Plymouth Pediatric Associates practice policies

It is the goal of PPA to provide the best possible medical care for our patients in an environment that is welcoming and family-friendly. We have developed these practice policies to support our goals.

Vaccines are one of the most important advances in the history of medicine. They are the best way parents can protect their children from deadly diseases. The doctors of PPA strongly believe in the importance of vaccines. The schedule put out by the American Academy of Pediatrics is the best way to keep your child safe. Alternative vaccine schedules put your child at risk, as well as children who come into contact with them. The false information spread in recent years regarding vaccines has led to the return of deadly diseases.

It is our hope to create a relationship of trust and mutual understanding with all of the families that we care for. We also have the duty to provide the best evidence-based care for your child, and to protect all of our patients from exposure to preventable diseases. Taking all of this in to account, we will no longer be able to offer alternative vaccination schedules. Thank you for your understanding and for allowing us to participate in the healthcare of your family.
Our goal is to provide your child with the best possible medical care. In order to avoid any possible misunderstandings, please carefully review the information below about insurance, billing and payment policies.

We are not contracted with all insurance plans, and it is not possible for us to know the details of your individual plan. It is the parents’ responsibility to be knowledgable about their insurance coverage and limitations. If our doctors are not on your insurance plan, payment is due in full at the time of your visit.

It is important to understand that your insurance is a contract between you, your employer and the insurance company. We are not a party to that contract. Not all insurance companies cover all services. You are responsible for knowing what is and is not covered under your insurance plan.

Some insurance plans require that you select a Primary Care Physician (PCP). If you have not done so, the insurance plan may deny coverage, so please make sure that you have selected a PCP prior to your visit. If you have not done so, you will be financially responsible for the visit.

You must add your newborn to your insurance policy as soon as possible. If you do not do so, you may be financially responsible for all visits. In some cases, if a newborn is not added within a 30-day period, you will have to wait for open enrollment, which would leave your child uninsured until that time.
Your insurance plan requires co-pays to be collected at the time of service. We accept Mastercard, Visa, Discover, checks and cash. If you do not pay your co-pay at the time of your visit, we will charge an additional $10 to cover the cost of billing services. Returned checks will be charged a $20 fee.

Please bring your insurance card to every office visit. If the insurance you designate is incorrect, you will be responsible for any balance.

For all services rendered to minors, the adult accompanying the patient is responsible for payment, whether a parent/legal guardian or not. If your child will be brought to our office by a babysitter or other caretaker, please be sure to arrange for payment of co-pay to avoid a service charge if we have to bill you. Credit card payment can be made on the phone prior to the appointment.

We bill monthly for unpaid balances. If any portion of your bill has been outstanding for greater than 90 days, you will receive a letter stating that if the balance is not paid within 10 days your account will be forwarded to a collection agency.

If you are experiencing financial hardship, please speak with our billing manager so that we can set up a payment schedule.

Failure to pay an overdue balance on your account, or to set up and abide by an agreed-upon payment schedule, can be cause for dismissal from our practice.

Self-pay: if your child is not covered by insurance at the time of your visit, or if you are from out of town and we are seeing your child as a service to you, the full amount of the visit is due at the time of service.
So that we may accommodate the needs of all our patients, it is essential that you make every effort to come to your child’s scheduled appointments and that you arrive on time. Unfortunately, when even one patient arrives late, it can throw off the entire schedule for that session. Therefore, if you are 15 minutes or more late for an appointment, we may need to reschedule your visit. Patients who arrive on time will be seen ahead of those who arrive late.

“No-shows” or appointments canceled with less than 24 hours notice will result in a fee of $50 (unless you call us on the day of the appointment to notify us that you are experiencing an emergency). Failure to give us adequate notice that you are canceling an appointment does not allow us to use that time to accommodate other children who are in need of appointments. Please be advised that if your family has 3 late cancellations or missed appointments within a two-year period, it may result in dismissal from our practice.

“Squeezing” in an extra child during a visit: Please know that when you do not inform us in advance that you would like us to examine and treat another one of your children during a scheduled visit, we have not allotted the necessary time in our schedule to accommodate your request. Therefore, all of the subsequent visits are delayed, thus increasing wait times for the patients with scheduled visits following your appointment, and creating a rushed feeling to your visit. If you would like more than one child seen, please inform the nurse when you are making your child’s appointment so that we can accommodate your request. If you request that we examine a child who does not have a scheduled appointment, we will need to register that child, create a visit in the medical record, and charge a co-pay if your insurance company has one.

We schedule our routine wellness check-ups to allow for time to perform the necessary screenings and exams that your child is due for. If problems come up or are discovered during the visit that require additional time or services, this may result in another charge being billed to your insurance company, and that might result in your insurer charging you a co-pay for that additional service. That co-pay is a requirement of your insurance company if additional services outside of the scope of a routine wellness check are needed.
Many of our patients are children whose parents are either separated or divorced. Our primary concern for these children is to promote their health and well-being. In such situations, we are happy to work with either or both parents to make sure the child’s healthcare needs are met.

When a minor child visits our office accompanied by either parent, we will assume that parent has full or joint legal custody, hence the authority to make medical decisions for the child, unless we are instructed otherwise, in writing, by a legal authority.

It is essential that we can depend on the child’s parents to communicate clearly with each other about the child’s health status and healthcare plans. Our general approach is to communicate our medical assessments and recommendations with the parent who accompanies the child to the office, or with the parent who contacts us by telephone or electronic communication. It is not feasible for us to take the responsibility of contacting each parent separately every time we see the child in the office. We are, however, happy to receive inquiries about the child’s health from either parent at any time.

We cannot mediate financial disputes between the two parents. When children visit our office, we hold the accompanying parent or guardian responsible for any payments required, regardless of divorce decree. Any disputes about reimbursement for medical expenses need to be settled between the parents privately.
In order to ensure that our adolescent patients receive the best possible medical care, Plymouth Pediatric Associates has adopted an Adolescent Confidentiality Policy which we would like you to be aware of.

Beginning at age 13, each patient will be encouraged to meet privately with their physician or nurse practitioner for a portion of their annual checkup. We believe that this privacy helps ensure that the patient provides us with complete and candid information that will assist us in caring for them.

The information discussed by an adolescent and their doctor or nurse practitioner is confidential. We will not discuss this information with anyone without the permission of the patient. While this information is considered confidential, we will always encourage our patients to be open and honest with their parents, and we will do our best to facilitate that communication.

The only time that we would break confidentiality is in the rare circumstance that we think a patient poses a risk to themselves or to another person.

This policy is consistent with Massachusetts state law regarding adolescent confidentiality, as well as the policy of the American Academy of Pediatrics. Research has shown that as many as 35% of middle and high school students have refrained from seeking needed health care because of concerns about privacy. Given how serious the consequences of not getting that healthcare can be, we believe it is essential for us to have this policy.

If you have questions or concerns about this policy please share them with your child’s pediatrician.
Respect At Plymouth Pediatric Associates we are committed to providing your child with the best possible medical care, and this includes treating you and your child with respect, kindness and dignity at all times. If at any time you feel that you or your child have not been treated in this way, please notify either your child’s doctor, our Clinical Manager or our Administrative Manager. We are also committed to providing a safe and supportive working environment for our staff, which means treating them with the same considerations. We fully recognize that under stressful circumstances tempers can flare. However, we will not tolerate any employee being subjected to rude or inappropriate language or behavior. Such behavior will result in dismissal from our practice with 30 days written notice

Cell phones Please silence your cell phone once you have entered the examination room. If a provider (nurse, physician or nurse practitioner) enters the room and you are talking on your cell phone, please end the call immediately or they will move on to the next patient until you are available.