Our Policies
We ask all patients to take a moment to read and sign our office policies, so everyone's on the same page.
Vaccine Policy
We believe that fully vaccinating your child is one of the most important things you can do to secure your child’s health.
Our practice is pro-vaccination and we follow the vaccine schedule recommended by the American Academy of Pediatrics.
We have created our policies with the safety and well-being of our patients in mind, and for that reason, we require patients who register with Peak to agree to follow the Massachusetts School Immunization Requirements. If you choose not to vaccinate your child according to these requirements, our practice will not be a fit for you and your family.
We believe that fully vaccinating your child is one of the most important things you can do to secure your child’s health. Our practice is pro-vaccination, and we require our patients to follow the vaccine schedule recommended by the American Academy of Pediatrics and to follow the Massachusetts School Immunization Requirement.
- While we do not mandate the flu and COVID-19 vaccines, we highly encourage our patients getting them each year.
- We do not allow for alternative or customized vaccine schedules.
- We require patients who transfer into our practice and are behind on their vaccine schedule to agree to a catch-up schedule to become patients with us.
We know Information comes from many sources, and it can be tough to figure out what exactly to follow. We are here to give you the most up-to-date and medically-accurate information to help you feel confident in your decisions. If you have concerns about the effectiveness or safety of vaccines, we are happy to talk with you about it.
While it is never our goal to part ways with a patient, ultimately, parents who remain firm in choosing not to vaccinate their children according to the Massachusetts School Immunization Requirements will no longer be able to receive care for their children at Peak Pediatric Care. Our commitment to the health and safety of all our patients is unwavering, and we stand by the science of vaccines.
Office Policies
We no longer require all patients and staff to wear a mask in the office. We do require certain sick visits to wear a mask along with the staff in the room with them. This includes all respiratory symptoms.
We understand that unexpected circumstances may arise, causing you to miss an appointment. To better serve our other patients, we kindly request that you inform us before the office opens on the day of your appointment so we can offer your slot to someone in need. It will be recorded as a no-show if you miss, cancel, or reschedule an appointment without proper notice.
If a family accumulates three missed appointments in 12 months, they may be dismissed from the practice.
For your convenience, we offer the option of double appointments for parents with two children needing to be seen on the same day. However, we will restrict this option for future visits if you miss a double appointment without proper notice.
After twelve months without any missed appointments, we will reassess the situation and consider lifting the restriction.
If you’re running behind schedule, please call us to see if we can still accommodate you. If you arrive more than 10 minutes late, we’ll do our best to see your child, but there may be a wait or the need to reschedule for another time.
Yearly well visits are an important part of maintaining your child’s health and wellness. During these visits, we’ll perform routine screenings and check-ins. If new health concerns arise or we need to discuss the management of chronic conditions, your insurance requires us to file a separate claim for this portion of the appointment, which may result in a copayment.
To ensure your child’s concerns are properly addressed, we may ask you to schedule a follow-up appointment.
Conditions that require medication need routine monitoring. For example, patients receiving birth control medication must be seen at least once per year, patients with asthma must be seen at least every six months, and patients on medication for ADHD, depression, and anxiety must be seen at least every three months to monitor dosage, side effects, and any other changes.
Once per year, this follow-up visit may be combined with a well-child visit. Still, if significant concerns are raised, or medications need adjusting, your insurance requires us to file a second claim for this part of the visit, and a copay may be collected.
Please submit refill requests through the patient portal or by calling your pharmacy several days prior to running out of your prescription. Allow 48 hours for refills to be processed. We may also contact you to schedule a visit to review and discuss your child’s health and medications.
We ask that you submit all referral requests through the patient portal so that we can ensure we receive all of the information required by your insurance. Please allow up to 72 hours to be processed.
Depending on current requests from other patients, medical forms can take up to 10 business days to be completed. We offer a rush service to receive your forms within 3 business days for $10 per form.
Mask Policy
We no longer require all patients and staff to wear a mask in the office. We do require certain sick visits to wear a mask along with the staff in the room with them. This includes all respiratory symptoms.
Cancel/Reschedule/Missed Appointments
We understand that unexpected circumstances may arise, causing you to miss an appointment. To better serve our other patients, we kindly request that you inform us before the office opens on the day of your appointment so we can offer your slot to someone in need. It will be recorded as a no-show if you miss, cancel, or reschedule an appointment without proper notice.
If a family accumulates three missed appointments in 12 months, they may be dismissed from the practice.
Missed Double Appointment
For your convenience, we offer the option of double appointments for parents with two children needing to be seen on the same day. However, we will restrict this option for future visits if you miss a double appointment without proper notice.
After twelve months without any missed appointments, we will reassess the situation and consider lifting the restriction.
Late Arrivals
If you're running behind schedule, please call us to see if we can still accommodate you. If you arrive more than 10 minutes late, we'll do our best to see your child, but there may be a wait or the need to reschedule for another time.
Well Visits
Yearly well visits are an important part of maintaining your child's health and wellness. During these visits, we'll perform routine screenings and check-ins. If new health concerns arise or we need to discuss the management of chronic conditions, your insurance requires us to file a separate claim for this portion of the appointment, which may result in a copayment.
To ensure your child's concerns are properly addressed, we may ask you to schedule a follow-up appointment.
Chronic Conditions
Conditions that require medication need routine monitoring. For example, patients receiving birth control medication must be seen at least once per year, patients with asthma must be seen at least every six months, and patients on medication for ADHD, depression, and anxiety must be seen at least every three months to monitor dosage, side effects, and any other changes.
Once per year, this follow-up visit may be combined with a well-child visit. Still, if significant concerns are raised, or medications need adjusting, your insurance requires us to file a second claim for this part of the visit, and a copay may be collected.
Medication Refills
Please submit refill requests through the patient portal or by calling your pharmacy a few days in advance to ensure you don't run out of your prescription. Our team will process the refill request within 48 hours. Sometimes, we may schedule a visit to review your child's health and medications.
Financial Policy
We understand that financial matters can sometimes be difficult to discuss. It’s important that we all have a clear understanding of what’s expected.
Patient Responsibility
It is your responsibility to confirm with your insurance that Peak Pediatric Care is in-network prior to your first appointment. If you are seen and your insurance is not accepted, you will be financially responsible for the visit.
Your insurance determines what you'll need to pay, including copays, deductibles, or out-of-pocket limits. Contact your insurance company for details on what they cover. After they've passed on your portion of the visit to us, it's our responsibility to bill and collect payment from you directly.
Missed Copay
We are required to collect copayments at the time of your appointment. We can’t waive this payment for any reason due to our contract agreement with your insurance company. If you forget to pay your copay at the time of your appointment, no worries! Just be aware that if it happens more than once, we may charge a missed copay fee of $10. Enroll in our Peak Pay program to avoid this fee, and keep your credit card on file for easy payments.
Financial Policy
We understand that financial matters can sometimes be difficult to discuss. It’s important that we all have a clear understanding of what’s expected.
Insurance Contracts
Patients Responsibility
Your insurance determines what you’ll need to pay, including copays, deductibles, or out-of-pocket limits. Contact your insurance company for details on what they cover. After they’ve passed on your portion of the visit to us, it’s our responsibility to bill and collect payment from you directly.
It’s your responsibility to check if we’re in-network with your insurance.
Billing for All Care Provided
We have to report all services and bill according to our fee schedule. Just like it’s a contract violation for you not to pay your insurance premium, it’s also a contract violation for us to not charge or undercharge for our services.
Insurance Cards
Bring your child’s insurance card to each visit. This helps us ensure we have the correct information and bill the right insurance.
Copayments
We are required to collect copayments at the time of your appointment. We can’t waive this payment for any reason due to our contract agreement with your insurance company. If you forget to pay your copay at the time of your appointment, no worries! Just be aware that if it happens more than once, we may charge a missed copay fee of $10. Enroll in our Peak Pay program to avoid this fee, and keep your credit card on file for easy payments.
Medically-based treatment
Peak Pediatric Care prioritizes your child’s health by following the recommended routine screenings, including developmental, hearing and vision, anemia, and lead tests. Unfortunately, not all insurance plans cover these screenings, so patients need to understand their coverage and inform our office if a screening is not covered before their appointment.
Time of Service Discount
No insurance or out-of-network? Pay in full at your appointment and receive a discount. This discount only applies on the day of the visit and can’t be applied to the portion of the bill you’re responsible for under your insurance plan, as that’s already discounted through our contract with your insurer.
Additional Fees
Medical Forms
Need a medical form filled out? We offer it as a free service, but it may take up to 10 business days due to high demand. Need it sooner? Our rush service is available for $10 per form and will be ready within 3 business days. Payment is required when the form is dropped off or sent.
Medical Records
Transferring from Peak and need your records? We’ll compile your summary of care, immunizations, growth chart, and last physical report for free. Full medical record, including all visits and notes, has a $15 handling fee.
Missed Copay
If you forget to pay your copay at the time of your appointment, no worries! Just be aware that if it happens more than once, we may charge a missed copay fee of $10.
Outstanding Personal Balance
Outstanding balances that become 60 days due may be assessed a $25 late fee. After 90 days, you will not be able to schedule appointments until the balance is paid. After 120 days, your account will be reviewed for collection agency placement.
Newborns
As new parents, we understand that you have a lot going on, but it’s important to remember to add your newborn to your insurance policy within the first 30 days. Failing to do so may result in you being financially responsible for any visits not covered, so don’t wait until it’s too late!
Account Balances
We expect all patients to pay their bills in full within 30 days of receiving a statement from us. Please get in touch with our office to set up a payment plan if you need more time to pay the balance. To ensure your account stays up-to-date, consider enrolling in our Peak Pay program, where you can securely keep your credit card on file.
- 60 Days: A late fee of $25 may be accessed
- 90 Days: Not allowed to schedule appts
- 120 Days: Will be reviewed for collections
Failure to pay an overdue balance on your account, or set up and abide by an agreed-upon payment schedule, can be cause for dismissal from Peak.
We accept various forms of payment, including credit cards, checks, and cash. A $25 fee will be added to your account if your check is returned.
Peak Pay / Credit Card On File
To make managing your medical expenses easier, we offer Peak Pay – the option to keep a credit card on file for quick and secure payments. Your credit card information is securely stored with our payment processing vendor, not in our computer system.
- We will automatically charge the credit card on file for account balances under $200, including copayments and deductibles.
- We will not charge your card for account balances until you have received your explanation of benefits statement from your insurance company.
- We will email you a receipt anytime we process a charge.
Peak Pay helps you avoid additional billing fees and makes checking in for your appointment easy, especially if calling from your car! Think of Peak Pay as setting up autopay for your credit card or phone bill.
Minors
Anyone accompanying a minor to their appointment is responsible for taking care of any payment due, like a copay. To make things super easy, you can pay over the phone using your credit card or, even better, enroll in our Peak Pay program!
Well Child Visits
Your child’s yearly physical is all about keeping your little one healthy. Unfortunately, if any new issues arise or we discuss managing chronic conditions during the visit, your insurance will require us to bill a separate claim and collect a copayment. These two parts of the visit must be billed and filed separately; otherwise, it would be considered insurance fraud on our part.
Overpayment
Occasionally there may be an overpayment made on an account. Provided that there are no outstanding balances on the account, we will ensure that a refund is issued within 60 days of the initial credit.
Custodial parenting arrangements
We understand that parenting arrangements can be complicated, but we’re looking to you when it comes to paying for your child’s medical care. No matter what your divorce decree, custody agreement, or other arrangement says, you’re responsible for covering the cost of the care we provide to your child. To help, we’ll provide receipts for any medical bills you pay if you need them.
Termination of Practice-Patient Relationship
In rare instances, Peak Pediatric Care may ask a family to transfer care out of our practice. Reasons for this request may include, but are not limited to:
- Repeated no-shows or late arrivals, which is unfair to our providers and patients and strains our practice;
- Unkind and disrespectful treatment of our staff, which is never tolerated;
- Rude or disruptive behavior, particularly in our waiting areas;
- Refusal to pay fees owed to the practice (or refusal to make or follow through with an agreed-on payment plan);
- Irreconcilable differences in medical philosophy; and
- For any other reason, the practice, in its sole discretion, deems termination of the practice-provider relationship is warranted.
Account Balances
We expect all patients to pay their bills in full within 30 days of receiving a statement from us. Please get in touch with our office to set up a payment plan if you need more time to pay the balance. To ensure your account stays up-to-date, consider enrolling in our Peak Pay program, where you can securely keep your credit card on file.
- 60 Days: A late fee of $25 may be accessed
- 90 Days: Not allowed to schedule appointments until balance is paid
- 120 Days: Will be reviewed for collections
Refills, Referrals, and Forms
Refills
Please submit refill requests through the patient portal or by calling your pharmacy several days prior to running out of your prescription. Allow 48 hours for refills to be processed. We may also contact you to schedule a visit to review and discuss your child’s health and medications.
Referrals
We ask that you submit all referral requests through the patient portal so that we can ensure we receive all of the information required by your insurance. Please allow up to 72 hours to be processed.
Forms
Depending on current requests from other patients, medical forms can take up to 10 business days to be completed. We offer a rush service to receive your forms within 3 business days for $10 per form.
HIPPA Privacy Policy
We safeguard your child’s personal medical information with utmost care, following all HIPAA regulations and practices. We use this information for treatment, billing, and to improve our services, or when we are legally required to share it. You may give us permission to make specific, additional disclosures, and may rescind that permission in writing at any time. You always have the right to obtain copies of your child’s medical record and personally distribute the information.
Read our full Privacy Policy for comprehensive information about your rights, your choices, and under what circumstances the information may be disclosed.
Peak Pediatric Care, PLLC
652 E Washington St, Unit 2
North Attleboro, MA 02760
(508) 576-5010
Your Information. Your Rights. Our Responsibilities.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Your Rights
You have the right to:
- Get a copy of your paper or electronic medical record
- Correct your paper or electronic medical record
- Request confidential communication
- Ask us to limit the information we share
- Get a list of those with whom we’ve shared your information
- Get a copy of this privacy notice
- Choose someone to act for you
- File a complaint if you believe your privacy rights have been violated
Your Choices
You have some choices in the way that we use and share information as we:
- Tell family and friends about your condition
- Provide disaster relief
- Include you in a hospital directory
- Provide mental health care
- Market our services and sell your information
- Raise funds
Our Uses and Disclosures
We may use and share your information as we:
- Treat you
- Run our organization
- Bill for your services
- Help with public health and safety issues
- Do research
- Comply with the law
- Respond to organ and tissue donation requests
- Work with a medical examiner or funeral director
- Address workers’ compensation, law enforcement, and other government requests
- Respond to lawsuits and legal actions
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us using the information on page 1.
- You can complain if you feel we have violated your rights by contacting us using the information on page 1.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints. - We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the case of fundraising:
We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Treat you
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
Do research
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Effective February 15, 2022
Peak Pediatric Care, PLLC
652 E Washington St, Unit 2
North Attleboro, MA 02760
(508) 576-5010
