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Lawrenceville Pediatrics

Appointment policy

We would like to schedule routine appointments in advance. If your child is ill and must be seen, we will make every effort to take care of him/her as soon as possible. You must call for an appointment first; generally we are unable to see non-emergency walk-ins. Please notify us at your earliest opportunity if it becomes necessary to change an appointment.

We prefer to see ill children in the morning in case any special arrangements or tests are required. Time is set aside for call-ins, so we would appreciate calls early in the morning if you feel your child needs attention. On certain days and during the winter season, we usually experience a large volume of telephone calls. We appreciate your patience as we take these calls in the order we receive them.

Telephone Policies

  • Emergency Calls

    Our practice is always covered by a physician for emergencies. Emergency calls are directed to the on-call physician immediately. In the case of severe life-threatening emergencies, we ask that you call 911 or proceed directly to the nearest emergency center. When you arrive, please have someone notify us of your location and the problem.

    For other urgent problems, always call first rather than drive to the emergency center. Often we will be able to provide you with first aid instructions or tell you where to take your child for the best emergency care.

     

  • Calls During Office Hours

    If you have any questions or problems that we can assist you with, you may call the office during routine office hours. The office staff will be happy to provide any assistance they can. They have been trained to make decisions on which patients need to be seen and how to treat children who do not need to be seen . However, if you would prefer to have your child seen no matter what the circumstance, please let us know. If a physician's assistance is required, or if you need to speak directly to a doctor, the nurse or secretary will convey the message. He/she will return your call as soon as possible.

     

  • After Hours Calls

    For non-life threatening after hours calls you may call our answering service.  Calls should be made only for emergencies or urgent problems that cannot wait until the morning. Please call 770-985-7914.  If you find you need after hours advice, we suggest you contact your insurance companies Nurse Advice line, which is part of your insurance company.  If you need further assistance after that, of course, we will be happy to assist you.

    Aetna                        800-556-1555

    BCBS (Emory)          866-545-3507

    BCBS Georgia           888-724-2583

    Cigna                        800-564-8982

    Humana                    800-622-9529

    Kaiser                       404-261-2825  option 1

    Peach State               800-704-1484  option 7

    United Health Care    888-842-4224

 

  • Prescription Refill Calls

    We will be happy to refill prescriptions during our weekday office hours. No refills after hours or on weekends. Please try to anticipate any refill needs for chronic medications as your supply begins to run low. However, it is a policy of the practice not to call in new prescriptions, antibiotics, or controlled drugs without first seeing the patient.

X-ray and Lab Evaluations

X-rays are not done in this office. Special studies may need to be referred to a radiology office or hospital.

Blood and urine samples may be obtained for routine testing in the office. Special studies may need to be obtained in the office and sent to an outside laboratory for completion, or your child may need to be referred to sites outside our office. We will work with you to comply with the guidelines of your insurance to ensure proper reimbursement.

Hospitalizations

Our doctors are on the non-admitting staff at Gwinnett Medical Center. Gwinnett Medical Center does not have a pediatric inpatient unit at this time. When babies are affiliated with our practice are born at Gwinnett Medical Center, we have arranged for their care to be done by the neonatologists from the NNICU (Drs. Leigh, Suskin, and Ahmed). We also have affiliations with Egleston and Scottish Rite Children's Hospitals, although we do not see patients at either.

Insurance and Payments

Our policy is payment be rendered at the time of visit. If your child is to be hospitalized, arrangements may be made with the office manager for filing a claim with your insurance. As a service, we will complete the attending physician section of your insurance form and mail it to your insurance company. Please be sure to complete your section. We allow sixty days for payment from the insurance company. After this time, if payment has not been received we will be happy to arrange a payment plan with the parents.

We are currently accepting the following insurance plans: 

Aetna HMO, POS, QPOS, PPO, Indemnity (All plans);
Alliant Health Plan
Beech Street PPO;
Blue Cross Blue Shield HMO, POS, PPO, Indemnity;
CCN PPO;
Cigna HMO, POS, PPO;
Coventry- Southcare;
Employers Health
Evolutions PPO;
First Health PPO;
Galaxy PPO;
Great West HMO, POS, PPO (formerly One Health Plan);
Humana HMO, POS, PPO;
Kaiser POS, PPO;
Life Well Health Plan PPO;
MRN PPO (Medical Resource Network);
Multiplan PPO;
Nova Net PPO;
PHCS POS, EPO, PPO (Private Healthcare Systems);
PPO Next;
Principal Edge Network
Pro Net PPO;
Southcare PPO;
Supermed PPO;
Tricare (Standard only);'
United Healthcare HMO, POS, EPO, PPO, Choice, Choice+ (all Plans);
USA Health Network PPO.

 

For HMO and POS plans, we must be listed as the primary care physicians (PCP) prior to your first visit to our office.

If you have a new insurance plan, the following link is a reference that was written by the American Medical Association to help you with questions that you may have about different health insurance plans.  Understanding Your Health Insurance Policy and Payment Practices

Other Information

The following financial policy became effective in our offices on April 1, 2009. 

The changing economic climate has forced us to re-examine many of our older practices.  As a result we have revised our older policies to reflect changes in our industry.  We are committed to providing excellent care in a timely, efficient manner and very much appreciate the confidence you place in us to provide health care for your children.

  1. All fees for self pay patients are required at the time of the visit.
  2. Our office will verify insurance prior to well child care.  We are happy to file an insurance claim however, verification does not identify specifically covered items and is not a guarantee of payment.  In the event a service we perform is not covered by your insurance, then full payment for this service is due within 60 days of receipt of the service.  This is including well child care, vaccinations, lab work, nebulizer treatments, procedures, antibiotic injections…etc.
  3. All insurance cards presented must reflect the current insurance plan, INVALID INFORMATION causing the claim to be returned will be subject to a $25 re-file fee per claim per filing.
  4. We require a 24 hour notice for cancellation of all appointments.  Failure to do so or missing the appointment will result in a $25 cancellation/no show fee which is not covered by insurances.  Reminder calls are a courtesy.  Cancellation/no show fees are applicable even if a courtesy call is not received.  Changing an appointment time on the day the appointment is made will be subject to a $25 fee.  For late arrivals the office must be notified in advance.  Patients who are being seen for an acute problem will have to be worked back into the providers schedule at the providers discretion.  Patients scheduled for well child care may need to be rescheduled so that it does not interfere with other scheduled appointments, and may be subject to a $25 late fee.
  5. We do not file insurance for problems related to motor vehicle accidents.  Full payment is due at the time of service.
  6. We are happy to complete sports physical or immunization forms at the time of service for no fee.  The fee is $10 if these forms are needed at a later date.  For more complicated, time consuming letters or forms such as Katie Beckett, SSI, ADD or chart summaries the charge will be $25.
  7. Copies of basic medical records ie, vaccination records are free.  The fee is a minimum of $25 if the entire chart is copied.
  8. No fees are associated with phone calls to the office during normal business hours, however, any after hour or weekend calls that require a return call from our physicians, nurses or the CHOA advice line will be subject to a $15.00 fee per call. These are not insurance covered charges.   No fees are applicable if the call is handled thru the participating
  9. Walk in patients will be scheduled for the next available opening with their provider for no fee.  Walk in patients who request to be “worked in” to a providers schedule will be seen by a triage nurse/MA and worked in at the discretion of the triage nurse/MA and provider.  There will be a $25 triage fee for this service and it is not an insurance covered charge.
  10. Add on patients (ie; unscheduled patients whose parents request at arrival to the office that they be seen with a previously scheduled sibling) will be seen by the provider if there is an available opening.  If there is no available opening, parents can choose to wait for an opening or they may pay the walk in fee of $25 and have their child worked into the provider’s schedule.

 

 

© 2006 Lawrenceville Pediatrics, PC

980 Lawrenceville Highway
Lawrenceville, GA 30046
770-962-8025

information@lawrencevillepeds.com