Welcome to our practice. We are pleased to be able to serve you. As specialists in the care of infants, children, and young adults, we strive to provide the best in personal health care and hope to follow your children from infancy through young adulthood.
This information is designed to help us work with you for your children by providing general information about the office.
EMERGENCY CALLS (day or night): Call 911 (emergency medical services) for life threatening emergencies in which your child may require resuscitation (your child is not breathing, is choking severely, is unconscious, or is having seizures, for example).
- Call our office for non-life threatening
emergencies such as dehydration, difficulty breathing, wounds that need
suturing, or fractures. When you call in, always state clearly, “This is
an emergency.” Do not let the answering service or office staff put you on
- For poisonings, call the poison control center at
NON-EMERGENCY questions can best be handled during regular office hours. We can then refer to your child's records at the office to remind us of past illnesses, medications and complications that may have a bearing on the advice we give.
If you feel that your child looks or acts sufficiently ill and needs to be seen, make the appointment without requesting a return call. If we have any question, the nurse will contact you.
Office personnel begin accepting phone calls at 8:00 every morning Monday through Saturday. After regular office hours and during the lunch hour, telephone calls to the office are relayed through the answering service. This is also true on weekends and on holidays. Therefore, whenever possible, please phone when someone is in the office to lessen the delay and inconvenience of having the call go through the answering service.
When leaving a message for the office, spell the patient’s name slowly and clearly. Give the phone number slowly and clearly twice. Please be aware of the difficulties we have in listening to messages from cell phones that don’t have a good connection. Sometimes parts of names or phone numbers get lost, and we have trouble returning the call. It is better to call and receive return calls on regular phones, not cell phones. Ifyour call is not returned within 2 hours, please call back to be certain there was not a technical problem in returning your call.
Our nurses are qualified to answer many general questions concerning your child. They are caring, experienced and quick to ask a doctor if there is any uncertainty about the answer to your question. All phone calls are routinely reviewed by a physician by the end of the day. If you have a well baby/child check-up scheduled soon, make a list of your concerns to discuss with your doctor during the visit. Those questions that can’t wait for your appointment may be handled through the phone nurse. Don't forget to check the "advice" section on the website - you may find the answer to your question right away!
We try to return your phone calls as quickly as possible. Please be patient if there is a delay on busy days. Emergencies must get first priority. If you can only be reached during specific time periods, let us know. We will try to accommodate your request.
Many of the insurance companies have health care phone numbers which connect you to recorded information about many particular problems or access to a nurse who can answer questions for you. For Blue Cross, call 1-800-249-3617. For Blue Shield patients, you can access www.mylifepath.com. Other companies may provide this type of service (call the customer service number on your insurance card for more information). Internet sites with a broad range of health related information and services include the American Academy of Pediatrics at www.aap.org. Other valuable websites are available via our website. Our own website, www.lrpmg.com, also provides all of the information contained in this handout as well as links to other trusted sites.
For prescription refills, please have your pharmacy FAX us the request. We only refill prescriptions during office hours. We need to have the child’s chart handy to check on dosages and disease status. Plan ahead so you don’t run out of important medicines.
Refill requests for ADHD/ADD medications must be called in a few days in advance.
Since early detection of disease or abnormality is the basis of practicing preventive medicine, we recommend regular check-ups. Some insurance companies do not pay for well check-ups or immunizations. Please ask your insurance company about its policy. If additional check-ups are needed (for example, sports physicals), our patients will be responsible for paying our usual charge themselves.
We encourage our older patients to see us alone whenever they wish, for all or part of their visits. With appropriate privacy we hope to have an open discussion of any personal questions or problems they might have. Please let them know that information they share with us will be treated confidentially and will not be discussed with anyone without their prior approval. We cannot see anyone under 18 years old without parental approval, either in person or in writing. If you anticipate sending your teenager to the office alone, we have a permission form that you can fill out in advance. It is available online or in the office.
All patients over 18 years old are legally adults and responsible for their own bills if their parents no longer pay for them. Los Robles Pediatric Medical Group, Inc. (LRPMG) must be informed if parents are no longer paying for their adult children’s care before their children are seen. Parents of patients over 18 years old may be required by Los Robles Pediatric Medical Group, Inc. (LRPMG) to take on such patients’ financial responsibility with LRPMG.
Privacy laws also pertain to patients over 18 years old. LRPMG can only inform parents of medical information relating to their adult children if LRPMG has authorization from the patient to do so, whether or not such parents are financially responsible for their adult children’s bills with LRPMG.
INFANTS & MINOR CHILDREN
It is best if we see all infants and minor children in the company of a parent whenever possible. We often need more information than a babysitter, grandparent, etc. may have available. If a parent or custodial adult cannot bring in their child, the adult who does bring in the child must have written authorization to consent for exam and treatment. The authorization form is available online or in the office. It is also better that we discuss the diagnosis and treatment directly with a parent. If you are unable to bring in your child, please give the child’s caretaker a phone number where we can reach you for consent for treatment or discussion if necessary.
Immunizations will be given at recommended intervals during the regular check-ups. They will be recorded on an immunization card which we will provide. Please bring this card with you at each check-up visit. Do not lose it as it is a very important record, and you will need to refer to it many times in the future. A charge will be made if we have to fill out another card.
Immunizations require the presence and signature of a parent or legal guardian if your child in less than 18 years old. Another adult may consent to immunizations for your child if the parent has so authorized (A downloadable form is available on our website).
Some insurance policies do not cover immunizations. You have the option of getting immunizations at the local vaccine clinics if you prefer.
CONCERNS ABOUT IMMUNIZATIONS
There are many inaccurate claims publicized in the media about risks of vaccines, even though there are numerous scientific studies that disprove the claims. Many parents are unsure about what to do because the concern of possibly harming their children. This is understandably a very important issue.
We continually review the safety of the vaccines we give. Study after study demonstrates the safety of vaccines. There is no evidence that any of the vaccines we recommend have been shown to cause autism or mental retardation. The facts show that immunizations are important to prevent serious diseases which can cause death or serious complications including brain damage and paralysis. The risk of not immunizing is much, much greater than any possible risk of problems from immunizations.
We give all the recommended vaccines to our own children, grandchildren and to the children of our staff.
For further information we have listed websites later in this handout that provide scientific evidence-based discussions of the various vaccines.
If your child is not fully immunized, we request you notify the receptionist at the time of making the appointment so that we can take the necessary precautions.
Home management of simple colds, earaches, sore throats, fever, diarrhea, vomiting, poisoning, choking, diaper rash, pink eye, constipation and head injury is discussed on separate pages in this information packet. There is a wealth of helpful information here, and we hope you will find it useful in the care of your child. Please call for advice only if necessary after reading the appropriate area of our Medical Information section in the second half of this packet or on our website. If you are concerned regarding the health of your children, we are always happy to see them – simply make an appointment; we would rather see a child before his/her illness becomes severe.
Antibiotics are rarely prescribed over the phone. A child with a specific condition requiring antibiotics must be examined before the diagnosis can be made with certainty. Most childhood illnesses are caused by viruses. Viral illnesses are not cured or helped by antibiotics.
In order to be effective, please give medicines as directed. Remember to give all doses as prescribed.
When laboratory tests are done on your child, we will call you if the laboratory work is abnormal. If the results are not of concern, you will receive an automated phone call. In complex cases where many tests have been done, we may schedule an appointment to discuss the tests and plan for further care or diagnostic studies.
CHARGES FOR MEDICAL CARE
Charges for medical care are unfortunately a potential source of problems and misunderstandings. If you have any questions, please feel free to discuss them with us. Our standard office procedure is that charges or copayments be paid at the time medical care is received.
If you have suddenly run up a large bill that cannot be paid off at once, please do not hesitate to mention it to the receptionist or to us. We are aware that these situations can arise and will make whatever arrangements we can to assist you.
In order for us to bill your insurance company properly, please give us your insurance card at each office visit. You may be responsible for paying the entire bill if we cannot bill your present insurance in a timely fashion. Regretfully, we are unable to bill secondary insurance.
If you change or discontinue insurance for any or all of your children, it is crucial to notify us and give us your new insurance information. Many insurance companies have a 90 day timely filing period. If the proper insurance is not given to us in a timely manner, you will be fully responsible for any charges that have incurred on your account.
Newborns must be added to a parent’s policy before 30 days of age.
We follow the federal HIPAA rules regarding privacy. This office is not responsible for any subsequent dissemination or disclosure of your confidential medical information once we provide such information, at your request, to your health insurer.
Certain types of insurance plans place restrictions on both the patients and doctors in terms of which specialists we can refer you to, what medicines we can use, where you can go for lab and x-ray, how often you can come in for check-ups, if immunizations or hearing/vision screenings tests are covered benefits, etc. It is very important that you understand fully what your insurance policy covers. We have no way of knowing the details of each individual policy.
PPO insurance plans pay us less than we formerly received for our care of your children. Unfortunately, therefore, we must now charge for services such as reviewing records, reading PPD tests, providing telephone consultations, replacing immunization cards, writing letters, (particularly letters requested to appeal insurance claims or to aid in non-medical issues) and completing school, camp, medication and immunization forms that were previously included in our fee. We wish it were otherwise.
SUGGESTIONS FOR IMPROVEMENT
We are very proud of the excellent pediatric care we provide and are constantly striving to make it even better. If you have any suggestions about how we may improve our office or care, please tell us. We would welcome the opportunity to discuss these matters over the phone or in person with you, but unsigned written comments are also acceptable. We will never be aware of problems or difficulties unless you inform us, and we will be grateful if you do.
Monday thru Friday: 8:00 AM – 11:45 AM and 1:30 PM – 4:45 PM
Saturday: 8:00 AM – 12:00 PM
Our goal is to keep waiting time to a minimum. A certain amount of time each day is reserved for illnesses and emergencies so as not to overcrowd the schedule and make you wait an unnecessarily long time. We do ask your understanding and forgiveness if you have to wait because of unavoidable delay. We also ask that you not just “walk in” for an office visit without an appointment. If you have an urgent problem, please call - we will arrange to have your child seen appropriately.
Please be on time for your appointment. If you are late, we will do our best to see your child, but it may be after those who arrive on time. Be aware that we may have to reschedule late arrivals.
Please call at least two-three months in advance to schedule physical examination appointments. For routine physical examinations, we prefer seeing one child at a time. We have found that both the physician and the parents can concentrate more effectively on a single child during the visit.
SICK AND WELL WAITING ROOMS
We have separate waiting rooms for well and sick patients. The “West Entrance” waiting room is down the hall to the right from the atrium. This is for well child check-ups and “shot clinic” patients. All others should enter our main entrance off the atrium.
On Saturdays, only the main entrance will be open. We schedule two well child checkups before illnesses on Saturday.
If you are unable to keep an appointment, please call to cancel it as soon as possible. As appointment time is limited, it is necessary to charge for appointments not kept or canceled at least 24 hours prior to the appointment time.
EMERGENCIES, WEEKEND AND NIGHT
Calls between Noon and 1:30 PM or outside of regular office hours should be reserved for serious or emergency problems. In case of extreme emergency, call 911 or take your child immediately to the Los Robles Hospital Emergency Department. When lesser emergencies arise, please dial the office number anytime, day or night. It is always better to call during office hours, if possible, since we have the chart and can refer to previous history. We can give more personalized information this way.
We do share call with other pediatricians when the office is closed. If you must call after hours, you will first speak with the after hours phone nurse who will answer medical questions and give guidance for your child’s situation. The phone nurse will also be able to reach the doctor on call. The advice of the after-hours phone nurse is designed to help you decide what action needs to be taken at that moment (going to the ER, waiting until the office opens, how to help now), not long term management of ongoing issues. After Hours Pediatrics is a facility in Thousand Oaks that provides excellent pediatric urgent care: see their website, After Hours Pediatrics, for more information.
We receive reports of all phone conversations with the after-hours phone nurses with the details of the problem and the advice given. These are reviewed daily and follow-up discussion or appointments are addressed. Los Robles Emergency Department and the “After Hours” pediatric urgent care reports are also usually sent to us, which we review.
Please give our name to any other doctor you see for any reason so they can send us a report.
INJECTIONS & SPECIAL
If your child is coming into the office for a weight check or a special procedure, please call and make arrangements in advance. We have several “shot days” scheduled each month for ordered immunizations. A child should be current in terms of check-ups prior to scheduling these immunizations.
Blank forms cannot be accepted. Please fill out your part before handing it to us. For school medication forms, you will need a separate form for each medication. Be sure to list the disease and name of medication where indicated.
We can usually complete a form within 72 hours. Please do not wait until the last minute to give us a form. Remember that each and every form must be carefully reviewed and authenticated by the doctor and this takes time.
Many forms require the information to be based on an examination in our office within 12 months of the date the form is signed by us. In any event, no form will be completed for any patient who has not had a physical exam in our office in more than 24 months. Many of the athletic clearance forms require the exam be no sooner than one year from the end of the season.
Forms are completed for those whose accounts are in good standing. Delinquent accounts must be addressed before forms are completed.
There is a charge to complete medical forms which is to be paid before the form is released.
Over the years, we have noted an increase in the amount of stress that our patient-families are experiencing. We can certainly understand that there may be times you may be worried or frustrated. In some cases, this stress is taken out with anger and verbal abuse directed toward our staff. Remember that our office and staff are here to help in anyway we can. We cannot tolerate abusive behavior by anyone. Please let a doctor know if there is a problem that exists despite the best efforts of our staff.