Policies

Tardiness & Cancellation

  • We value the time we have reserved for your children's appointment. If you are unable to keep your appointment, please notify our office at least 24 hours in advance so that we can offer the time to another patient.
  • A $40.00 no-show or late cancellation fee will be charged if this notice is not provided.  This fee is the responsibility of the patient and cannot be billed to insurance. Payment is due before or at the patient's next appointment.

Work-In & Walk-In Appointments

  • We strongly discourage walk-in appointments. Simply contact our office before arriving at any of our locations and we will make every attempt to have your child seen.
  • If you arrive at any of our locations seeking treatment without an appointment, your child will be scheduled for the first available appointment time. If there are no appointments available, you will be considered a Work-In and we will see your child if and when an opening in the schedule occurs, which may not be until the end of clinic (after 5:00 pm).
  • Please contact our office by phone before arriving at any of our locations seeking treatment.
  • Patients seen as a Work-In or Walk-In may be billed an additional fee.

Communication Policy

  • Our office utilizes the Healow portal for communication with patients.
  • All messages and questions to providers and staff - including medical questions, referral inquiries, refill requests, labs and imaging questions, or billing questions - must be sent through the patient portal.  Providers and staff will respond through the portal.
  • If a staff member must initiate a message due to refusal to utilize portal, a fee of $10.00 will be applied per message initiated.

Medication Refills

  • Please contact your pharmacy directly to request a refill on a medication that has been filled at your pharmacy in the past. This method will result in the most timely and efficient processing.
  • Upon receiving correspondence from your pharmacy, we will make every attempt to handle your request within one (1) business day; however, please allow up to 48 hours for processing.
  • If your request is urgent, please indicate this in your portal message.
  • If your child requires a refill on their ADD or ADHD medication, we require 3-5 business days, and an appointment is required every 3 months.

ADD/ADHD Policy

  • If diagnosed and treated with medication, our office requires quarterly follow-up visits (every 3 months), regardless of the number of refills received since the last follow-up.
  • Controlled substances will not be sent to the pharmacy outside of office hours.
  • Refill requests and questions must be sent through the child's portal.
  • Patients are responsible for providing and ensuring that the correct pharmacy is on file.  Fees will be assessed if provider must resend prescriptions to new or different pharmacies.

Lab Orders

  • If the physician orders STAT lab-work on your child, we will contact you with results on the same business day or early the following business day
  • For other lab-work ordered, please allow seven to ten business days from the date the test was completed to be contacted with results. If you have not received results from our office after ten business days, please contact our office.

Medical Records & Shot Records

  • In order for our practice to release any medical information, and in accordance with the Privacy Policy listed above, a Medical Release Form must be on file. Please complete a Medical Release Form and provide it to our office either by fax or in person prior to requesting medical or shot records.
  • After we receive the medical records request our office will provide you with your child’s records within fifteen business days.
  • You are able to access a copy of your child's immunization record on the patient portal.  Print option is available in online portal only.

Form Requests

  • Sports clearance forms, camp forms, and other related forms will not be completed if your child has not had a Well Child Check-Up within the last twelve (12) months. Other forms may also require a visit with your physician.
  • Please bring all requested forms to your Well Child Check-Up or follow up appointment and ensure the parent portion of these forms are completed prior to your child’s appointment date.
  • If your child has a current Well Child Check-Up, please provide our office with the requested form either in person, by fax or email to info@pedsofnwh.com.
  • We ask parents to allow three to five business days for the completion of forms.
  • Depending on the nature of the requested form, a service fee may be charged.

Referrals

  • If your child is referred to a specialist by one of our physicians, the Referral Clerk will contact you via patient portal within five business days to provide you with the necessary information.
  • If it is required by your insurance, the Referral Clerk will obtain authorization for your specialist visit. When authorization is required, additional time may be required to provide referral.
  • If you would like your child to be referred to a specialist, we may require an evaluation with one of our physicians.

Custody Agreements

  • In cases of divorce, separation, or change in guardianship, we will require legal documentation indicating which parent(s) are authorized to make medical decisions and receive medical information.
  • The parent or guardian presenting the child for care is responsible for all copayments, deductibles, and outstanding balances at the time of service.  Payment arrangements between parents are the responsibility of the parents.  Our office cannot mediate, communicate payment requests between parties, or become involved in custody or divorce matters.  Receipts will gladly be provided for reimbursement as needed.

Minors Seeking Treatment without a Legal Guardian Present

  • Any patient under the age of 18 is considered a minor.
  • In order for a minor to receive treatment, he or she must either be accompanied by their legal guardian or we must have written permission provided by the legal guardian for treatment to be provided when the minor is accompanied by someone other than the legal guardian.
  • If you would like to provide written permission for your child to receive treatment while accompanied by someone other than yourself, please complete the Consent by Proxy for Non-Urgent Care form and provide it to our office either at the time of your child’s appointment or via fax.
  • If you would like to provide permission for your teenager to seek care independently, please complete the Consent for Underaged Teen to Seek Independent Care form.