We LOVE delivering pediatric care and enjoy the personal relationships we have with our patients and families. We must however charge for these services and expect reasonably prompt payment. That way, we can continue to “be there”, whenever you need us. Below is a list of our billing policies that will help us continue to deliver the highest quality medical care that you deserve:
Co-payments, coinsurances, deductibles, and charges for non-insurance covered services must be paid at the time of service. IF you are unable to pay at the time of visit, a $10.00 surcharge will be applied to your bill.
Let us know if your family is under significant financial hardship. Payment plans can be arranged if necessary.
- We now offer the ability to use your credit card to pay your balance online through our website www.mainstreetpeds.com . The process is extremely easy and secure.
- Fees for forms are payable when the forms are presented to the office (at our desk or enclose check if mailed). Please pick up forms at our desk or include a self-addressed stamped envelope if you wish the form mailed. Please allow 2 weeks to process these forms.
- Form fees as of May 1, 2014.
- Standard forms: $10
- Endocrinology, FMLA, and other complex forms: $20
- As before, there is an additional $20 charge if forms are required within 48 hours.
- There is no charge for prescription medication authorization forms or immunization forms.
Missed appointment charges: We do charge for missed appointments. There is a $35 fee for a routine prior scheduled, missed or cancelled appointment with less than 24 hours notice. Illness visits should be cancelled more than 4 hours in advance. There is a $15 fee for missing a vaccine only visit with one of our Medical Assistants without 24 hours notice. Late arrivals may need to be rescheduled.
Re-scheduling appointments if you arrive late: As a courtesy to our other scheduled patients, you may have to re-schedule your appointment if you arrive 20 minutes late or more.
Bounced checks: If your check does not clear your bank on a second submission (we automatically resubmit), you will be billed an additional fee of $35.
Repeated bounced checks: Main Street Pediatrics is unable to accept checks from families if two checks are returned to us without payment. Future payments will need to be made using cash or credit card.
Walk-In Appointments: We always want to assist ill children and accommodate families. Please call the office for an appointment if your child or children need to be seen. We will try to see walk-in urgent patients and extra children brought in to be seen who do not have appointments (though at times that is difficult and can delay other patients). There will be a $25 charge in addition to the normal office visit charge for all walk-in or add-on appointments, with the exception of our Towson office walk-in visit times of 4-6 PM Monday through Thursday. Walk-in visits and times are for acute uncomplicated services (not for ongoing, complicated or chronic health conditions).
After Hours/Weekends/Holidays: If your child needs to be seen at the office, there is a charge of $30 for after hours Saturday, Sunday or Holiday visits, in addition to the regular office visit fee. These charges will be submitted to your insurance carrier and we will expect payment from participating insurers. Charges for similar services at urgent care centers are often much higher than ours and your co-payment is generally smaller for office visits.
- Main Street Pediatrics may charge for physician telephone services when the physicians’ decision-making skills are required, but the call does not result in a current office visit. Examples include telephone consultations for:
- Chronic health conditions (asthma, seizures, medication management, etc)
- Educational and behavioral issues
- After hours calls
- After hours prescription refills
- New prescription medications or diagnostic or treatment recommendations
Main Street Pediatrics will submit charges to all participating insurers for expected reimbursement. Families will receive bills for these services only in instances of rejected coverage by their insurer.
Main Street Pediatrics physicians participate with the vast majority of insurers in our area: private insurance plans, HMO plans, PPO plans as well as Medical Assistance and Medicare. Examples include but are not limited to Blue Cross/Blue Shield, Carefirst, Blue Choice, GHMSI, United, Mamsi, Optimum Choice, Aetna, EHP, Cigna, Aetna, Amerigroup, Coventry, Lifebridge. Please check with our offices AND your insurance company to verify that we do participate.
Many insurances require that you choose a Primary Care Physician (PCP) for your child, and may require that you use a specific lab or radiology facility, or set of referral/specialty physicians when needed. Some insurers require preauthorization for certain services or prescriptions. Please contact your insurance company and find out if you have any such restrictions and let us know. Employers choose different insurance coverage, and we may not know the specifics of your insurance plan. It is your responsibility to assure that your insurance and physician assignments are in order when you come to visit us.
Be sure to sign up any new family members (babies etc) with your insurance carrier immediately, to obtain coverage.
Main Street Pediatrics and its physicians have been recognized for superior patient care by Blue Cross, Blue Shield plans, United Health Plan, MAMSI Health Plans, and Aetna Insurance companies.
We want you to call. We do not want anyone sitting at home (or at the office) worrying about something, and not calling us. There is NO such thing as too small of a question, and we want you to feel comfortable with all issues regarding your child and family.
Therefore, we try to make ourselves as available as possible by opening the office at 8:30am each day and returning your telephone calls throughout the day. It is preferred that you call early in the day if possible, to give us time to return your call. Please try to leave your phone line open if you are waiting for a call back (ESPECIALLY for after hours calls). If your call involves a non-urgent issue, particularly one that may require more lengthy discussion, please provide an alternate number to return your call later in the day. If you will be changing location or telephone availability within a few hours of calling us, please let us know.
After hours and weekend phone calls made to the office are received by voice mail and answered promptly by the pediatrician on-call. For those voicemail messages, it is important to speak clearly, especially when leaving your phone numbers. Our voice mail system always dispatches an urgent page to the physician, so please do not leave a message after hours that does not specifically need physician help. Issues involving refills, non-urgent referrals, appointment times, administrative issues or healthy children are best handled during our regular weekday hours.
The vast majority of your visits, well and sick, will be scheduled with your regular pediatrician. We feel that is the best way to establish and continue a personal relationship with your doctor. Knowing our patients and their families is something in which we take great pride. Click here if you would like to schedule non-urgent appointments on-line.
There may be times when your child has a more urgent need to be seen, in which case any of us will be happy to accommodate you. Our offices open early, and often stay open late to assist you. The Towson office has arranged evening walk-in hours Monday through Thursday from 4pm to 6pm, and the Foundry Row office is open until 7pm on Tuesday through Thursday to better accommodate your busy schedules. In addition, both offices are available weekend mornings for patients who need to be seen. Speak with your physician or office receptionist about available visit hours.
Initial physical examinations are often lengthy visits, because we need time to get to know each other. It is helpful to have all medical and immunization records sent to us PRIOR to the visit so these can be reviewed beforehand.
Well Child Visits (Check-ups) The newborn visit should be scheduled at a few days of age to 2 weeks of age (your physician will discuss this with you). Subsequent well visits will occur at 1 month, 2, 4 and 6, months, 9, 12 and 15 months, 18, 24 and 30 months, and then annually starting at age 3 years. These visits provide an assessment of all aspects of your child’s health, growth, development and behavior, and give you the opportunity to ask questions you have. Your pediatrician will discuss what to expect over the next phase of your child’s life. If there is not enough time during the checkup visit to discuss all concerns, or if there are items that would benefit from further discussion, the pediatrician will suggest setting up additional visits.
Cancellations: If you need to cancel or reschedule an appointment, particularly a well visit or consultation, please do so at least 24 hours in advance. A significant amount of time is allotted for these appointments and we would like to offer this time to other patients if you are unable to keep your appointment. There is a $35 fee for routine appointments missed or cancelled with less than 24 hours notice.
Arrive On-Time: We try to be as on-time for our appointments with you as possible. Please come to the office promptly for your scheduled visit so that we can give you and your child the attention you need. It may be difficult to help you and the other families we need to see if you are late. As a courtesy to our other scheduled patients, you may need to re-schedule your appointment if you arrive 20 minutes or more late.
Walk-In Appointments: We always want to assist ill children and accommodate families. Please call the office for an appointment if your child or children need to be seen. We will try to see walk-in urgent patients and extra children brought in to be seen who do not have appointments during regular office hours (though at times that is difficult and can delay other families). Specific walk-in hour times may be designated by the office to help with illness needs. Check with your office or doctor about these extra services.
After Hours/ Weekends: If your child becomes sick after hours, on weekends, or over the holidays, we are happy to help. If the issue cannot or should not wait until the next morning, contact us through our urgent after hours number and we will return the call as soon as possible. If your child needs an appointment the next day, but is OK to wait overnight, contact us after 8:30AM for assistance. Weekend morning visits can be arranged in this fashion
Referrals, Forms, Prescription Refills
Please allow sufficient time for these requests. Referrals must be registered with your Insurance carrier and can take several days for us to get approval for you. Call us as soon as possible to start processing your referral.
We ask at least 24 hours notice for prescription refills so that we can review your child’s chart and assure we are offering the best care for any ongoing problem. Call us or click here to request a refill of your medication.
School, daycare, camp and similar forms take time to review, and to provide all requested information. We routinely complete these forms in two weeks. If you require the forms to be filled out within 48 hours, there will be an extra $20 fee. For a complete list of form fees, click here.
You have the right to:
- Competent, considerate and respectful health care, regardless of race, creed, age, sex or sexual orientation.
- Choose your own Main Street Pediatric Physician depending on availability.
- A personal clinician who will see you on an on-going basis.
- An individualized treatment plan which takes into account you, your child’s and your family’s issues and needs.
- A complete, easily understandable explanation of your condition, treatment, illness expectations as well as wellness needs.
- Confidential management of communication and records pertaining to your medical care.
- The information necessary to make an informed decision about any treatment or procedure.
- Coordination of care with referral physicians.
- Same day urgent illness appointments when you call us early in the day.
- 24 hours, 7 days per week access to a Main Street clinician for urgent issues.
- To participate or not in any research project that might be presented for your consideration.
- Any explanation of your medical bill.
- The opportunity to file a complaint should a dispute arise regarding care, treatment or service.
- The expectation that Main Street Pediatrics will take reasonable steps to overcome cultural or other communication barriers that may exist between you and the staff.
You are responsible for:
- Knowing your health care clinician’s name and contact information.
- Giving your clinician correct and complete health history information, e.g. allergies, past and present illnesses, medications and hospitalizations, family and social history.
- Providing staff with correct demographic and contact information, so we can readily reach you in the event of a schedule change and to give medical or clinical results.Providing staff with correct insurance information, including any secondary insurance, initially, and when you have any changes.
- Communicating to other caregivers not present during the office visit, all pertinent information discussed by the doctor.
- Signing a “Release of Information” form when asked so your clinician can get medical records from other clinicians involved in your care and have outside clinician visits forwarded to us.
- Telling your clinician about all prescription medications, or other therapies, or over – the -counter medications you take.
- Telling your clinician about any changes in your condition or reactions to medications or treatment.
- Keeping your appointments, arriving on time and if you must cancel your appointment, please call the office at least 24 hours in advance.
- Payment of copays, and any balances due at the time of service.
- Prompt payment of any balance due for services rendered, after insurance submission.
- Treating the Main Street staff in a cordial and respectful manner.
- Allowing for 2-day notification for prescription refills.
- Allowing for 2-week notification for any form completion.
- Requesting referrals and knowing/obtaining information from your insurance carrier as to network of providers, labs and radiology facilities for referral management.