Pediatric and Adolescent Medicine
Dr Steven Alcuri
Dr Steven Alcuri I 198 Thomas Johnson Dr I Suite 14 I Frederick, MD 21702 I Telephone: (301) 846-0811
ACCOUNTS AND INSURANCE
It is not easy to operate a small personalized-attention practice in today's economy and medical environment. All across the country, small practices are being forced to close in favor of the larger, more business-like facilities. The purpose of these policies is to insure that the practice operates efficiently, and has the resources to operate properly.
Copayments, if you have one, are due at your visit when you check in.
At each visit, we will file an insurance claim on your behalf.
You are responsible for providing us with current and accurate insurance information. Basically, that means bring your current insurance card to your visit.
You are also responsible for identifying a financially responsible party - the person designated to receive statements if there is a balance after your insurance processes our claim. There are often copayments, co-insurances and deductibles that become patient balances after the insurance pays its portion.
We will record the person who brings the child here as the responsible party, unless you tell us otherwise.
If your insurance company asks you for what is called Coordination Of Benefits information (i.e., do you have any other insurance), please respond promptly. Generally, insurance companies will deny claims if that information is not provided promptly. That means if you do not respond, you will be paying premiums for insurance but will not have any benefits.
Coinsurances and deductibles, if you have them, will be invoiced after your claim is processed.
There is a 1% per month service charge on any balances outstanding more than 60 days.
If a balance is outstanding more than 120 days, services will be suspended until the balance is cleared in full.
We will accept any reasonable time payment plan arrangements, provided you reach out to us and ask for one if you need it.
But if you don't play fair with us - if you run up a balance and do not respond to our statements or calls - we will discharge you from the practice, and file for a judgment in the District Court of Maryland. In the entire history of the practice, the Court has never denied us a judgment.
APPOINTMENTS
As a small personalized-attention practice, our appointment time is one of our most valuable assets. An appointment not kept is an appointment time wasted, that could have been offered to someone else. With that in mind:
Please give at least 24 hours' notice if you need to cancel or reschedule an appointment. That way, the time can be offered to someone else who needs it, and not go to waste.
We will make our best efforts to give reminders for schedulable-in-advance appointments, such as well care exams or medication management…provided the contact information you give us is good. If you change your phone number or e-mail without telling us, or your voicemail box is full, there is nothing we can do about that. In any case, an appointment reminder is a courtesy. You are not absolved from keeping your appointment if you don't get a reminder.
We will ask you to arrive in advance of your appointment time - typically 15 min for regular "sick visit" appointments, 30 min for well care appointments. This is to allow for check-in; updating of address, phone, and insurance; screening forms and procedures that go with well care appointments at certain ages. If you are late for an appointment, we will work you into the schedule as time permits. We will not ask patients who are on time after you, to wait longer because you are late. On especially busy days, late arrivals may have to be rescheduled.
There will be a service charge, currently $25, for appointments cancelled or changed without 24 hours' notice, or missed altogether.
If that should happen with a multiple appointment - two or more children scheduled together - we will no longer offer you multiple appointments.
We are not willing to continue with families that repeatedly miss appointments, or cancel them on short notice. As we see it, families that repeatedly miss appointments are not really interested in us, or who we are, or what we do. Families that miss three or more appointments are subject to discharge.
VACCINES
Vaccines are one of the most significant medical advancements of the last century.
We do not take children into the practice whose parents or guardians refuse vaccines.
(For what it is worth, we are not aware of any other pediatrician practice in Frederick that does.)
We are willing to make reasonable accommodations for delaying or deferring vaccines - "reasonable" to be determined on an individual basis. We cannot advise you on which vaccines to defer, or for how long, since there is no factual basis for it.
We do not discuss the perceived merits of refusing or deferring vaccines. The importance, necessity, and safety of vaccines, have been determined by powers far higher than us. We are practitioners, not vaccine researchers - our job is to get the vaccines into the community. Instead, we refer you to reliable fact and evidence based information sources, such as the Children's Hospital of Philadelphia Vaccine Information Center: http://www.chop.edu/centers-programs/vaccine-education-center.
FORMS
Pediatrics is a forms-intensive discipline. Children require all kinds of forms, for school, preschool, day care, sports, camps, and the like. In a typical year, we incur thousands of dollars of payroll for staff to fill out forms. This cost has to be covered, and it is certainly not covered by what insurance companies pay us for your visits. For that reason, there is a $15 charge for forms. All practices do this.
Please look at your forms before you turn them in to us. All forms have a "to be completed by parent" section, even if it is just the patient's name and birthdate. We need this section properly filled out by you, before you turn in the forms. We will return the forms to you if it is not.
We will not sign off on any forms where the parent has filled in any of the "to be completed by physician" section.
For some forms, a current well care exam (typically within a calendar year) is required. For any form that requires the physician to certify, "I have examined…" a current well care exam is required. Some programs, such as school sports, not only require a current exam, but have a very specific time frame for it.
The turnaround time for forms is 2 -3 days. Please tell us when you turn in your forms how you would like them returned to you - hold for pick up or mail. We cannot e-mail completed forms - it is not HIPAA compliant. If there is idle time while you are here, we will offer you that time to fill out your forms on the spot. But please don't count on it.
PRESCRIPTION REFILLS
Refill requests can be made by telephone, or through the practice portal.
With rare exception, prescription refill requests are completed same day.
Some prescriptions require follow-up visits, or periodic medication management visits, as part of the standard of care for prescribing. You will be given follow-up instructions at the time of your original prescription visit, should it apply. It is necessary that those visits be completed before refills can be issues. It is not appropriate to ask for refills for old prescriptions, for what appears to be the same problem at a later date. In any case, a current visit is required for any prescription a year or more old. This, too, is a standard of care. For these reasons, we would prefer that you not ask your pharmacy to request refills on your behalf.
SEPARATED PARENTS
The people who study these things, tell us fifty percent of marriages in the United States end in divorce or separation; and, year to year, forty percent of children are born to unmarried parents who may or may not live together. Conflict and discord is common, and there is often substantial disagreement between the parents about who is financially responsible for the children, and who has authority to seek medical care. Under these conditions, parents sometimes try to involve us, the child's doctor, in the domestic dispute - something we simply cannot agree to do:
" We will not take a side with one parent against the other.
" We will not accept one parent's allegations against the other at face value.
" One or the other parent or guardian must agree to be the financially responsible party. If it is not be the person bringing the child here, that person must agree in writing. We will not become involved in disputes over who is financially liable.
" Regardless of the custody arrangement, both birth parents have access to records, and authority to bring the children here, unless there is a court order to the contrary. One parent does not have the authority to restrict the access of the other. We must have a copy of the court order on file in order to honor it.
" We will not report to one parent about what the other is doing.
OFFICE POLICIES AND PROCEDURES