Policies

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.

Everyone's Time is Equally Valuable.

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.

Our practice makes every effort to run on time with appointments, as we believe everyone’s time is equally valuable.

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.

For new patients, a fee may be charged if the FIRST appointment is missed.

Patients who are more than 15 minutes late for their scheduled appointment may be asked to reschedule. You will be notified of the time available and will be advised to reschedule your appointment if necessary. We appreciate your cooperation on this matter.

Appointments allow our doctors and staff to provide dedicated attention to our patients needs. Therefore, we have a 24-hour cancellation policy. A $50 fee will be charged for all missed appointments or appointments not cancelled at least 24 hours in advance.

Pediatric Partners of Gwinnett would like to take this opportunity to welcome new members to our practice and thank our returning patients. To avoid confusion regarding our current billing policy, please  review the following and sign below. A copy will be provided for your records upon request.  

 1. Co-payments are due prior to your child being seen and can be paid through the Patient Portal, InstaMed,or in person. A service fee may apply for any copayment not paid at the time of service. 

2. If your child is seen for a wellness visit and also treated for a medical condition, your insurance carrier may process this visit with a copayment or coinsurance, or some services under another benefit, for which you will be responsible. 

3. If you do not have insurance or are underinsured, payment is due at the time of service.

4. Private paying patients are eligible for a discount if payment is made at the time of service. 

5. All payment arrangements must be made prior to your child being seen. If payment arrangements are allowed, it is your responsibility to submit payment within 30 days, whether or not you receive a statement. A partial payment must be made at time of service.

6. You may only be sent two statements before we begin collection proceedings if payment arrangements are not made. All accounts sent to an outside agency for collections will be assessed up to a 40% collection fee and any self pay discounts will be added back to your account. A courtesy call to the last number we have on record will be made but is not necessary in order to forward an account to a collection agency. Please note - once an account is sent to collections, your child may be discharged from Pediatric Partners of Gwinnett. 

 7. A $30.00 service fee will be charged for all returned checks relating to your child’s account and any offered  private pay discounts will be added back to your account. 

8. Be aware of your insurance plan! We will attempt to verify coverage through the insurance company, though it is not a guarantee of coverage. Call your insurance carrier to confirm we are in your network, we are listed as your PCP (if needed), or if you have any questions. Some insurance plans process certain diagnosis and/or procedures under Behavioral or Mental Health benefits, and not medical benefits. 

9. Whomever brings your child to the office is responsible for any payment due related to that office visit. This includes grandparents, babysitters and other caretakers. Please complete the Consent to Treat form specifically naming anyone other than a parent authorized to accompany your child to our office and giving us permission to release your child’s medical information to this person. We will request a photo ID from each person bringing your child to our office to verify their identity. This form must be updated annually.

10. No one under age 18 years will be treated without a parent or guardian (or authorized person over eighteen years old) present. 

11. A copy of all your insurance cards should be provided at the time of service. If updated insurance information is not received by our Billing Department within your insurance plan's timely filing limit, the balance is parent/patient’s responsibility. Please be advised - timely filing may be as little as 30 days. 

12. We file your insurance as a courtesy. If payment is not received from your insurance company within 45 days, the balance is your responsibility. 

13. If you are sent to a specialist and your insurance requires a referral, please contact the front office once you have the appointment scheduled. as we need to know the appointment date and time. Most insurance requires at least 48 hours’ notice for a referral so please, do not wait to contact us the day of the appointment. 

14. Please give our office 24 hours’ notice if you cannot make your child’s appointment. If you do not give us at least 24 hours’ notice, a service fee of $50.00 per patient may apply. 

15. A $10.00 fee will be applied for each form and/or letter not requested within 30 days of an office visit. 

We appreciate your cooperation. Please let us know if you have any questions or need assistance. You can reach our Insurance and Billing Department at 770-923-6400, #4 or insurance.billing@gwinnettchildren.org.

I accept full financial responsibility for the above named child and acknowledge that by signing below, I have read and understand this billing policy. I acknowledge my payment options are  through the secure Patient Portal, telephone, mail, or in office.  Upon my request, a copy of this policy has been provided for my records.  

Patient Name ____________________________________ 

DOB _____________________________  

Signature/Relationship/Date ________________________________________________________________________________       

The Department of Health and Human Services has established a “Privacy Rule” to help insure that personal health care information is protected for privacy. The Privacy Rule was also created to provide a standard for certain health care providers to obtain their patients’ consent for uses and disclosures of health information about the patient to carry out treatment, payment, or health care operations.

As the parent or guardian of our patient, we want you to know that we respect the privacy of your child’s personal medical records and will do all we can to secure and protect that privacy. When it is appropriate and necessary, we provide the minimum necessary information to only those we feel are in need of your child’s health care information and information about treatment, payment, or health care operations, in order to provide health care that is in your child’s best interest.

We also want you to know that we support your full access to your child’s personal medical records. We may have indirect treatment relationships with your child (such as laboratories that only interact with physicians and not patients) and may have to disclose personal health information for purposes of treatment, payment, or health care operations. These entities are most often not required to obtain patient or parental consent.

You may refuse to consent to the use or disclosure of your child’s personal health information, but this must be in writing. Under the law, we have the right to refuse to treat your child should you choose to refuse to disclose your child’s Personal Health Information (PHI). If you choose to give consent in this document, at some future time you may request to refuse all or part of your child’s PHI. You may not revoke actions that have already been taken which relied on this or a previously signed consent.

If you have any objections to this form, please ask to speak with our HIPAA Compliance Officer.

You have the right to review our privacy notice, to request restrictions, and revoke consent in writing after you have reviewed our privacy notice.

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.

Pediatric Partners of Gwinnett firmly believes in the effectiveness of vaccines in preventing serious illness and saving lives, and in the safety of vaccines manufactured today. We follow the recommended schedule and guidelines established by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC), which are based on years of careful scientific study and data gathered on millions of children by thousands of scientists and physicians. Based on all available literature and current studies, we do not believe vaccines and their preservatives cause autism or other developmental disabilities.

Because of vaccines, most people today have never seen a child with polio, tetanus, whooping cough, bacterial meningitis or even chickenpox, or had a friend or family member whose child died of these diseases. Yet, because parents are electing to forgo immunizations, large outbreaks of measles, whooping cough and other preventable diseases are now being seen in Europe and the United States.

We believe that when a parent makes a conscious decision not to vaccinate, they take a significant risk with their child's health as well as the health of others around them. Not vaccinating puts all children at unnecessary risk for life threatening illnesses, resulting in disability and even death. We do not want to scare or coerce you but to emphasize the importance of vaccinating your child and recognize that choosing to vaccinate may be an emotional decision. We will do everything we can to convince you that vaccinating according to the recommended guidelines is the right thing to do and want to thoroughly address all of your doubts, questions and/or concerns.

The decision to vaccinate your child is ultimately yours. However, If you refuse to vaccinate your child for any reason other than a valid medical condition, we cannot continue treating him/her and you will need to transfer to an alternate pediatric practice. You will need to make a final decision within 10 days of this letter. By then, you must begin vaccinating your children or advise us you are transferring to a new pediatric practice.

As medical professionals, we are committed to protecting the health of all the children we serve and feel very strongly that vaccinating children on schedule is the right thing to do.