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Patient Policies

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Welcome to our practice and thank you for choosing us to serve your health care needs.

This website is designed to answer many of the questions that you may have. The more you know about our policies and methods of practice, the better we may be of service to you. Should you have any questions, please do not hesitate to contact us. It is our goal to provide you and your family the best medical care possible and to maintain a pleasant and long-lasting relationship with each of you.

Appointments

Appointments can be made by calling our practice directly at 407.898.6005. Please bring your current insurance card, referral form if required, a list of any prescription currently being taken or refills needed and a list of any questions you may have. 

If your insurance requires a prior authorization for a specialist, please obtain this as soon as possible and ask for it to be faxed to our office prior to the appointment.

What to bring to the appointment    

  • Prior authorization (if needed) 
  • Insurance Card 
  • Picture ID 
  • Co-Pay 
  • If your child has been having problems in school, please bring any school reports you have when you come for the evaluation. This includes: Report cards, IEP's, Teachers reports and/or Standardized test results: Cognitive (IQ), Achievement, Adaptive, etc.
  • Teacher's Vanderbilt behavior form completed.

Arriving to the appointment
For new patients, we ask that you arrive 30 minutes prior to your scheduled appointment. If you are a returning patient, please arrive at least 15 minutes prior to your appointments. Each visit requires a brief questionnaire to fill out prior to seeing your care provider. Co-payments, deductibles and outstanding balances are due at the time of every visit.

We do our best to stay on time with the schedule, but occasionally a provider may go over the allotted appointment time. Please know that every child is important to us and the same special attention will be given to your child. Please make arrangements for child care for siblings for at least the first 3 initial evaluation appointments. Other children in the office, particularly younger, frequently make the evaluation more challenging. Thank you for your understanding.

Billing and Financial Policy

If you have insurance, we will file the claim and bill your provider. However, patients are responsible for any required co-payments or outstanding balances. Payments are expected at the time of visit.

Billing Information

BASIC POLICY: Payment for service is due in full at the time service is provided in our office. INSURANCE: As a courtesy, we will bill your insurance carrier for you if proper paperwork is provided to us. Co-payments and deductibles are due in full at the time of service. Your insurance policy is a contract between you and the company. The agreement is a private one and we are not a party to your contract. If you do not inform us of any special requirement or guidelines in your contract and we subsequently order services not covered, we will have no choice but to bill you directly. We do not routinely research why an insurance carrier has not paid or why it paid less than anticipated for care provided. If an insurance carrier has not paid within 60 DAYS of billing, the amount due will be your responsibility and will be payable in full by you. If your insurance carrier changes, you must notify us immediately. If insurance information is not provided within 30 DAYS of office visit, you will be responsible for any visits during that time frame.

COVERED SERVICES: Please check with your insurance carrier what are the services covered in your policy and also, make sure that our physicians (Dr. Cely and Dr. Forrest) are providers in your health plan. In addition, please learn the process that your insurance requires to obtain authorization for services. Some insurance companies require referral from your pediatrician; others require that you have your primary physician call the insurance company to obtain prior authorization by phone. Once you have obtained authorization or referral from your primary care physician, be aware that every plan has different co-pay plans according to the number of visits authorized and also, some insurances require that you obtain an authorization once you have used your first set of authorized visits.

NON-COVERED SERVICES: Some of the services we provide may be non-covered or are not considered reasonable and necessary under your policy, but have been deemed to be in the best interest by your physician. If this is your case, we will need you to check with your insurance company prior to administering the test. You will have the option of declining or pay the test in full at the time of service. A list of billing codes is available upon request.

PAYMENTS: If you have a balance due on your account, you will receive statements from our corporate billing office. The letter you receive from your insurance carrier, (EOB) Explanation Of Benefits, will show the amount they covered and what portion is your responsibility. Our billing office will send three statements before turning your account over to collections. Your child will not be able to be seen until that collections balance is paid. Please remember that when you receive our statement, you have already received quality care from our physician. Prompt payment upon receiving your statement is appreciated.

MINOR PATIENTS: The adult accompanying the child is responsible for full payment. If a balance is due at anytime, it is your responsibility to pay that balance. In case of divorced parents, legal payment arrangements must be worked out prior to appointment.

Cancellation Policy

MISSED APPOINTMENTS: Our services are by appointment only. Your appointment represents valuable time for both you and your provider. Please call the office at least 24 hours in advance to cancel appointments. It could also inconvenience the medical team and our other patients, therefore delaying our ability to deliver our special quality of care.

In fairness to other patients and the providers, we require at least 24 HOUR notice to cancel appointments. You will be charged a fee of $100.00 if you fail to keep your appointment or do not give the necessary 24 hour notice.Insurance companies do not pay for missed appointments, so you will be responsible to pay this before your child can be seen again. Patients who repeatedly miss three appointments within a six month period without notice will be dismissed.

Emergencies and On Call

If you have an emergency, please call 911. For other urgent requests, please call our office number at 407-898-6005 which will be redirected to the answering service after hours. You can expect a call back within 30 minutes. If you cannot wait for a return call or have an emergency situation, please go to the nearest Florida Hospital Emergency Department.

Lab and Test Results

For the most part, lab and test results will be discussed at a follow-up appointment. Upon completion of the specific test, further instructions will be given as to how and when the results will be made available.

Late Policy

Please be advised that we have a strict late policy.  New patients are required to arrive 30 minutes prior to the appointment time to complete the initial registration process/questionnaires and the new patient paperwork (found on this website) must be completed.  If the new patient paperwork is not completed prior to the appointment we will have to reschedule the patient.  Established patients have a 5 minute grace period, if more than 5 minutes late the appointment will be rescheduled.  No fee will be assessed if patient is late and reschedules appointment.

Prescriptions

Calls for prescriptions received in this office after 12:30 pm will be addressed the following day after 2:00 pm. Please try to call the office at least 48 hours in advance for all medications. Calls received after 12:30 pm Friday will be returned after 2:00 pm on following Monday.

Prescription Refills

If your child has not been seen within 6 months, we will not be able to provide medication refills until your child has come into the office for a visit. It's important for your child to be consistent with the prescribed medications. Interruptions to the medication schedule can cause adverse reactions for your child. We strongly encourage you to keep your scheduled appointments or reschedule within enough time so there won't be any interruptions we require 48 hours notice to process all prescription refills and it may take 72 hours before it is mailed out. Please be certain to contact our office in advance to allow up to 72 hours turnaround time. Thursday and Friday prescription requests will be processed on the following Monday and Tuesday.

Records Release

If you need copies of your child's medical records, there is a charge of $1.00 per page due upon picking those records up. A medical record release must be signed to release any records.

Please complete the records release form (Authorization of Use And Or Disclosure of Protected Health Information) to obtain your medical records from your previous family physician and any specialists you may be consulting. Our Practice Privacy Policy is available at the office for your review.

Physician and Specialist Referrals

Please call the office at least three (3) days before the appointment to give us the information needed to complete the referral. That information includes: your name, the physician you are being referred to, his/her phone and fax numbers, the date of the appointment, the diagnosis for the referral, your insurance, whether it is for a visit or a specific procedure (such as surgery) and where it is going to be performed (office or hospital). We do not mail referrals to specialists. Please familiarize yourself with your insurance plan, and determine if it requires you to take a referral with you.

Provider Phone Calls

When calling our office to speak with a care provider, please be aware that they are seeing other patients throughout the day, and often not able to respond immediately to telephone calls.  If your call is urgent, please make this is clear in your message. If you are in an emergency situation please call 911 or go directly to the nearest emergency room. Most crises in this field of service warrant taking your child to the emergency room, for further tests and care.

Additional Payments

There is a charge of $25.00 for any letters dictated or written by our Providers. This will be billed to your child's account. Please submit payment prior to your next appointment.