Payments and Insurance
Parents are financially responsible for their child’s care. Like other professionals, we expect payment for services rendered at our clinic at the time of the service unless prior arrangements are made. For your convenience, we accept Discover, Visa, and MasterCard. Should you anticipate any difficulty paying for your care, please consult our office staff. We will make every effort to work with you whenever possible. Unless other arrangements are made, we turn over unpaid accounts to a collection agency or attorney after an appropriate period of time and you will be responsible for the costs of collection.
We will assist you in filing your insurance for your reimbursement if you have insurance through one of the Managed Care plans in which we participate. At this time we participate in BlueCross BlueShield of Mississippi, Aetna, Mississippi Health Partners, First Choice, United HealthCare through First Choice and the CHIPS program. We are sorry but we do not accept Medicaid.
If you have insurance that is not through one of the managed care plans that we participate in, we will furnish you with a copy of our fee ticket. You will be able to send this to your insurance company for reimbursement. You will be asked to pay at the end of each visit for all services rendered.
Divorced parents may have a divorce decree that establishes their financial responsibilities with respect to each other. We are NOT a party to the decree or bound by the terms of the divorce decree. The decree is an agreement between the parents, not with our practice. We require the parent accompanying the child for treatment to accept primary responsibility for payment of services.
Some insurance plans offer coverage for preventative health care services or “well-baby” care. If your family does not have preventative care coverage, vaccines are available for a minimal charge through our office and the Vaccines for Children Program. Please feel free to ask about this if you have any questions.
If you have insurance coverage through a managed care plan that we participate in, we will bill the appropriate insurance carrier for their portion. It is your responsibility to pay any deductibles, co-pays, or co-insurance amounts at the time of the visit. Given the many insurance plans available, we ask you to become familiar with the coverage and regulations of your family’s insurance plan.
Pre-authorization and networks
Please be aware that many insurance carriers require prior notification of any hospital services, including labs and x-rays. Certain insurance carriers also require updates and pre-authorizations of medical treatments. Many carriers have a list of “in-network” physicians. These lists are important if the need for a possible referral to another physician arises. You need to become familiar with the hospitals and specialists that are approved by your insurance plan. You also need to be familiar with your plan’s requirements for referrals. If your insurance carrier requires a referral from your pediatrician in order to see a specialist, we ask that you contact our office at
least seven to ten days in advance of your desired specialist appointment date to assure adequate time to process your referral.
In case of an extreme emergency in which there is an immediate need for a physician to sustain life, we recommend taking your child to the nearest emergency room or calling 911. A physician is on duty 24 hours a day at each of the emergency rooms in the Rankin and Hinds County area. If you are our patient, we should be notified of your arrival. If your emergency is not life threatening but warrants urgent attention, please refer to the section on telephone consultation below.
An important part of our service to our patients is 24 hour availability because significant illness and injuries can occur at any time. Our physicians rotate after hours call responsibilities to provide continuous call coverage for our patients at all times. We do appreciate receiving only calls pertaining to emergency and urgent medical problems after our regular office hours. Please refer to the section on telephone consultation which follows for information on how to contact us by telephone after hours. Because of the large number of calls coming after hours that are routine and should be handled during office hours, there is a $10.00 charge for all after hours calls returned by a physician. If your child is seen the next day or in the emergency room, the fee will be waived.
We cannot give advice or speak about a medical condition concerning your child if the child is not an established patient at our clinic.
During regular office hours , you should call our office concerning minor problems, colds, constipation, prescription refills, etc. Our nurses, under the direction of our physicians, will return phone calls made to us during regular office hours. Please have a pen and paper handy and stay at the number you left so that you do not miss the nurse’s call. If the nurse is unable to help you, a physician will return your call, usually during the noon hour or after 5 p.m., unless our schedule allows us to return them earlier.
If you feel that your child will need an appointment, it is not necessary to speak with the nurse. You should make an appointment directly with the receptionist, but if you are unsure, our nurses will return your phone call to help evaluate the need for an appointment. If you have an emergency, tell the receptionist this. She will notify the nurse or physician immediately.
When you call our office, be specific about the problem or question that you desire to be addressed. In discussing health problems with either our nurse or physician, the following information is helpful:
- length of illness
- main symptoms
- medications with dose currently being taken
- medication allergies
- your child’s weight and age
- your child’s temperature, if they have a fever
- the phone number of a pharmacy that is open
After our regular hours, telephone calls made to our office should be limited to emergency and urgent medical problems which cannot wait until the office is open. After hours, your call will be answered by a pediatric nurse who should be able to help you. If the nurse is unable to help you, a physician will return your call. Please understand that several calls may have been placed at one time or the physician may be dealing with an emergency, so it may take some time for the physician to call you back. We will, however, return your call as soon as possible. After a reasonable amount of time, if we have not called you back (45 min – 1 hr.), you should call our office back to again leave a message. If you have an emergency which requires immediate assistance, take your child to the nearest emergency room or call 911. If it is an urgent problem, but not requiring an immediate trip to the emergency room, please call our office. PLEASE HAVE A PEN AND PAPER READY WHEN YOU CALL.
The simplest and most effective way of communicating laboratory testing results to our patients and parents is to have the parent call our office after a specified amount of time. Tracking a parent down with laboratory results is a time-consuming and costly endeavor for which you, the parent, must bear the cost. Because of this reason, it is our office policy to have parents contact us for their child’s laboratory results.When a lab test is done on your child, we will inform you as to when you should call back for the results. At that time, we can discuss the results of your child’s laboratory testing and also any further plans based upon those results. Of course, if an abnormal result of a laboratory test is received on your child, we will call you immediately to discuss this with you. Please leave
the telephone number where you can easily be reached with the nurse.
Follow-up visits are another important aspect of our practice. Certain serious illnesses require follow-up visits until the problem is resolved. Other illnesses, such as ear infections, also require follow-up visits, usually ten days to two weeks after the infection, to ensure that the problem has resolved. Follow-up visits are extremely important to ensure that further treatment is not needed. It is your responsibility to keep the follow-up appointments as recommended by our office. Failure to keep your follow-up appointment may result in significant health effects in your child.
Routine prescriptions and refills are issued during regular office hours only. If you are calling for a refill, please give us the patient’s name, medication, and pharmacy phone number. We generally do not prescribe antibiotics over the telephone and refills for controlled substances, such as Ritalin, Dexedrine, Concerta, etc., must be picked up at the office. We also ask for one week’s notice if you need a refill on these controlled substances. If you need such prescriptions, call the office, and the nurse will let you know whether an appointment is necessary. If you live out of town and would like a prescription mailed, please supply us with self-addressed,
stamped envelopes (this does not apply to controlled substances as mentioned above).