Policies

Appointments

  • Sick Appointments

    We make every effort to schedule appointments for ill children on the day that you call us. Please call our office ahead of time so that we can minimize the time that you will spend waiting.

    If you have a medical emergency during office hours, we will do our best to see your child immediately or refer you to the appropriate facility.

  • Appointment Required

    All visits require an appointment except for Saturday morning walk-in clinic in the Wilmington office. Patients who walk in with a non-emergency condition will be fit into the existing schedule as best as possible, or they will be asked to return later in the day when the schedule allows.

Other Policies

  • Vaccine Policy

    PURPOSE: We firmly believe in the effectiveness of vaccines to prevent serious illness and save lives, in the safety of our vaccines, and that all children and young adults should receive the recommended vaccines according to the schedule published by the Centers for Disease Control and the American Academy of Pediatrics.  We also believe unvaccinated children pose a risk of spreading these serious diseases to other children who are either too young to be vaccinated or who are unable to be vaccinated because of medical conditions.

    Vaccine Schedule:   As recommended, vaccines and the schedule at which they are given are the results of many years of scientific study and data gathering on millions of children by thousands of scientists and physicians. This being said, we recognize that there has always been and will likely always be controversy surrounding vaccination. The vaccine campaign is truly a victim of its own success. It is precisely because vaccines are so effective at preventing illness that we are even discussing whether or not they should be given. Because of vaccines, many of you have never seen a child with polio, tetanus, whooping cough, meningitis, or even chicken pox. Such success can make us complacent about vaccinating.

    We are making you aware of these facts not to scare you or coerce you, but to emphasize the importance of vaccination. We will do everything  we can to convince you that vaccinating according to the schedule is the right thing to do.  Our goal is to educate and to alleviate any fears you may have.  At each well visit the benefit of immunizations will be discussed with you in the hope that you will accept  the vaccine(s).  Should you refuse to vaccinate, you will be asked to sign a declination form which will remain a part of the permanent record.  Refusal to sign the declination form or efforts to alter it in any way is basis for immediate dismissal from the practice.

    Finally, if you absolutely refuse to vaccinate your child despite all our efforts, we may ask you to find another practice who shares your philosophy and with whom you will be more comfortable.  If an older child is unvaccinated, or under vaccinated, we would be happy to start them on a catch-up schedule to ensure they are fully protected.  If that is not acceptable to the you, we may again ask you to establish care with another practice.  For the most recent vaccination schedule, please visit CHOP.  As a prospective new patient of the practice you will be asked for your vaccine record prior to being seen for sick or well visits.  If your child is unvaccinated and you are unwilling to consider vaccines we will ask you to find a practice more in line with your philosophy.  This policy also applies to existing patient families with new babies who choose not to vaccinate.

  • Financial Policy

    According to the contract you entered into with your insurance plan, you are responsible for any and all co-payments, deductibles and coinsurances at the time of your visit.  Self-pay patients and those with high deductible plans are expected to pay for service in full at the time of the visit.  If we do not participate in your insurance plan, payment in full is expected at the time of your visit.  We will supply you with an invoice that you can then submit to your insurance company for reimbursement.

    The adult accompanying the patient to our office is responsible for payment of the applicable co-pay, deductible or coinsurance regardless of whether it is the parent or guardian.  For instance, if another family member brings your child to the office, he or she should have with them a copy of your insurance card and any applicable payment.  In divorce or separation situations, we do not split the financial responsibility for payment of the service.

    Patient balances are billed immediately upon receipt of your insurance plan's explanation of benefits (EOB).  If after 90 days, you have not satisfied the payment due, or made other arrangements, your account may be sent to a collection agency.

    For your convenience we accept cash, check, debit cards and credit cards (Visa, MasterCard, Discover and American Express).  A $40.00 fee will be charged for any check returned for insufficient funds and from that point forward we will only accept cash, debit or credit transactions.

    Making your payment by phone is an option for those paying with a credit card.

    We require 24 hour notice should you need to reschedule and/or cancel your appointment(s).  Failure to provide appropriate notice will result in a $25.00 missed appointment fee charged.

    Unless other arrangements have been made with our billing department, delinquent accounts must be paid in full before we can offer you an appointment.
     
  • Non-Covered Services Policy

    NON-COVERED SERVICES WAIVER

    I understand that some services may not be considered eligible for benefits but are recommended by my healthcare provider to ensure high quality care for my child.  I understand that my health insurance coverage has certain restrictions and limitations, such as authorization requirements, and non-covered services and supplies. Since I have chosen to obtain the services and/or supplies, I agree to be financially responsible for any and all related charges(s), if not covered by my insurance.
     
  • Privacy Policy HIPAA

    Carolina Pediatrics of Wilmington, P.A - Notice of Privacy Practices.

    This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

    The purpose of this Detailed Notice is to inform you about your privacy rights and provide you with information on how Carolina Pediatrics of Wilmington, P.A. may use and disclose your personal health information.  All Carolina Pediatrics of Wilmington employees, staff, personnel, and volunteers must follow the terms of this Notice. We are required by law to keep health information that identifies you private to the extent described in this Notice, follow the terms of this Notice and provide you with this Notice of Carolina Pediatrics of Wilmington's legal duties and privacy practices with respect to your personal health information.

    Uses and  Disclosures

    Treatment.
    Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating  your health, diagnosing  medical conditions, and
    providing  treatment.  For example, results of laboratory tests and procedures will be available   in your medical record to all health professionals who may provide treatment or who may be consulted by staff members.

    Payment.
    Your health information may be used to seek payment from your health plan, from other sources of coverage such as an automobile insurer, or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.

    Health care operations.
    Your health information may be used as necessary to support the day-to-day activities and management of Carolina Pediatrics of Wilmington. For example, information on the services you received may be used to support budgeting and financial reporting, and activities to evaluate and promote quality.

    Law enforcement.
    Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law-enforcement investigations, and to comply with government mandated reporting.

    Public health reporting.
    Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state's public health department.

    Other uses and disclosures require your authorization.
    Disclosure of your health information or its use for any purpose other than those listed above requires your specific written authorization. If you change your mind after authorizing  a use or disclosure of your information  you may submit a written revocation of the authorization. However, your decision to revoke the authorization will not affect or undo any use or disclosure of information that occurred before you notified us of your decision to revoke your authorization.

    Additional Uses of Information.

    Appointment reminders.
    Your health information will be used by our staff to send you appointment reminders.

    Information about treatments.
    Your health information may be used to send you information that you may find interesting on the treatment and management of your medical condition.  We may also send you information describing other health-related products and services that we believe may interest you.
     
  • Appointment Policy

    Our practice makes every effort to run on time with appointments, as we believe everyone’s time is equally valuable.  If one of our providers is running behind, we will let you know.  If you are unable to wait, we will help you reschedule the visit. 
     

    As a courtesy, we will remind you of your upcoming appointments via phone/text message/email.
     

    We ask that you arrive 5 minutes before your scheduled appointment time.  We understand sometimes things happen beyond your control that may cause you to be late. However, we reserve the right to ask you to reschedule if you arrive late for your appointment.
     

    Missed Appointments: Broken appointments represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you. We reserve the right to charge a fee for canceled or missed appointments. We request 24 hours notice for cancellation of appointments.
     

    A fee may be charged for a second missed appointment. The third consecutive missed appointment will result in discharge from the practice.

     

  • Forms Policy

    Please bring all needed forms to your child's visit.  There will be a charge for all forms that are not brought in the day of the child's visit.  Routine forms that are brought in or requested after the day of the child's visit will be completed within 48 hours for a charge of $8.00.  These include, but are not limited to: Kindergarten, Day Care, Sports Forms, Camp forms.  If you have a form for completion that is not listed here, please inquire with the Front Desk.   Many forms require the parent/guardian to complete the top portion of the form, if this is the case with your form you must complete this prior to submitting it to Carolina Pediatrics for completion.
     

    Immunization Records are always available (24 x 7) on your patient portal at no charge.    
     

    Completion of complex forms will be charged $25.00 per form for each initial and updated form requested.  These include FMLA forms, College Entrance Forms, Adoption Forms, Driver’s License and Military forms* and can take up to 5 days to complete.  *Military forms, depending on circumstance, may require an office visit in order to complete.  This will be determined by the Provider at the time of the request.
     

    If same day service is requested there will be an additional charge of $10.00 per form.  Forms brought in the day of the child's visit will NOT be charged.
     

    Payment is required when form(s) are dropped off – cash, check or credit/debit card.  Forms faxed or emailed to the office must be paid via phone prior to completion with a credit/debit card. 
     

    There is no charge to the parent or guardian for forms required for pharmacy supplies, OT, Home Health, DSS, Foster Placement, WIC forms, Medication Forms, or Educational Services (EC) forms
     

    All forms can be returned to the requestor via secure email if preferred.

  • Patient Rights and Responsibilities

    Carolina Pediatrics of Wilmington - PA Notice of Patient's Rights and Responsibilities  

    As a patient you have certain rights and responsibilities. We recognize that a respectful relationship between the healthcare provider and the patient is the foundation of proper medical care. 

    Patients have the right to:

    • Receive humane care and treatment, with respect and consideration
    • Privacy and confidentiality when seeking or receiving care except for life threatening conditions or situations
    • Confidentiality of your health records
    • Be informed of and to exercise the option to refuse to participate in any research aspect of your care without compromising access to medical care and treatment
    • Receive accurate information concerning diagnosis, treatment, risks involved, and prognosis of an illness or health related condition
    • Ask about reasonable alternatives to care
    • A second professional opinion regarding one's health care and treatment
    • Participate actively in decisions regarding one's health care and treatment
    • Accessible information regarding the scope and availability of services
    • Be informed about any legal reporting requirements regarding any aspect of screening or care

    Patients have the responsibility to:

    • Provide complete information about one's illness/problem, to enable proper evaluation and treatment
    • Ask questions so that an understanding of the condition or problems is ensured
    • Show respect to health personnel and other patients
    • Re-schedule/cancel an appointment so that another person may be given that time slot
    • Provide the practice with any updates or changes in demographic information including address, phone number, and email address
    • Provide the practice with any updates or changes in insurance information including secondary insurance coverage 
    • Pay bills or file health claims in a timely manner
    • Use prescriptions or medical devices for oneself only
    • Inform the practitioner(s) if one's condition worsens or an unexpected reaction occurs from a medication


    If you believe that your rights as a patient have been violated, you should call the matter to our attention and may do so by sending a letter outlining your concerns or complaint to the attention of:


    Practice Manager
    Carolina Pediatrics of Wilmington, PA
    715 Medical Center Drive
    Wilmington, NC 28401


    You will not be penalized or otherwise retaliated against for filing a complaint.

    Individual Rights

    You have certain rights under the federal privacy standards. These include:

    • The right to request restrictions on the use and disclosure of your protected health information
    • The right to receive confidential communications concerning your medical condition and treatment
    • The right to inspect and copy your protected health information
    ​• The right to amend or submit corrections to your protected health information
    • The right to receive an accounting of how and to whom your protected health information has been disclosed
    • The right to receive a printed copy of this notice

    Carolina Pediatrics of Wilmington, P.A. Duties:

    We are required by law to maintain the privacy of your protected health information and to provide you with this notice of privacy practices.
     

    We also are required to abide by the privacy policies and practices that are outlined in this notice.

    Right to Revise Privacy Practices

    As permitted by law, we reserve the right to amend or modify our privacy policies and practices. These changes in our policies and practices may be required by changes in federal and state laws and regulations. Upon request, we will provide you with the most recently revised notice on any office visit. The revised policies and practices will be applied to all protected health information we maintain.

    Right of Minors to Consent to Treatment

    Under North Carolina law, minors, with or without the consent of a parent or guardian, have the ability to consent to services for the prevention, diagnosis and treatment of certain illnesses including: venereal disease and other diseases that must be reported to the State; pregnancy; abuse of controlled substances or alcohol; and emotional disturbance. 

    Requests to Inspect Protected Health Information

    You may generally inspect a copy of the protected health information that we maintain. As permitted by federal regulation, we require that requests to inspect or copy protected health information be submitted in writing. You may obtain a form to request access to your records by contacting the Administrative Assistant, Privacy Officer or the Deputy Privacy Officer at Carolina Pediatrics. Your request will be reviewed and will generally be approved unless there are legal or medical reasons to deny the request.

    Complaints

    If you would like to submit a comment or complaint about our privacy practices, you can do so by sending a letter outlining your concerns to:


    HIPPA Privacy Officer Carolina Pediatrics of Wilmington, P.A.
    715 Medical Center Drive
    Wilmington, NC 28401


    If you believe that your privacy rights have been violated, you should call the matter to our attention by sending a letter describing the cause of your concern to the same address.
     

    You will not be penalized or otherwise retaliated against for filing a complaint. Carolina Pediatrics of Wilmington is committed to protecting the confidentiality of your health information.

  • Patient Centered Medical Home

    What is a Medical Home?   

    At Carolina Pediatrics we are committed to providing our patients with the very best evidence based medicine for their children.   

    A Patient Centered Medical Home is how health care is delivered to patients.  The medical home team at Carolina Pediatrics manages care and services for you- acting ast the "hub of your health care".  Examples of this include managing referrals to other providers, radiology and diagnostic tests.  PCMH puts the patient, at the center of the health care system and provides primary care that is Accessible, Continuous, Evidence Based, Comprehensive, Family-Centered, Coordinated and Compassionate.

    Provision of an Advanced Care Team:  

    Your care team at Carolina Pediatrics has been developed to ensure that as your Primary Care Provider the treatment sought inside and outside of the practice is coordinated, including but not limited to timely referrals to specialists and/or diagnostic facilities., to provide communication with you and with the outside provider by following up to ensure communication from the provider post visit/diagnostic.  Other team members are in place to ensure that the needed documentation within the medical home chart is maintained.  This is done both electronically and through manual input into your electronic medical record so you have a single source for your childs most current medical information.   Additionally, the team provides a clinical liason (Triage Nurse) to dispense advice and direct care 24 hours a day, 7 days a week, 365 days a year, and to create access to the Physician on call when needed.

    Your current team:

    • Referral Care Coordinator - Ladonna, MA Wilmington office; Lauren W, MA Hampstead office
    • Documentation Care Coordinator - Rene', MA
    • Diagnostic Test Care Coordinator - Tacey, RN and Lauren W, MA
    • Triage Nurse(s) - Joanne RN, Tacey RN, Jenna RN, Erin RN, Denise LPN

    Medical Home Responsibilities

    Our Responsibilities to You:

    • To listen to your questions and concerns and to explain disease, treatment, and results in an easy to understand way.
    • To coordinate your overall care across the complex healthcare system, sending you to a trusted specialist if necessary and following up on the healthcare services you receive
    • To provide you with same day appointments whenever possible.
    • To provide instructions on how to access the care you need when the office is not open and to be available to you after-hours.                                                                      
    • To provide clear instructions about your treatment goals and future plans for every visit.
    • To provide access to our practice before, during and after business hours by giving you access to a patient portal which provides you access to your childs medical records and a message center for non-emergent questions.
    • Additionally, by offering after hours phone support (7 days a week / 24 hours a day) 

    Your Responsibilities to your Medical Home:

    • To ask questions and be active in your care.
    • To provide your health history, and other important information, including any changes in your health.
    • To call our office first with your health concerns unless it is an emergency.
    • To inform us whenever you utilize any other health system such as an urgent care, the emergency room or a self referral to a specialist.
    • To have a clear understanding about your treatment goals and future health goals.

    Opportunity to Provide Feedback to us (Patient Survey):

    After each and every visit to our office(s) a patient survey will be delivered to your email.  Our goal is to gather feedback from you, our patient, on how we can continue to improve on the patient experience whether it be for a sick or well visit.  This feedback is reviewed with all staff and decisions made using the information provided.  Please help us be the best medical home we can be by responding to the survey. 

  • Antibiotic Policy

    We work hard to not overuse antibiotics.
     

    We educate families on appropriate use of antibiotics, but follow evidence-based guidelines and don’t automatically treat ear pain or a green snotty nose with antibiotics.
     

    We do not routinely prescribe antibiotics over the phone as we do not believe that is good medicine. We will prescribe an antibiotic when we believe it is an appropriate treatment.

  • Technology Policy

    Efficiency through the use of technology
     

    You will be encouraged to consult our website, register for and use our patient portal, and effectively use automated reminders for appointments and for routine care/immunizations that are due.

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