Policies

Missed/Canceled Appointments

Missed or canceled appointments with less than 24 hours notice detrimentally affects the practice and other patients.  The first occurrence per family account will result in a reminder letter.  A second occurrence will result in a $50 fee and a probationary letter.  A third occurrence will result in dismissal from the practice.  For appointments scheduled same-day that are canceled with less than 4 hours notice a $50 fee also applies.

Late Arrival

We understand your time is valuable and strive to run our schedule on time as much as possible.  Patients who arrive late for appointments disrupt the schedule and consequently negatively impact other patients’ waiting time.  For this reason we ask you to please arrive on time for your appointments.  Patients arriving more than 10 minutes late may be asked to reschedule and the missed-appointment policy would apply.

Divorced/Separated Parents and Custodial Arrangements

Henrietta Pediatrics does not become involved in disputes between divorced, separated or custodial parenting arrangements regarding financial responsibility for their child's medical expenses. By signing as guarantor below, you agree to be financially responsible for the care we provide to your child, regardless of whether a divorce decree, custodial or other arrangement places that obligation on your former spouse or the child’s other parent. We will be happy to provide receipts for paid medical bills for you as requested. Please note that if a child is not accompanied by a parent/legal guardian, the accompanying adult will be required to make any applicable payment.

Behavior Expectations

Disrespectful behavior will not be tolerated.  Instances of yelling, swearing, or threatening gestures may result in immediate dismissal.

Masks

For your protection and the safety of our staff, anyone over age two is expected to wear a mask while in the office until further notice.  Patients who arrive without a mask may purchase one for $1.  Anyone not wearing a mask will be asked to leave and the visit will be considered “canceled” with < 24 hours notice.  (Occasionally some developmental disabilities may make wearing a mask challenging for some children—please discuss any concerns of this nature with our staff PRIOR to your appointment).

Completion of Personal Patient Forms  

Daycare and school physical forms and immunization records will be generated at the time of well visits and made available on the patient portal.  Other forms (eg. camp forms, working permits, medication administration forms etc) require additional staff time and resources and will be completed within five business days from the time of request.  As a courtesy to families, these forms may be expedited to be completed within one business day for a convenience fee of $10/ form.  All personal information components (eg patient name, address, phone number etc) must be completed prior to submission or the form will be returned.

After-Hours Calls

After hours physician availability is provided 24/7 for URGENT medical needs.  Non-urgent questions or concerns can be sent anytime through the patient portal and will be addressed when the office opens.  Phone calls and telemedicine visits after hours will be billed to your insurance company and may be subject to any applicable co-pay or deductible depending on your insurance plan. 

At Henrietta Pediatrics we believe that vaccinations are one of the most important health-promoting interventions we perform as medical professionals, and one of the most important healthcare choices you make for your family.  Our patients follow the immunization schedule provided by the American Academy of Pediatrics.

Vaccines are safe, they prevent serious illness, and they save lives. For your health and protection our entire staff is also fully immunized with all currently recommended vaccines.

If vaccinating your child on schedule is not part of your healthcare goal then we will not be a good fit for you.

Henrietta Pediatrics participates with most insurance plans.  Each insurance policy is different and it is therefore impossible for us to know what your particular benefits may be.  Therefore, it is important to contact your insurance company if you have any questions regarding your benefits and for you to know what your payment obligations will be at the time of service.  

Copayment Plans

If you participate in a copay plans, any applicable copayment will be collected prior to time of service.  Payment may be made by cash, check or credit card.  We also accept Health Savings Account (HSA) cards for payment. 

High Deductible Plans

If you participate in a high deductible plan and have not yet met your deductible in full, a $50 flat rate will be collected prior to time of service.  You will be issued a bill for any remaining deductible due for the date of service.  Payment may be made by cash, check or credit card. We also accept Health Savings Account (HSA) cards for payment.

A refund will be issued if Henrietta Pediatrics collects any excess amount after insurance processing.

Credit Card on File*

After insurance processing you will be required to pay your bill on time by the statement date.  To facilitate this process families will be expected to keep a credit card on file.  If alternate arrangements for payment have not been made by the statement due date your credit card will be processed.

If we are unable to process your credit card a $25 fee will be applied to your account.

If you require a financial installment plan, please notify the office in advance.

If you choose not to have a credit card on file you are responsible for paying all bills on time.  If your bill becomes overdue past the statement date you will then be required to keep a card on file or will be released from the practice. 

Returned Checks

Returned checks will be assessed a fee of $50.

Lack-of-Payment Fee

A lack-of-payment fee of $25 will be applied if payment is unable to be made within 24 hours of the time of service.

Patients Without Insurance Coverage 

We are happy to work with families that prefer to pay directly for services or do not have insurance.  For such patients, a time-of-service discount will be applied to the bill if it is settled in full on the day of service. This discount does not apply after the day of the visit.

Additional services provided at well visits

Well child visits are geared towards preventive care and monitoring of developmental milestones.  At times additional questions or concerns may arise that fall beyond the scope of these visits.  For your convenience we will try our best to address these concerns at the time of the visit if time allows, however, your insurance company may recognize these services as outside the scope of a well visit which may incur an additional charge from your insurance company. 

*This policy does not apply to patients with Medicaid and Medicaid HMO insurance

To help provide timely service and make sure each patient is dedicated enough time for their concern please call ahead to schedule an appointment--we do not take walk-in appointments. If you are late for your appointment we will try to work you back into the schedule if possible. Out of courtesy to our other patients you may be asked to reschedule your appointment if you arrive more than 10 minutes late.