Office Info

Appointment Policies

We pride ourselves at Hamden Pediatrics on providing quality comprehensive care at each visit while striving to keep time in our waiting room to a minimum. If you are not able to keep an appointment, please give us at least 24 hours notice. Any appointment canceled within 24 hours will be considered a missed appointment, and a $30 charge may be incurred. If you think you will be late for your appointment, please call our office; we will do our best to accommodate you, however we may ask you to reschedule. Excessive missed or late appointments will be discussed with a physician. While our office will call you to remind you of an appointment 48 hours in advance, this is a courtesy call only and it is your responsibility to know when your child has an appointment.

Please book all well or healthy child care visits as early as possible. During certain times of the year appointment slots fill quickly.

Prescription Policy

New Prescriptions

Our office requires an evaluation by one of the physicians for any new prescriptions. This is to ensure that any new medication is safe, appropriate and necessary for your child. For this reason, our office cannot prescribe any antibiotics for acute illnesses over the phone. If you are uncertain if a medication or an office visit is necessary, please ask to speak to one of our nurses. Make sure to alert our staff and your physician of any changes to your child’s medical history, medications and allergies.

Refills

We are happy to refill your prescriptions at any of your appointments, and ask that you notify our nurse when checking in. If you need a refill on a routine prescription, please call your pharmacy first. If you are calling our office to request a refill, please have your pharmacy name and phone number available. Requests should be made at least 7 days in advance to ensure there are no interruptions with your child’s daily medication. Refill requests are only handled during normal business hours and we kindly ask that you do not contact us through our answering service for routine prescription refills.

Refill requests received from a pharmacy will be addressed promptly by one of our nurses. You may receive a phone call to confirm the need for a given medication, appropriate dosing and whether a follow-up visit is required. Prescriptions for controlled substances (such as medications for ADHD) are prescribed on a monthly basis. Parents should call several days in advance for refills. Certain medications (such as stimulants, asthma controller medications, psychiatric medication, etc.) require more frequent visits at 3 to 6 month intervals in order to keep your medication current.

Yearly physicals must be up to date for all routine medication refills.

Financial Policies

Insurance Plans

At each visit,  please present your child(ren)’s up to date insurance card(s) to the front desk and our staff will make a copy to keep on file.  It is your responsibility to keep us updated with your child’s health insurance information. Please understand the details of your benefit plan regarding covered services including, but not limited to, participating laboratories. Please note that some insurance plans do not cover telemedicine visits. Many have authorized the use of telemedicine visits due to the COVID-19 pandemic, but we advise you to call your health insurance plan for any specific limitations. Not all services provided in our office are covered by every plan. Medical care and treatment is dictated solely on medical necessity, and is not based on your individual medical coverage. Any service not covered by your plan will be your responsibility.

It is your responsibility to know if a written referral or authorization is required by your insurance company to see specialists, whether preauthorization is required prior to a procedure, and which specialists are covered. These referrals require a visit with your child’s pediatrician first. Our office will submit referrals and/or authorizations to the designated specialist. Your insurance carrier may require your child’s pediatrician to be on file, and/or to appear on your child’s health insurance card. If applicable, please ensure that you have updated this information with your insurance company.

If your insurance company requests additional information from you, such as evidence of coordination of benefits, they will not reimburse our office until you provide that information. Failure to provide this information may result in full charges that will be deemed your responsibility. Most insurance carriers require that newborns are added to your health insurance policy within thirty days of birth. Failure to do so may result in you being responsible for full charges.

Billing/Payment Policy

Our billing company, PedsOne, is outsourced to a separate location. Their  staff can be reached at 866-371-6118. You may receive calls, letters, or emails from them. Please do not ignore your statement even if you believe you have already paid your bill. 

While the filing of insurance claims is a courtesy that we extend to our patients, all charges not covered by your insurance company are your responsibility. According to your insurance plan, you are responsible for any copayments, coinsurances, and deductibles. All copayments are due at the time of service in our office. We accept cash, checks, Visa, MasterCard, Amex, Apple Pay,  and Discover. The accompanying parent, guardian, babysitter, etc is responsible for presenting payment at the time of the visit. If you are unable to attend the appointment with your child, please send in your payment with your child, their caretaker, or call in the payment. 

Hamden Pediatrics is not a party in divorce or separation agreements. We will bill one guarantor. We do not handle billing or insurance coverage disputes between parents. The individual bringing in the child for services will be held responsible for any co-payment or unpaid charges on the account.

Any remaining unpaid balance after the insurance company has processed, including copays, co-insurance, deductibles, or non-covered services, are due in full within thirty days of receipt of your billing statement. We realize families  experience financial difficulties from time to time. We will work with you to set up a payment plan for outstanding balances that you are unable to pay in full. Payments must be made every month until the account balance is $0.00.

After Hours

You have several ways to reach us after hours, depending on your child’s needs. We encourage families to utilize our patient portal for non-urgent requests. You can send routine questions, refill requests, as well as forms to be completed,  and your message will be returned within 24-48 regular business hours. You can also call our office after hours, and our answering service will direct your call to the on call physician. Our physicians are required to document extended hours for visits and calls. If your insurance company does not cover the fee associated with these documentation codes, you may be held responsible.

Missed Appointments

It is your responsibility to give the practice sufficient notice (at least 24 hours prior to the scheduled appointment) if you cannot keep your child’s appointment. Other patients lose the opportunity to be seen when a no-show occurs. If you are more than ten minutes late to an appointment, we may kindly ask you to reschedule. You may be subject to a fee of $30.00 for each missed appointment. After three missed appointments in a twelve month period, dismissal from the practice is at the discretion of the practice.

Medical Records

Hamden Pediatrics will send free of charge, copies of: immunization history, most recent well care exam, growth charts, allergy, medication, and problem lists. If any additional items are requested to be copied, $0.65 per page (allowable under Connecticare Statute) will be charged. A release form will need to be signed by the patient, guardian, or legal representative before records are released.

Forms

School, daycare, camp, sports, and WIC forms can be completed at the time of your child’s well visit at no additional charge. Please give your forms to our receptionist when you check in or send them through the portal. Any additional forms brought or mailed in after a scheduled visit require at least two business days to process, and will incur a charge of $5.00 per form. Please include a self addressed envelope if forms are to be returned by mail.

Sports Physicals

If your child’s last physical was not recent enough for sports clearance and you are unable to schedule a well visit before the forms are due, we offer screening/clearance exams with your child’s pediatrician. These screenings are NOT covered by insurance.  This clearance does not take the place of thorough routine annual well visits. A fee of $60 will be charged for this service and is collected prior to the visit. CVS Minute Clinics have similar sports clearance fees, however they do not have access to your child’s records, medical history, or immunizations.

Sick at Well Visits

We are required to document any ADDITIONAL concerns or conditions that arise at well visits. The codes used may have charges and therefore may require a copay at your child’s well visit as well as other fees that may not be covered by your insurance or that are applied to your deductible.