Office Policies

The following are seen by appointment only:

• Follow up appointments
• Well exams and immunizations
• Hearing/vision screening
• School/Sport/College/Camp/Kindergarten physicals
• Sick visits

A provider is on call 24/7 with any concerns you might have regarding your child.

**ALL NEW PATIENTS MUST ARRIVE 15 MINUTES PRIOR TO THE 1ST APPOINTMENT TIME TO AVOID CANCELLATION**

Newborn Payment Policy 

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Hospitalizations

Wake Med in Cary and Apex do NOT hospitalize children (ER visits only). If your child needs to be admitted they will go to Wake Med in Raleigh.

If you are scheduled to deliver at Rex or Wake Med and would like us to be your new baby’s pediatrician, please notify your OB/GYN team in advance.

HIPAA Notification

Our practice has implemented the Health Information Portability and Accountability Act to protect in the privacy of the patient health information. In your absence we will request from the person with your child some form of photo ID for comparison to your child’s patient profile that you have completed giving specific persons permission for Consent for Treatment and Patient Health information. If the person with your child is not listed on the Patient Profile, our office will be contacting you. Anyone other than the parent picking up prescriptions, forms, or any other information on your child will also need to present photo ID.

Current Information

As a patient at Holly Springs Pediatrics, you are required to notify our staff of any changes in your patient information, such as insurance, benefits, employer, patient name, home address and/or contact numbers. You will be asked to present your current insurance cards at each appointment.

Billing Policy

The following is a synopsis of Holly Springs Pediatrics’ billing and payment policies.

All co-payments are expected at the time of service. For your convenience, Holly Springs Pediatrics accepts cash, personal check, Visa/Master Card/Discover debit cards and credit cards. Surcharges will be assessed for returned checks or co-payments not made at the time of service.

Our contracts with insurance companies require that we verify your current coverage and collect a co-payment at each visit. If your insurance plan requires deductibles and co-insurance, you will be responsible for these charges. Please bring your insurance card to every appointment.

Fees for Non-Covered Services

The following fees will be charged for services that are not covered by insurance:

• Missed sick appointment (if not canceled 2 hours prior) $25
• Missed routine well visit (if not canceled 24 hours prior) $50
• Late arrival for well visit (more than 15 min after scheduled start) $50 + reschedule
• Returned check $35
• Co-payment not paid at time of service $20
• School/sports/daycare/camp form (waived if presented at time of well visit) $10
• “Rush” (same day) forms (waived if presented at time of well visit $15

We are available on Saturdays to treat your urgent patient needs. However, appointments scheduled on Saturdays, after 5PM on Monday’s and Thursday’s and on holidays will be subject to a $30 surcharge. If you are insured, this charge will be billed to your insurance carrier. If declined by them, it will be charged to you.

All accounts past due by 90 days or more are subject to being sent to collections with a 35% fee added to the total balance. 

Claims Filling

As a courtesy to our patients, we file claims with your insurance company and also coordinate benefits with secondary payers. You will be responsible for timely payment of any patient balances as directed by your insurance. You will also be responsible in the event that the claim is disputed or unpaid.  It is up to you to understand your insurance policy including deductibles and co-insurance.  It is your responsibility to provide up-to-date insurance information at every visit.

After Hours Triage Calls

If you have an emergency, you can call the office after business hours and you will be transferred to a medical answering service. A registered nurse will answer and triage all calls and will page the on-call doctor if necessary. There is a $20.00 fee($25 during holidays) for after-hours calls and this will be billed directly to you. Your insurance will not cover this charge. During the hours of 8:00 AM – 5:00 PM Monday through Friday, and 8:00AM-1:00PM Saturday, our staff provides this valuable service.

No Show Policy

Each time a patient misses an appointment without providing proper notice, another patient is prevented from receiving care. Therefore, Holly Springs Pediatrics reserves the right to charge a fee, as outlined above, for all missed appointments (“no shows”) and appointments which, absent a compelling reason, are not canceled with 24-hour advance notice. “No Show” fees will be billed to the patient. This fee is not covered by insurance and must be paid prior to your next appointment. Three or more FAMILY “no shows” for an established patient may result in a discharge from our practice.  No shows for NEW patients will automatically result in a discharge from the practice.  Thank you for your understanding and cooperation as we strive to best serve the needs of all our patients.

Late Policy

You have the responsibility to arrive at our office at your scheduled appointment time. Holly Springs Pediatrics reserves the right to reschedule patients that show up 15 minutes late to their appointment.  **ALL NEW PATIENTS MUST ARRIVE 15 MINUTES PRIOR TO THE 1ST APPOINTMENT TIME TO AVOID CANCELLATION**

Divorce Policy

We believe that divorce, separation and custody agreements should not enter into a child’s medical treatment. The parent who is requesting the medical treatment is individually responsible for the payment of the medical bills. We are not a party to your divorce agreement; we will collect co-pays and deductibles from the attending parent.

“Joint Custody” means that each parent has equal access to the child’s medical record.  Without a court order, we will not stop either parent from looking at their child’s chart or obtaining their child’s test results. In the circumstance of joint custody, we will not call the other parent for consent prior to treatment or to inform the non present parent of the assessment and/or plan of care, if any. Again, we will discuss with the accompanying parent, information pertinent to the child’s history and/or present exam. It is then the responsibility of the parents to communicate with each other.

We reserve the right to charge an administrative fee for copying records should the requests become excessive.

Should issues between the parents become disruptive to our medical practice, we reserve the right to discharge a family from our care and responsibility.