Office Policies

Dear Parents,

Welcome to Central Jersey Pediatrics.  It is our privilege and an honor to have the opportunity to provide you with the best possible care available.  In order to conform to the insurance regulations and keep our costs competitive, we kindly request you to comply with the followings.

As a Physician, me and my staff would like to be OPEN and HONEST with all our patients and parents from the beginning, and build Doctor-Patient relation on a solid ground. Over the past 14 years from interactions with multiple personalities and nature of insurance companies, we have concluded the following guidelines. We welcome your family and would be an honor to have you as our patients. We hope that you would also understand and comply to build the relation in the best of your children’s future care. We appreciate your trust in us. Please keep in mind, our goal is for well being and best possible care of our patients. That being said……….

For New patients few points in brief:

Insurance Nuisance:

1. For Referrals: In the event that your insurance plan requires you to have a referral:

¨      It is up to the physician to decide whether you need a referral or not. If you have a HMO/managed care plan, most insurance companies require us to treat you up to a reasonable extent in our reach.

¨      Kindly give us 3 or more business days to prepare referral.

¨      If your insurance company delays/denies the referral, we will not be responsible for any inconvenience/expenses.

¨      We are unable to issue backdated referrals.

¨      Please pick up your referral from our office a few days before your visit with a specialist.

2. It is your responsibility to be fully familiar with your insurance coverage and benefits. Due to varying insurance company requirements, we cannot be responsible for referring you to a facility not covered by your insurance company (For Example: for blood work, x-ray, specialist or other paramedical specialty). Prior visiting to any facility or doctor for further work up or treatment, please confirm with your insurance or related facility.

3. For eyeglass check or recheck, please check with your insurance if you have vision plan benefit, and if you do, follow your insurance guidelines.

Office Policy:

1. We do not fax any kind of medical documents anywhere.

2. Due to the nature of the examination involved, sports forms will require a special physical which is a separate visit from a regular check-up. Therefore, please make a separate appointment with us for such needs. We may not be able to provide sports physical on a new patients due to the short time frame of our association with you.

3. Due to coordination of care issues, we will be unable to provide our services to patients going to multiple doctors without our knowledge or prior discussion.

4. As a courtesy, we make reminder phone calls the day before an appointment.  However, it is parent’s responsibility to remember appointment and be on time.

5. Most likely, a sick child is seen on the same day. If your child is ill, please call us between 10:00 to 10.30 am on week days and 8.00 to 8.30 am on Saturdays to make an appointment for an office visit. We are unable to guarantee the time or office location of your choice for same day appointments, as we are available for half a day at each of our two offices.  Also, please be considerate to our other patients and be on time, so that they do not have to wait.

6. On Sundays and Holidays, if your child is sick, please call us at 8:00 am. If possible, we will try our best to accommodate your child to be seen on the same day. If your child appears to be falling ill before a weekend, please call us on Friday or at the latest by Saturday morning to make an appointment for an office visit. Please do not wait till Saturday afternoon or Sunday. Once the office is closed for the weekend, the medical care would be delayed or you have to spend your precious time in the emergency room.

7. We understand that some of our patients have both working parents and would like the last appointment for the day.  Kindly schedule these appointments in advance.  Patients who have scheduled these appointments in advance will have priority.  Our office staff will strive to be flexible, but we do appreciate your understanding the constraints involved in scheduling.

8. Saturdays are generally very busy regarding appointments, and we realize how important the time is for you on weekend.  We try our best to see your child quickly and precisely, this can be accomplished if only all the patients come on time. Therefore, please be on time and do not cancel your appointment at last minute. If you think you need more time to discuss your child’s health, than please schedule appointment during weekdays morning/early afternoon. This will give us both sufficient time to spend and discuss.

9. As a courtesy to our parents we will fill out one form or vaccination records per year FREE of charge. Requests for completions of any forms, reports or other paperwork may require up to 3 or more business days and a fee of $ 10 or more per form, paid in advance, proportional to the amount of the preparation involved. Kindly realize that filling out forms is never an emergency. We request you not to hold onto forms and rush to have them completed at the last minute.  Schools and other educational/recreational facilities do give forms sufficiently in advance so that doctors have adequate time to complete them. Certain forms may require a visit to our office.

10. When child is sick, please call as early as possible as the office opens (10:00 am). According the sickness, we can see your child as soon as possible. After hours phone calls are generally for emergency cases ONLY. Please be very discrete about it. If child is sick all day, DO NOT wait till nightfall to call us. When you call us day/night and if we suggest that your child needs to be seen, we will guide you when and where you should bring the child for an evaluation. After the telephone advice during night or weekend, we would like to see your child in the next available office appointment. Please bring them to the office for an evaluation even if they appear to recover from the illness. Many times the follow up examination alters the course of medical advice. If you are advised for follow-up visit to office for any particular reason, please make sure you schedule that appointment. Non compliance in this may result in suboptimal care for your child.  We strive to provide the best possible care for your child. A conflict in this matter may force   us to ask you to look for another physician.

11. Well-Care and Sick-Care visits should NOT be combined in any situation. If your child has a health issue, please schedule an appointment separate from that of the well check up. Please DO NOT wait until next regular check-up visit to discuss about your child’s health issue. When in doubt, call at our office, we will be more than happy to give you an advice. If problems arise at the regular visit, we might ask you to reschedule well check-up visit or schedule an appointment for evaluating the problem that we just discovered. We like to discuss certain problem at length and explain to parents their option for treatment.

12. We strongly recommend age appropriate regular check-ups for all our patients. We will inform you at the regular visit when your next appointment should be. Please make that appointment well in advance before leaving our office, so you could get the time slot that is convenient for you. This also helps as you do not need to worry about remembering to make that next appointment. Please do not call us at the last minute and try to squeeze an appointment for your child. Time to time, we give you a call or mail you a letter reminding you to schedule a well care visit. After few reminders, if you fail to make the regular check-up appointment, we may ask you to choose another doctor for future care. Vaccination is not the only reason children should be brought in for regular check-ups. We monitor for different age appropriate developmental milestones and growth parameters during each well check-up visit. That is also the time to find out about problems with vision, hearing, blood pressure, etc.

13. We request you to schedule well care / shots visits for children 4 years and older, during the months of May to August as they tend to be healthier during that period.  Also, if well check up is completed, any required school forms and sports physicals can be filled without delay. Between Sept.15th and Nov.15 our office would be busy administering flu shots administering flu-shots. We do not give any well-care appointments during this time for this age group.  Once the school starts, you may not want to take your child out from the school for the well check-up.  Moreover, we have very limited slots available during after-school hours. Once the winter starts, the school-going children tend to get sick more often, and therefore, it would be difficult to schedule for well check-ups.

14. Please do not ask our office staff or call inquiring about which shots or vaccinations will be given at next visit. Our office staff is not trained to make that decision. Even though we follow the schedule recommended by the American Academy of Pediatrics, we individualize the immunization schedule to the needs of your child. As each child is different with his or her own unique requirements. We would make the recommendation at the time of the visit based on the examination.

15. Ear cleaning is considered as a surgical procedure from the insurance point of view. Most insurance do not reimburse ear cleaning with regular appointment. So if needed, we may ask you to schedule a separate appointment for that procedure. It is very painful for your child if ear cleaning has to be done when he or she has an ear infection. In order to effectively care for your children, we urge you to bring them to the office so that the ears can be cleaned with minimal discomfort.  

16. We strongly recommend all our new patients to bring patients medical records including vaccination records in proper form from previous physician’s office.  We do not accept regular vaccination cards as proof of record as some of them are not properly updated. For any new patients coming to our office, we do not give vaccination at their first visit as it takes some time for us to go through their records and figure out what exactly they require.

17. To provide coordinated care to our patients, we request that we remain pediatrician for all children in the same family. There are many inherited genetic conditions that could affect the siblings and also many infectious diseases spread among the family members.   It is better not to give fragmented care for our patients and their family. For the same reason, we do not accept temporary patients. If you do not agree with this office policy, please do not schedule an appointment.

18. We accept new patients and love to take care of your children as our patients. But, we do not give second opinion for any reason. Most of the chronic or serious problems do require multiple visits and might take some time to diagnose and manage. It is in the best interest of your child to continue with one physician who takes care of these issues until resolved. Doctor shopping may not only resolve issues but might lead to further complications. Only time and faith in your current doctor will be the best policy.

19. If you need copy of any medical records or document for your own need, there is a charge $ 1.00 per page for photocopying medical records or documents. (Permitted by NJ department of health.)

20. As a courtesy to our patients who needs to change their physician, we will provide a free signed medical record summary for one time ONLY. We need a written request and a minimum of seven working days or more to review the charts and prepare the medical record summary. You are expected to pick up the record summary as we do not mail or fax it. If for any reason, you cannot pick it up in person, you may make arrangements to have it sent to you via UPS/Fed-ex by providing us with a prepaid envelope. We advise you to make a copy of the record summary for yourselves before giving the original to your new physician. If for some reason, you need the record summary again, there is a charge of $50.00.  There is also a charge of $50.00 to provide records for any insurance company (such as a life insurance or disability insurance) that requires medical records.
21. Prescriptions are never called over the phone. Please make sure that you have sufficient supply of maintenance medications that your child needs. Please DO NOT wait till weekend or when office is closed. If you are running out of them and you do not have any refills left, please call the office during regular office hours and make an appointment.

22. Please notify our office of any changes to your insurance, cell/home/work phone number, email address, home address or other related important information.

23. We strive to resolve any differences that may occasionally arise between you and our office. For irreconcilable differences, we may ask you to choose another physician for your child’s future medical care. We will inform you verbally and/or in writing. In situation, we will provide ONLY emergency medical care (not routine well care or shots) for the next 30 days.

24. We request you to remove “call block” from your phone number which you expect a phone call back. Doctor’s number will be private when he/she returns your call. In which case you may not know that the physician is calling you back. Doctor might not be able to get through and will not be responsible for any delay in treatment/inconvenience if there is a call block. You can remove call block for private number from your phone by dialing *87. We also request that you keep your telephone line open, if you are waiting for a call back from doctor.

25. Patients are only seen with appointments. We strongly request no walk-in patients please. If you are running late please call us. If you come more than 20 minutes late, sometimes we may have to reschedule your appointment or you may have to wait for the next available slot.

26. As a courtesy to you, we are willing to provide care for sick children of your friends or relatives visiting New Jersey. In such cases, we collect the fees for the examination at the time of the visit and later refund it if and when their insurance reimburses our office.

Financial Policy:

1.     We are committed to providing the best treatment for our patients and charge what is usual and customary in our area. We take our responsibility with utmost seriousness and would appreciate prompt payment for our services. Patients are responsible for payments regardless of their insurance company’s arbitrary determination of usual and customary rates.

2.     We will provide you with a receipt for all your payments at the time of your visit. Kindly keep this receipt in safe custody as we may not be able to provide you with another receipt or copies of statements at a later date.

3.     Under certain special circumstances, you may be requested to pay at the time of your visit, regardless of the kind of your insurance. For Circumstances include (i) not having a proper Insurance ID card with doctor’s and patient’s name(s) on it, (ii) we cannot confirm your coverage with your insurance company at the time of your visit (i.e. in evenings, weekends, holidays or inability to contact your insurance company). We will promptly refund you once after your insurance reimburses our office.

4.     Regarding Managed Care Insurance in which we participate: Please supply our office staff with your primary and secondary insurance identification card(s) at the time of your appointment. If your insurance requires co-pay or deductible, kindly pay it, at the time of the appointment.

5.     There are certain instances under which we request you to be responsible for the payments.  For example, incorrect insurance information provided at the time of your visit might lead to a delay in filing a claim with your insurance company. If your insurance company fails to compensate us for services rendered for any reason, payment will be your responsibility.

6.     At times your insurance carrier may deny payment for authorized services. If so, you may be requested to help resolve these issues with your carrier.

7.     Regarding Non-Participating Insurances: We do our utmost best to be a participating provider for a wide range of insurance companies.  In the event that we do not participate with your insurance, bill payment at the time of service is your responsibility. Please kindly recognize that your insurance policy is a contract between you and your insurance company and our office is not part of that contract.

8.     Kindly pay in cash ONLY.  We are unable to accept credit/debit cards or checks for payments to keep our overhead expenses low.

9.     Due to disruptions associated with cancellation of appointment, there is a nominal $35.00 fee associated when canceled less than a 24-hour notice. Parents with repeated missed/delayed appointment will be asked to choose another physician for future care of their children,

10.  Payment must be received by the due date. A late fee of up to $ 50.00 will be charged after patient/parent is notified in person, by mail or phone for each visit.

Any account that is due over 14 days without payment is subject to immediate collection process. Accounts that sent out side agency/attorney for collection will be subjected to 35% additional charge plus attorney’s fees. After one year additional charge will be 45% plus attorney’s fees.

11.  A charge of $35.00 will be collected for any bank return check, along with the previous balance.

12.  We require social security number from both the parents and government issued proof of identification with photo. No exception is given to any one regarding this policy. Just because you have insurance, insurance company do not give us guarantee of payment. We take your privacy very seriously and do not share social security numbers with any outside agency/person except for collection purpose. We do not require social security numbers if you plan to pay in cash at the time of your visit each time.

And Finally…………..

Current policy or changes will be posted in our office.  If there are any changes to the policy, it will be updated from time to time.