need for referral to a hospital, specialists or other medical provider arise, every effort will be made to refer you to one who participates in your particular insurance plan. Our office will contact your insurance plan in an effort to obtain approval for your referral, however, you will need to contact your insurance company 3-5 business days after your visit with us to obtain authorization information for the referral.

Please be advised that many insurance companies will only pay for services provided by certain hospitals, specialists, labs, etc. You may be required to pay 100% of your bill if you chose to go to a provider that is not covered by your insurance carrier. Please check with your insurance company to confirm where you should go for these services.

Please note; we are not your insurance company. We are your health care provider. We cannot overrule any decision regarding coverage from your insurance company. If you have a question regarding services, which may or may not be covered, please contact your insurance representative.

Insurance Participation:

Insurance is intended to cover some, but not all of the cost of your care. Most plans require co-payments, deductibles and other expenses, which must be paid by the patient. It is important for you to become familiar with your insurance policy and to bring your insurance card with you to each visit. This will allow you to receive the maximum benefits of your specific insurance plan.

Our office participates with over 30 area and national carriers; however, there are instances when we are not contracted with your specific insurance carrier or you may not have insurance coverage. In these cases, 100% of our fees are required to be paid at the time of service. As a courtesy to you, we will file your claim for services received so that your carrier reimburses you in a timely fashion. In order for us to provide this billing service for you, we must obtain the following data from you: name and mailing address of the carrier; policy number; group number; policyholder’s full name, date of birth, and social security number. We will only be able to bill your carrier once per date of service. Otherwise, after your visit and payment of our fees, you will receive all the information necessary to file your insurance claim on your own behalf. If you have any questions regarding your coverage, please contact your insurance carrier for an explanation of your healthcare plan.

Many insurance companies require you to select a primary care physician (PCP) prior to being seen for care. If your carrier has this requirement, please be sure you have notified them of your selecting the physician of choice in our office. It is your responsibility to add a new baby or adopted child to your insurance policy. Insurance claims, which are denied as the result of improper PCP designation, will become your financial responsibility.

Insurance Facilitator:

Child Health Plus is a federal program administered locally by Blue Shield of Rochester. This program is meant to insure that no child in New York State goes without health insurance because of the inability to pay. Eligibility is determined based on federally issued income guidelines.

Blue Choice Option is a managed care program for Medicaid eligible families in the seven counties including and surrounding the Rochester area.

Long Pond Pediatrics is pleased to offer our patients the convenience of applying for Child Health Plus and Blue Choice Option at our office.

A facilitator comes to our office on a monthly basis to assist our patients with the application or re-certification process. The facilitator is available from 8:30 am to 1:00 pm. The date varies each month depending on availability. New applications take approximately 45 minutes to complete. Application packets are available at our office listing the necessary documentation. Please contact us prior to scheduling your appointment so that we can mail the necessary paperwork to your home. Having the documentation ready at the time of your appointment will speed up your application process.

Payments:

• All payments for our services must be made at the time of service. Should you have extraordinary financial pressures, we will be pleased to assist you with a payment plan, agreed upon in writing with our Billing Manager, prior to services being rendered.
  
• According to your insurance contract, as well as ours, co-payments are required to be collected at the time of service. No Exceptions. Co-pays not paid at the time of the visit must be reported to your insurance company and a handling charge will be added to your account balance in our office.
  
• Due to the terms of our insurance contracts, we are unable to extend professional courtesy visits.
  
• The custodial parent of our minor child patients will be responsible for medical expenses originating from our office. It is the responsibility of the custodial parent to be reimbursed from any additional parties. Any additional issues regarding financial responsibility should be addressed through Family Court Services.
  
• For your convenience we accept cash, checks, Visa or MasterCard.
  
• Fees not paid at the time of service will result in additional billing charges applied to your account.