Office Policies

Welcome to Summer Pediatrics. Our staff is dedicated to providing you with the highest quality health care. We hope this information helps you understand how our office operates, as well as your responsibilities during your visits. We kindly ask that you refrain from eating, drinking, or using cellular phones while in our office.

Appointments and Late Arrivals

• We ask that patients arrive on time for their appointments. When patients are late, it becomes difficult to maintain our schedule. If you arrive more than 15 minutes late, you may need to be rescheduled to avoid inconveniencing other patients. Alternatively, you may be seen if the day's schedule allows for it.
• We expect patients and parents to provide at least 48-24 hours' notice if they are unable to attend their scheduled appointments. When you confirm an appointment, it means other patients miss the opportunity to book that time slot. Additionally, our providers dedicate their time to you, and often, staffing and product orders are arranged based on your appointment.
• Please note that if you miss a scheduled appointment, a fee of $50 will be charged. If a family has three missed appointments without notice, they will be automatically discharged from our practice. 
• All Children under the age of 18 must be accompanied by an adult.

Insurance Plans

• It is your responsibility to confirm with your insurance company whether our physician is currently under contract with your plan or if you can access "out of network" benefits. Any questions regarding medical care, well-baby visits, preventive care, lab tests, x-rays, and immunization coverage should be directed to your insurance carrier before your visit. You agree to be responsible for all co-payments, deductibles, and any non-covered services as determined by your insurance plan.
• Please remember to bring your child’s insurance card to each appointment. You may also be responsible for additional charges, such as laboratory testing and vision screenings, depending on your coverage. If you change insurance plans, please inform us immediately. If you fail to notify us of any changes in coverage, you will be responsible for paying for the services rendered.
• It is your responsibility to understand your plan benefits. Not all plans cover well-child visits, vision/hearing screenings, or physicals. If these services are not covered, you will be responsible for payment.
• If we are your primary care provider, make sure our name/phone number appears on your most up-to-date card. If your insurance has not been informed that we are your primary care provider, you may be financially responsible, you will be responsible for your current visit.

Financial Responsibility

• Co-payments and any past-due balances must be paid at the time of check-in. I will ensure I am prepared to make these payments. A $15.00 service fee will be charged in addition to your co-pay if not paid at the time of service.
• I understand that my account will be charged $30 for insufficient funds or returned checks.
• Patient balances are billed monthly. We ask that you pay your statement balance after receiving your first statement. A 20% surcharge will be assessed on all balances over 60 days old.
• For scheduled appointments, any outstanding balances must be paid prior to the visit or you will be asked to reschedule.
• Self-Pay if I do not have proof of insurance coverage at the time services are rendered, I understand that payment is due at the time of service.
• Collection Policy: If we need to refer your account to a collection agency or law firm to collect any unpaid balance, you will be responsible for paying the collection costs in addition to the unpaid balance. If your account is sent to collections, or if you do not pay the outstanding balance or establish a payment plan, we reserve the right to discontinue our services and classify your account as delinquent. In such cases, we will provide you with a medical record release form for your signature, allowing you to transfer your care to a new physician.

Wellness Care

• Wellness care is an essential part of keeping your child healthy and regular check-ups are required by Summer Pediatrics. Patients who do not have preventative coverage can receive this service at a discounted rate if paid at the time of service.

Referrals

• It is your responsibility to know if a selected specialist participates with your insurance.
• A scheduled visit is required for a referral.

Forms

• There is no charge for a certificate of immunization given at the time of your child's visit. There is no charge for 1 page physical or medication forms presented at the time of visit.
• For Chronic conditions, needy forms will be free when requested during a scheduled visit for the problem.
• Any additional school, camp, sports forms, or letters are subject to a $25 flat fee. 

Medical Records

• A written authorization is required to release medical records. The staff will provide you with the form.  Please be aware that $15 per USB drive is charged, and if requested on paper, there is a charge of $.65 per page and a $15 administration fee.
• We provide records of your child’s visits with Summer Pediatrics only. All records for outside facilities or providers should be obtained from them directly.

Prescription Refills

• Prescription refills may be requested but are only accepted through the portal- Pharmacy requests will be denied. Please allow 48 to 72 hours for all prescription refills.
• For monthly medication refills, we require 5 days’ notice, during regular business hours. Please plan accordingly.
• For controlled substances, an appointment is required.

Photo Wall/Social Media

• We love celebrating our amazing patients and would be honored to feature your child’s smile on our photo wall! Photographs will only be displayed with the parent or guardian's written consent. Participation is completely voluntary, and consent may be withdrawn at any time without affecting your child's care.

I have read and understand this office policy and agree to comply with and accept the responsibility for any payment that becomes due as outlined in this document.