Frequently Asked Questions

1. Are you accepting new patients?
We are accepting new patients only through prenatal consultation with families expecting their first child. We like to start off on the right foot with each family by meeting for a prenatal consult to discuss parents’ expectations for their child’s medical care.

2. Do you require vaccinations for your patients?
Yes, for the safety of all of our patients, we require our patients to follow the CDC Recommended Childhood Vaccination Schedule. Any patients who have fallen behind for various reasons are advised on a timely and safe catch-up schedule.

3. Do you have same-day appointments?
We save appointments for same day use. We schedule only 2 well checks per hour per doctor in advance. That allows 1-2 office/sick visits per hour to be added on the same day. If you are trying to schedule a same day office visit/sick visit on-line, you may not see availability since we reserve those spots. Please send a message by OhMD at 8:30 am when we open and we will advise you of the available times to bring your child that day.

4. Do you accept walk-in sick visits?
We see patients by appointment only. If your child is sick, please send a message by OhMD or call during normal business hours and we will tell you the best time to bring your child. This prevents a sick (often time contagious) child from sitting in the office, waiting to be seen. Best for a sick child to spend a little more time resting at home than sitting in the doctor’s office.

5. Do you have weekend hours?
We offer Saturday hours during the school year (between Labor Day to Memorial Day weekends). Our Saturday hours are generally from 9am- 11am, but sometimes the hours vary slightly and we update them on Google and our website.

6. What do you advise when my child is sick and it is after-hours?
Please send a message by OhMD and we will ask you a few questions to determine the best course of action and to make recommendations.

7. Do you offer phone consultations with the doctor?
We can schedule a phone consultation with the doctor for $35 consult fee. We PREFER to see our patient along with talking to you face to face in the office directly as this provides better information for us to make recommendations. If you want to talk without your child present, we can check your child, then talk with you separately after the exam. It is best to bring an additional care giver to watch your child while we talk in a separate room unless your child is old enough to sit alone quietly while we talk.

8. Billing Questions:

Patients with deductibles:

- We do not know exactly what your patient responsibility will be prior to an office visit as it very much depends upon what needs to be done at the time the care is provided.

- You can call member services ahead of time on your insurance plan to get an idea of what your patient responsibility would be. You can ask them for your negotiated rates and coverage based upon anticipated CPT codes:
Typical office visits that require 15 minutes or less, CPT code 99213 (99203 for new patient).

- Longer office visit (>15minutes) or if there is a higher level of medical decision making (review of laboratory results, xray results, prior records or need for letters, referrals, form completions) the CPT code is usually 99214 (99204 for new patient), but sometimes 99215 (99205 for new patient) for more complex care.

- Additional tests performed in the office have separate CPT codes that are paid according to your insurance policy.

- As a courtesy to our patients with deductibles, we will bill your insurance first and you will receive a statement by email or mail that details your patient responsibility that you can pay on line.

Patients with co-pays and co-insurance:

- We charge the co-pay at the time of the visit.

- The co-pay cannot be waived as this constitutes insurance fraud and we could lose our insurance contracts.
           Patients seen for Well (Preventative Care) Visits and Office (sick) visit on the same day:

- If your child is ill at the time of a well check and the illness requires additional time or decision making (new prescriptions, letters, asthma or allergy forms, etc) beyond our usual time for a well check, we are required to bill for an office visit.

- If you have a co-pay plan, you will be responsible for co-pay.

- If you have a deductible plan, we submit the claim to the insurance and you will receive a statement for what falls to patient responsibility for you to pay online.

- We cannot waive co-pays and deductibles when an office visit diagnosis is made apart from the well child diagnosis.

- Sometimes, we will need to “convert” the well check to an office visit and have you return at a later time for the well check if your child is too ill to participate in developmental assessment or to receive vaccines on that day.

- Sometimes we are asked by parents to convert a sick visit into a well check. If time allows and your child is well enough to have the preventative care visit performed, we will make that change to save you the time of needing to come for an additional visit. In that case, we will bill for an office visit (the initial reason for the appointment) in addition to the well check. You will still be responsible for a co-pay or deductible cost, but it does save you need to return for a separate well check.

If you have billing questions, please contact us M-F between 8:30 am- 5pm, (713) 894-2751.