PROTOCOLS RE : DIVORCE / SEPARATION / UNWED PARENTA / CHILD CUSTORY/LITIGATION & COURT PROCEEDINGS

Documentary proof of custody and authority to act: In divorce/separation/unwed situations, we require a signed copy of the custody order be provided to our office prior to the delivery of care to confirm the information as to the status of legal custody, who is supposed to hold insurance on the child/children and the specific language critical to determining whether the consent of both parents is required for treatment of a minor child. An unsigned copy of a court order will not be accepted. A certified copy of a court order is preferred.

Financial Responsibility: If the patient is a minor (or is subject to guardianship under Court Order), a parent or legal guardian must consent to treatment and accept responsibility for payment for services rendered. In the case of divorced, separated, or unwed parents, whichever parent brings the child to the appointment is responsible for any payments due. Arrangements (including court orders and Decrees) notwithstanding, the parent or legal guardian who bring the child to the appointment will be considered the financial responsible party and will be billed and agrees to be liable for all balances outstanding.

Full payment for services rendered is expected at each visit. Arrangements for reimbursement by a responsible party from co-parents or other parties must be addressed directly by the parties themselves, the parents, or by the legal guardian. Our office will not intervene between parents or interpret court orders regarding payment obligation. Our office routinely does not give refunds or transfer monies between parents in a divorce proceeding. The parties who have custody of the minor child or their guardians are expected to address any accounting between the parties outside this office.

If there is insurance that is applicable to the care of the child in our offices, we require you to also provide us with a signed order or signed agreement demonstrating who is court ordered or legally responsible to carry primary insurance applicable to the child. Our office cannot and will not bill an insurance entity for childcare held by someone other than a biological parent unless we have a signed court order/legal document authorizing that billing. We are required to follow court orders first and then proceed with the insurance thereafter. If the circumstances change as to insurance or court orders regarding payment for care of a minor child, the parents or the guardians have an affirmative responsibility to advise the practice of such changes.

Communication of information about a child: Without a court order specifically addressing communication of information and which order prohibits communication of medical information about a minor child to one or to both of the parents of such child, we will not refuse to update any parent from receiving information about the medical care of his/her child. However, it is our policy that the parent who brings the child to the appointment is responsible to communicate clearly with the other parent who was not present, about the plan of care. Our office does not provide an additional visit (telehealth or in person, without the child) after the original

appointment, to the other parent, to go over the plan discussed during the visit. The practice reserves the right to provide medical records from patient encounters to the noncustodial or co- parent, but the practice is not obligated to orally explain a care plan or any medical diagnosis twice, once to each parent, except in the case of a genuine emergency or other exigent circumstances.

Parental or other conferences or conference calls: If a face-to-face conference, or a conference call is required to jointly advise the parents of a child about the medical status, care, plan, or prognosis of a child, such a conference or conference call shall be conducted in a civil, professional, and collegial manner with the best interests of the minor child at the forefront. The practice reserves the right to terminate any conference or conference call when one or more of the parties becomes disruptive, raises his or her voice in anger, threatens any person, or does not act in a civil, professional, and collegial manner and in the best interest of the child.

 

Court Appearances:

a. Medical Records: Due to the detailed nature of medical records, and the electronic nature of those, the practice keeps detailed records of the medical care provided and of the billing generated. Upon reasonable request, and with the prepayment of the standard medical records ease, the medical records custodian of the practice can provide an affidavit of authenticity as to medical records and/or as to billing upon ten(10) days' advance notice except in emergency circumstances. Prepayment of the medical records fee is a requirement for the production of the medical records because of the administrative time and requires away from attending to patient care. Efforts to subpoena medical records at the last minute will be resisted.

b. Testimony: With rare exceptions, our physicians and are staff do not appear in court in legal proceedings, and we will oppose efforts to subpoena our physicians and staff to court especially at the last minute, without prior scheduling for a date and time certain to appear, and without arrangements for the payment of the professional fees and expenses that are foregone by any such court appearance. Please advise your attorney accordingly If a need for professional testimony under oath is legitimately required, the parties and their attorneys are encouraged to consider use of a video deposition scheduled in advance of the applicable court hearing or trial in which that testimony is needed. If a video deposition is scheduled, the parties will be advised that the professional fees and costs that will be incurred, and arrangements must be made in advance of such deposition duration of the deposition or court appearance. Efforts to subpoena the physicians or staff at our practice at the last minute, which is with less than thirty (30) days' notice, will be resisted because of the inconvenience and disruption that occurs to the other patients of the practice and their children who were not involved in contentious litigation. If court testimony or a deposition is required, the attorneys are required to agree to a date and time certain for such testimony, subject to court approval, and counsel shall be required to agree to take such court testimony out of order, subject to court approval, in order to accommodate the testimony at the date and time scheduled. Rare exceptions can be made

to this policy, but generally only on behalf of the State in a criminal prosecution, such as in abuse cases, or an analogous emergency circumstance.

Withdrawal: The practice reserves the right to cease care of any patient and to dismiss the patient from the practice in the event these protocols are not followed or if we determine in our sole judgment that optimal patient care cannot be delivered to the minor child under the circumstances then and there existing. We will not tolerate abuse, harassment. Disruptive conduct or discourtesy to our physicians or to our staff. Please provide a copy of these protocols to your attorneys with thanks.

Acceptance of these Protocols: The provision of care at this practice, constitutes the acceptance of the custodial parent(s) or guardian(s) of these protocols. If you are a noncustodial parent, in order to prevent confusion and misunderstanding, it may be wise to provide a copy of these protocols to the noncustodial parent and/or to the noncustodial parent's attorney or to any guardian. In the event custody changes, please advise the medical practice in order that we may ensure that the noncustodial parent or guardian is also advised of these protocols.