Preventive Medicine



Good healthcare for newborns, infants, children and adolescents begins with the well-child checkup and other services that keep children healthy. These are preventive services. Our doctors and staff provide these services based on a plan called Bright Futures. The American Academy of Pediatrics (AAP) made this plan to help doctors and families know what preventive services children should receive from birth to 21 years of age, such as screening tests, and advise about staying healthy and safe. This plan can be altered to suit each child as needed. We also follow the AAP vaccine schedule for newborns, infants, children and adolescents.

Because preventive services are important to keeping children healthy, the Patient Protection and Affordable Care Act (health care reform law) includes a rule that all preventive care screenings and services included in the Bright Futures plan and vaccine schedule must be covered by most health plans. This is not always true, though, as some older plans, called grandfathered plans, do not have to pay in full for preventive services.

Health Plan Terms to Know

• Co- Payment: A fixed amount that you can pay for certain health services before the health plan pays
• Co-Insurance : The portion of the charge that is not paid by the health insurance plan( usually a fixed percent of each amount paid by the plan)
• Deductible : An amount that must be paid by you before the plan will begin paying for services

There may also be times when a child needs a service that is not considered preventive on the same day as a well-child visit. If a child is not well or a problem is found or needs to be addressed during the checkup, the physician may need to provide an additional office visit service ( called a sick visit ) to care for the child. This is a different service and is billed to your health plan in addition to the preventive services provided on that day. You may have a co-payment for office visits or coinsurance/deductible amounts that you must pay out of pocket before your health plan pays for these services.

We value your time and want to make the most of each appointment for the child. This is why we will address any problem that needs a doctor’s care during well-child visits so that only one trip is needed. Some services that may be provided and billed in addition to preventive services include : The doctor’s work to address more than a minor problem ( eg, if the doctor gives a prescription, orders tests, or changes care for a known medical problem), medical Treatments, any surgery (such as removal of ingrown toenails, wart treatments or circumcisions.)

We do not want you to be surprised by a medical bill but must always bill your health plan based on the actual services provided. Please feel free to ask questions about services that may not be paid in full by your health plan on the day of your visit. It is our pleasure to help.
 

*****We are not in network with Blue Cross Blue Shield HMO policies*****