Tots n Teens Pediatrics
3434 Kildaire Farm Rd. Suite 124 Cary NC
Ph: 919-362-7155
Policies 
APPOINTMENT POLICY:
FINANCIAL POLICY:
SEPARATED/DIVORCED FAMILIES:
2. In the case of contracted insurance only, copay is due at the time services are rendered. Subsequently all charges deemed patient's responsibility by the contracted insurer are due to Tots N Teens Pediatrics by the parent who authorized treatment.
Welcome to Tots N Teens Pediatrics! We are glad you have chosen us to take care of your dear little ones. We hope to have a long and happy relationship with your child and your family. The following information outlines our appointment policy.If you have any questions please ask our staff for additional clarification.We offer same day and advance appointments to our patients. When you have an appointment we try our best to see your child at the appointment time unless an emergency precludes it.Please arrive 15 minutes prior to the time of your appointment to fill out some forms. If you are late for your appointment by more than 10 minutes, we may ask to reschedule you or that you be seen as a walk-in. Cancellations require 24 hour notice.
We have a no-show policy in place. In order to improve scheduling opportunities we encourage patients to call and cancel their appointments 24-hours prior in order to allow for better use of patient, staff and physician time.
- 1st No-Show – the patient will receive a phone call informing them they missed their appointment and another missed appointment, without notifying the practice, will result in a $20.00 fee.
- 2nd No-Show – the patient will receive a letter informing them that they have now missed two (2) appointments without notifying the office and they will be charged a $20.00 fee.
- 3rd No-Show – the patient will receive a certified letter informing them that their account has been flagged as habitual no shows and that another no-show may result in dismissal from the practice. They will again be charged a $20.00 fee.
- Patients who No-Show a double appointment, (bringing in two children at the same time), will be restricted from scheduling double appointments in the future. A note will be entered into the Practice Management System.
All insured and non- insured patients will be charged a $20.00 “no-show” fee on the second and third missed appointments. Dismissal from the practice may result after a subsequent no-show. Please know that most insurances do not cover the no-show fees. This fees is automatically billed to the patient.
FINANCIAL POLICY:
Our practice participates with most major insurances. Claims are filed as a courtesy. Please bring your insurance card [Private or Medicaid] every time you visit us. You will be asked to verify your information at each visit. If you do not bring your insurance card, payment is expected in full at the time of service provision. Statements for any balance on your accounts are mailed monthly. Any delinquent accounts over 60 days are subject to collection activity. Enquiries regarding the specifics of your insurance coverage should be directed to your plan member services or employee benefits administrator.
Insurance coverage is not a substitute for your financial obligation for medical services rendered to your child by our physician. It is a contract between you,the insured and the insurance company.Payment is to be made at the time of service for all copays,deductibles or all non-covered services. We accept cash and a variety of charge cards for your convenience.
NON-CONTRACTED INSURANCE OR SELF PAY:
If we do not participate with your insurance plan, we ask that you pay in full at the time services are rendered. We will provide you with an itemized bill that you can submit to your insurance company.
SEPARATED/DIVORCED FAMILIES:
1. For those families where parents are separated or divorced, the parent authorizing treatment and bringing the child to be seen is responsible to us for payment. All payments are due when services are rendered.
2. In the case of contracted insurance only, copay is due at the time services are rendered. Subsequently all charges deemed patient's responsibility by the contracted insurer are due to Tots N Teens Pediatrics by the parent who authorized treatment.
3. If the divorce decree requires the other parent to pay all or part of the treatment costs, it is the authorizing parent’s responsibility to collect from the other parent. Tots N Teens Pediatrics will not act as a mediator in collecting our payments
4. A copy of the bill with appropriate insurance coding may be given to the authorizing parent at each visit if requested.
5. If the account is not resolved in a timely manner, the authorizing parent’s information will be submitted to our collection agency.
6. Non-compliance with this policy may result in transfer of care to another practice.
RETURNED CHECKS: Returned check fees is $35.00.
PRESCRIPTION REFILL/MEDICAL RECORDS/FORMS POLICY:
Please give us 48 hours to refill your prescriptions,copy records and complete forms.The parent portion of all forms should be completed before submitting the request.There is a fee of $25 to copy the records.There is no charge for filling out Sports Physical,Kindergarten Physical,and Camp Physical forms.We do it as a courtesy to our parents.
Routine refills should be requested during normal clinic hours and not after hours or weekends.
Thank you in advance for your cooperation in adhering to our office policies.This in turn will help us contain our medical costs and provide a smooth flow of care to your loved ones.
