Policies

Pediatric Associates of Northern Colorado (PANC) is committed to providing the highest quality of medical care and developing a strong provider-patient relationship with you and your child. To support this commitment, we are providing you with a clear statement of our office and billing policies, which are listed below. We ask that all parents or legal guardians sign and acknowledge the receipt of this document. 

Healthcare billing through insurance companies can be confusing and if you have further questions, please do not hesitate to call a member of our Billing Staff - 970-440-2120. 

Responsible Party/Guarantor 

• The “Responsible Party or Guarantor” is the person who is responsible for the payment of services.  
• Copayments are due at the time of visit. 
• Please be aware that your insurance contract is between you and your carrier.  

It is your responsibility to verify that our office is a “in-network provider.” 

1. Verify eligibility and benefits per your specific plan. 
2. Provide an insurance card at each visit. 
3. Notify the office of any insurance changes within 60 days from Date of Service. 
4. All charges are patient responsibility until account if paid in full. 

• We will gladly submit your claim to your health insurance for the services provided. However, any charges accrued on the account are your responsibility. You will be expected to follow up on any unpaid or incorrectly paid charges, regardless of insurance coverage. We will be happy to assist you in any way we can, but you are responsible for timely payment to your account. 
• For a returned check, a $50.00 service fee will be added to your account. 
• You will be responsible for the charges incurred by the minor children (under age 18) who come into the office unaccompanied, or in the presence of another caregiver (i.e., grandparents, baby-sitter, etc). 

NOTE: We require a signed authorization/permission form for another caregiver to bring your child for an appointment. Please make sure that we have this one file to prevent any delays with visits. 

• When the patient turns 18, they become their own guarantor. This information will be changed in our electronic medical records (EMR) demographics.  

NOTE:  A updated authorization will need to be signed by the patient for parent or caregiver to be able to speak with a provider or clinical staff regarding any patient medical information. 

Insurance Coverage: 

We recommend you contact your insurance company to determine if we are in-network providers. Although Pediatric Associates contracts with most commercial insurance companies, it is difficult to know if we are in-network with all of the different plans. Please contact the member services number located on the back of your insurance card to determine provider information. 

If your insurance is determined as a discount plan, such as Medishare discount plan, you will be considered self-pay, and a claim can be provided to you for submittal to insurance for reimbursement. 

Invoicing/Payments: 

After we have submitted a claim to insurance, we will send you an itemized statement. Payment is due upon the receipt of the first statement. If you have questions or need to set up payment arrangements please call our billing office Monday-Friday 8:00-3:00pm. Delinquent accounts (over 90 days past due), will be sent to collections. NOTE: If your account goes to collections, you will be dismissed from the practice. We will only be available for emergency care for 30 days, until you establish care with another physician. 

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.

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.

We want to ensure the highest level of health and safety for the children we care for in our practice. That means that all children should be fully immunized. The only medical appropriate exceptions are for children with an allergy to a vaccine component or immunodeficiency syndromes in which some vaccines are contraindicated.

In the last twenty years, there have been outbreaks of diseases in the United States that could have prevented by vaccines. Many of these outbreaks have led to infections in unvaccinated children, because they are at greater risk for these diseases. While the recent epidemics of measles and pertussis (whooping cough) infections have primarily affected unvaccinated children, they also disproportionately affect children with developmental disabilities and those receiving chemotherapy for cancer, who are medically vulnerable due to these chronic illnesses.

Well-funded, well-publicized anti-vaccine groups have continued to recycle discredited pseudo-scientific studies and spread alarming misinformation about vaccines. This has led to confusion even in those who are strongly supportive of vaccines. We understand that those families who are reluctant to vaccinate their children only want to want to do what is best for their children and are fearful that the stories might be true. We believe that the anti-vaccine movement has done a great disservice to these children and families.

Even if you are not planning to vaccinate your child, we hope to discuss your concerns in our clinic. We would be more than happy to share resources we trust with you to help you answer questions you may have. You can explore the helpful links available on our family resources page to get started.

We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives. We also believe that the families who visit our clinic want their children safely protected from infectious diseases.

We firmly believe in the safety of our vaccines.

We firmly believe that all children and young adults should receive all of the recommended vaccines according to the schedule published by the Centers for Disease Control and Prevention and the American Academy of Pediatrics.

There is no medical reason to alter or delay the schedule. Vaccines contain only a small number of unique immune stimulators. We are exposed to far more immune stimulators on a daily basis than if all of the vaccines combined.

We have spent hundreds of hours educating parents. We believe that our education has been solidly founded on scientific evidence.

We firmly believe, based on all available literature, evidence, and current studies, that vaccines do not cause autism or other developmental disabilities. We firmly believe that thimerosal does not cause autism or other developmental disabilities. In addition, thimerosal has been removed from almost all vaccines.

We believe that it is important for all children to be vaccinated.

We firmly believe that much of the protection of vaccines comes from herd immunity. Most vaccines produce immunity in 90–95% of children. The remaining 5% who do not produce immunity are protected by herd immunity. This means that a highly vaccinated population limits the spread of most infections – even to those who are not vaccinated – by preventing infection spreading from one person in the midst of the large population or “herd.”. As more people choose not to vaccinate, herd immunity is eroded, putting everyone at greater risk.

We plan to keep seeing unvaccinated children.

There is a growing trend among pediatric practices to decline seeing patients who are not vaccinated. At this time, we plan to continue to see unvaccinated children in the hope that we can help families to understand the importance of vaccines and their safety, and ultimately convince them to vaccinate their child.

There may be a time in the future that we will also follow this national trend and ask these families to seek another medical provider. If you decline recommended vaccines, your provider will ask you to complete the American Academy of Pediatrics Refusal to Vaccinate Form, which will be scanned into your child’s medical record.

RULES FOR UNDERIMMUNIZED PATIENTS AND FAMILIES:

If your child is ill with a possible vaccine-preventable disease, please enter through the building’s side door after alerting us you have arrived.

Symptoms of a vaccine-preventable disease may include:

• Cough
• Fever
• Rash
• Eye drainage
• Vomiting

A mask may also be required for your child if coughing is a symptom.

There will likely be additional tests ordered for your child if they are at risk for a serious vaccine-preventable disease. In some cases, if it is deemed likely that your child is suffering from a vaccine-preventable disease, your child may need to be seen in the ER rather than in our clinic.

Please do not bring your child into the office if you suspect they may have a vaccine-preventable disease without observing these precautions. It is our duty to protect all of the patients in our waiting room — especially those who cannot be vaccinated due to age or medical contraindications.

Please let us know if you have any questions about this policy or about vaccines and their safety.

Thank you,

Your PANC provider team

Due to HIPAA regulations, our office requires written consent from a parent or legal guardian to see and/or treat children under the age of 18. This also applies to a patient being brought in by anyone other than the parent or legal guardian. Once a patient turns 18, new patient intake sheets are filled out and signed by the patient. HIPAA guidelines mandate we must have the patient’s consent to release their medical information, even to a parent.

Our office requires payment or insurer specified copayment for an office visit at the time of the visit. If we have to bill you for your copay, there will be an additional $10 billing service charge.

If you have a true emergency please call 911.  Our practice offers after-hours services in case you have urgent questions that cannot wait until the morning.  There are two options:  You may click the "page my doctor" button on our home page and type the questions for the Children's Hospital Nurse Triage Service.  Or you may call 970-484-4871 and talk to a live agent from our paging service. The Triage Nurse will then call you to determine the next steps. Next steps may include treatment recommendations over the phone phone, a referral to the ER or an urgent care center, or a follow-up appointment in the clinic the following day.

FEES

• After-hours calls: you may be charged $15
• The after-hours phone call fee will not be charged if the patient is seen within 48 hours of your call.

Our nurses have voicemail and messages can be left for them throughout the day. They receive a large number of calls every day, so please be patient when waiting for a return call. If the situation is critical or you need to make an appointment, please inform the receptionist so that your needs can be addressed immediately. The nurses not only receive calls with questions from patients and parents, but also calls from labs, other offices, and pharmacies for refills.

When leaving a message for the nurse, please speak clearly and be sure to leave your phone number, name, and spelling of the child’s first and last name.

If you are calling regarding results for tests not performed in our office, please leave the child’s name, the date of test, and the lab or facility at which it was performed so that the nurses have all of the information readily available when returning your call.

Please be aware it may take 72 hours for any forms to be completed.

For the quickest response please leave a Portal Message through your child's My Health Connection page.  

We prefer this as the quickest way for you to get a response.  Phone calls may take up to 1-2 days for a response.

Portal messages are a great way to stay connected to our office. You can send forms, PDF files and photos. You may reach out to us for any questions you may have.*

 *Depending on who responds and if advice is given there may be a $25 charge for portal advice. *

Routine Medication Refills

Please contact your pharmacy first. They will contact us directly for refill requests. When leaving a message for medication refills, the nurses will need:

• Name of the child
• Spelling of their name
• Name of the prescription medicine
• Dosage information
• Name and location of the pharmacy

PRESCRIPTION REFILLS WILL BE CALLED IN:

• Monday – Friday, 8:30 a.m. – 3:30 p.m.

If an ADD/ADHD medication refill is needed, please give 48 to 72 hours of advance notice.  Please send us a portal message when you need a refill, with the medication name, dose, one month or three month supply, and your pharmacy preference. 

Medication recheck visits for ADHD, Depression, Anxiety, and Asthma visits (if on a controller) are performed every six months. Yearly well-care visits are recommended as well and can also serve as medication recheck visits.

Forms that need to be filled out by a nurse and/or signed by provider can be dropped off at our front desk or you may scan and email to info@pediatricassociatesnc.com. We ask for 2 to 3 business days for completion. 

PARENTS

Please read the requirements for physicals on camp and sports forms.  If you need a form filled out, and it indicates the need for a physical exam within the last year, we cannot sign the form unless your child has had a complete physical exam within that time period.

Note:  If you need a form filled out the same day, we are happy to accommodate, but there will be a $20 rush fee. Simply bring the form to our office with your payment, let us know it is a rush form, and we will get it done by the end of the business day.

Sign up on My Health Connection to access your child's vaccine records from your home and print if needed.  Click the portal icon on the top of our home page to get started.

Well-care physicals typically take 30 to 45 minutes. Most daycare facilities, camps, and middle-school and high school sports require a physical every 12 months. The American Academy of Pediatrics (AAP) recommends yearly physicals for children from two years old to 21. Visits are more frequent for children under the age of two.

Well-care physicals consist of a complete physical exam that includes:

• A developmental evaluation
• Measurement of height and weight
• Hearing and vision screening
• Blood pressure check
• Scoliosis check
• Neurological exam
• Immunization update

Depending on the age of the child, we may also check for anemia and perform an autism and developmental screening. You and your care provider will discuss diet and sleep patterns. You will also have an in-depth conversation regarding safety and behavioral issues.

With adolescent physicals, discussion topics may also include high-risk behavior, sexuality, peer pressure, school-related issues, and depression. Additional screenings for anemia, high cholesterol, and depression are performed for teens.

Sick appointments are scheduled with a 15-minute time slot by default, but if your child has multiple symptoms, problems, or concerns, please let the receptionist know when you make the appointment so that more time can be reserved for their visit. We want to make sure the doctor has enough time to address all of your concerns without feeling rushed.

For online scheduling of sick appointments, you are given a few questions that will either leave the appointment time at 15 minutes or extend visit time. 

Our clinic schedule is not set up for walk-in appointments. Please call ahead to set an appointment time. We have an unscheduled visit charge of $15 in addition to your copay. If you have an appointment for one of your children, but bring a sibling whom you would also like to be evaluated, there will be an unscheduled visit charge in addition to the copay for each child. Please call ahead to schedule the visit for the sibling to avoid this charge and assure that both children can be seen.

Because not showing up for an appointment takes time from the schedule which cannot be filled by another patient/ please call to cancel a visit you do not intend to complete. If you don't arrive for your scheduled appointment time within ten minutes, the delay will be treated as a no-show, and your child's visit will have to be rescheduled. You will also have to pay the fee for a missed appointment. We ask that you arrive ten minutes prior to your appointment time to ensure that registration can be completed before your scheduled clinical time with the provider and nurse. 

Failure to cancel prior to 24 hours before the visit will result in the following cancellation fees:

• Well-care check - $75.00
• Medication visit - $50.00
• Evaluation (ADHD, Autism, Depression, Consultations) - $75.00
• Circumcision procedure - $75.00

Cancelling Other Appointments

We require a minimum one-hour notice to cancel or reschedule ALL other appointments.

• Failure to cancel a sick visit at least one hour prior to your visit time will result in a $25 late cancellation fee.
• The above noted fees will NOT be billed to your insurance — they are your personal responsibility. Our office confirms appointments the day before your scheduled visit or on Friday for Monday appointments. This is provided as a courtesy; it is your responsibility to remember your appointment.

IF AN APPOINTMENT IS MISSED THREE TIMES, YOU WILL BE ASKED TO TRANSFER CARE TO ANOTHER PRACTICE.

Please call 970-484-4871 to cancel or reschedule an appointment.

We accept most insurance for your child’s pediatric care. To confirm that we are an in-network provider for your insurance, please call or check your insurer’s website.

If you have any questions or need clarification about any of our insurance policies, please don’t hesitate to call.

We look forward to meeting you and beginning our relationship with you and your family!

Many insurance companies require a referral from your primary care physician before a specialist may see you. Once you have been referred to a specialist by our office, call your insurance company. You can also check your insurance provider’s website to see if the specialist is in-network and if a referral is needed. Once you have been referred, call that specialist, set up an appointment time, and then call us promptly with that date and the specialist’s name. It is important to do these steps in sequence to assure maximal insurance coverage.

Policy for Divorced or Separated Parents

Pediatric Associates of Northern Colorado’s providers and staff are dedicated to our patients. We understand that divorce or separation can be a challenging time for families, and we are committed to providing the best care possible for the children involved. To ensure that we can maintain a professional and supportive relationship with all parents, we have established the following policy:

1. Our pediatric practice providers, staff, and billing office will not take sides or be placed in the middle of any domestic issues, conflicts, or disputes over the phone or in the office.
2. PRIOR to visiting our clinic, please make decisions regarding appointments, office procedures, and vaccinations.
3. We recognize that both parents have the right to access their child’s medical information and participate in their healthcare decisions. Therefore, only in situations where a DOCUMENTED COURT ORDER is ON FILE will a parent be denied access to a minor child’s health records and/or visits to the office. Pediatric Associates of Northern Colorado must have a copy of this Court Order on file in the minor child’s electronic chart.
4. If there is NOT a court order on file with our office, either parent or legal guardian can sign the “consent to treat” form and authorize any names of individuals to bring their child to our practice, be present during visit, and consent to any treatment during that visit. We will not be involved in any decisions that are brought against the named individuals on the consent forms unless instructed by the court.
5. We will not accept any communication from one parent about the other parent’s medical decisions or treatment unless the communicating parent has legal custody or medical power of attorney over the child.
6. It is the responsibility of both parents to communicate with each other about the patient’s care, office visits, and any other pertinent information relevant to the patient. It is not the responsibility of the provider to communicate visit information to each custodial parent separately. Our providers WILL NOT CALL the non-attending parent following visits.
7. Payments, including copays, are due at the time of service. The responsibility of the bill for minors is the parents or legal guardian. It is our policy to collect payment at the time of service from the parent or guardian who brings the child for their appointment. Any disputes about payment that end up in the collection process will be due at the next time of service or the patient will not be seen.
8. Should the issues that come between parents become disruptive to our clinic or there is non-compliance with this policy, we reserve the right to discharge the family from the practice.

We hope that this policy will help provide a stable and supportive environment for children and families during time of transitions. Our goal is to provide the highest quality of medical care to all of our patients and to support both parents’ efforts to care for their children.