Policies

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 prescribe antibiotics over the phone and we never provide refills for antibiotics.  

We will prescribe an antibiotic when we believe it is an appropriate treatment.

We ask that you arrive 10 minutes before your scheduled appointment time. 

* Please have your insurance information on hand when you arrive for your appointment.

*Please try to arrive with completed forms needed whenever possible. Forms can be found under the 'Forms' tab above on the drop-down menu.

We understand sometimes things happen beyond your control that may cause you to be late. However, if you arrive late for your appointment, we will do our very best to see your child, depending on the nature of your appointment, we may need to ask you to reschedule if you are late.

Our practice makes every effort to run on time with appointments, as we believe everyone’s time is equally valuable.

Missed Appointments: Broken appointments represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you. We reserve the right to charge a fee for canceled or missed appointments. We request 24 hours notice for cancellation of appointments.

For new patients, a fee may be charged if the FIRST appointment is missed.

St. Rose Pediatrics 

Office Financial Policy 

Including Paperless Communication OPT-IN Policy

Patient: ____________________________________________ Date of Birth: _____________

Date: ______________________

I understand that I, the parent, legal guardian, or financially responsible party will be responsible for all charges for services rendered regardless of insurance coverage. This includes co-payments, co-insurance, deductibles, and any other services that are not covered by your insurance plan.

___________________________________________________________Date: ______________

Patient/Parent/Guarantor Signature:

I authorize the release of any medical information to my insurance company necessary for processing the claim.

___________________________________________________________Date: ______________

Patient/Parent/Guarantor Signature:

I authorize payment of medical benefits to the treating physician for services provided directly from my insurance carrier.

___________________________________________________________Date: ______________

Patient/Parent/Guarantor of Patient Signature:

Financial Policy Agreement

While our main concern is that your child receives the proper medical care needed to maintain his/her health, our Financial Policy Agreement outlines patient and family financial responsibilities. Our practice is committed to providing high-quality care and ensuring a clear understanding of financial expectations. Review this policy carefully and discuss any questions you may have with our service providers and our staff. 

All co-pays are due at the time of service. Payment for services on a cash visit is due IN FULL at the time of service. We accept cash, checks, Discover, American Express, Visa and Mastercard. For those with temporary hardships, we have payment options we can offer.

We will submit insurance claim(s) on your behalf if we have a provider contract with your insurance company. However, it is your responsibility to follow up with your insurance company if your claim(s) are unpaid. If your insurance company changes, it is your responsibility to notify us and provide a copy of the new insurance card immediately. 

PLEASE READ THE FOLLOWING CAREFULLY

1. Your insurance coverage is a contract between you, your employer, and your insurance company. We are not a party to that contract. Our relationship is with you, and you are responsible for payment of services provided, regardless of your insurance coverage. It is the patient's responsibility to understand insurance benefits, including coverage limits, deductibles, co-pays, and referral requirements before receiving services.

2. Not all services are covered by your insurance company. It is your responsibility to know what is covered under your insurance plan. Fees for non-covered services are due at the time services are rendered.

3. If you have an HMO (Health Maintenance Organization) plan, please make sure that you have contacted them prior to your visit and name St. Rose Pediatrics as your primary care physician.

4. Our office bills for healthcare services provided in the office only. Fees for lab work and cultures processed by an outside lab will be billed separately by the attending lab.

5. If your insurance company does not pay within 60 days, we reserve the right to begin billing you directly and you will need to contact your carrier to resolve unpaid bills between you and your carrier. After 90 days, accounts are considered delinquent and will be placed with a private collection agency. All accounts placed with a collection agency will be subject to all reasonable collections and any applicable court fees.

6. Returned checks will be subject to a $30 fee.

7. There will be a $40.00 charge for No Show appointments. For any appointment cancellations, please contact the office via our patient portal or by phone. We ask for a 24-hour notice to avoid any no show fees.

ELECTRONIC COMMUNICATION AND PAPERLESS BILLING CONCENT                         The practice values efficient communication and the environmental benefits of going paperless.

• Patients have the option to receive appointment reminders, statements, and other designated practice communications electronically, such as secure patient portals, emails, and text messages.

• To opt-in for electronic communication and paperless billing, provide a current and preferred email address and mobile number below. You may also update communication preferences at any time through the patient portal or by contacting the office.

• By opting in, the patient acknowledges that while the practice strives to use secure platforms and reasonable safeguards for electronic communication, inherent risks may be associated with transmitting health information electronically.

• Consent for electronic communications can end at any time by notifying the office in writing. However, some communications may still be sent electronically for treatment, payment, or healthcare operations, as permitted by HIPAA and relevant Nevada law.

• The practice will ensure that all electronic communications comply with federal and Nevada state regulations, including HIPAA Privacy and Security Rules. 

  9.     Patient Acknowledgment:

• By signing below, you acknowledge that you have read and understand the Financial Policy and, if applicable, consent to receive electronic communications as outlined above.

Patient Name (Printed) ____________________________________________________

Date of Birth: _______________________

Signature of Patient/Responsible Party: ____________________________________

Date: _______________________

Paperless Communication OPT-IN

Email Address for Electronic Communications:

 ______________________________________________________

Email

Mobile Number for opt-in Text notification to review and pay:

 ______________________________________________________

Mobile Number

Our Patient Portal is provided by St. Rose Pediatrics for the exclusive use of its patients and authorized parents, legal guardians, and other caregivers.

If you believe your account security has been compromised, please notify us immediately so we can reset your credentials. New patients will be assigned a temporary password at their first office visit.

By logging in, you attest that you are a member of one of the groups above and will use any confidential medical information disclosed to you only for its intended purposes. Any other use is strictly forbidden.

**IMPORTANT NOTICE REGARDING PATIENT PORTAL MESSAGES**

Effective immediately, please do not attach photographs when messaging providers through the patient portal, as we cannot view them.

Additionally, please refrain from sending portal messages for nursing advice after 4:45 PM Monday through Friday and on weekends and holidays. 

Portal messages are only monitored during business hours. Thank you for being understanding.

Efficiency through the use of technology

Our Patient Portal is provided by St. Rose Pediatrics for the exclusive use of its patients and authorized parents, legal guardians, and other caregivers.

If you believe your account security has been compromised, please notify us immediately so we can reset your credentials. New patients will be assigned a temporary password at their first office visit.

By logging in, you attest that you are a member of one of the groups above and will use any confidential medical information disclosed to you only for its intended purposes. Any other use is strictly forbidden.

**IMPORTANT NOTICE REGARDING PATIENT PORTAL MESSAGES**

Effective immediately, please do not attach photographs when messaging providers through the patient portal, as we cannot view them.

Additionally, please refrain from sending portal messages for nursing advice after 4:45 PM Monday through Friday and on weekends and holidays. 

Portal messages are only monitored during business hours. Thank you for being understanding.

As medical professionals, we feel very strongly that vaccinating children on schedule with currently available vaccines is absolutely the right thing to do for all children and young adults. 

*Please see our Vaccine Myths tab for more complete information.

We are making you aware of these facts not to scare you or coerce you, but to emphasize the importance of vaccinating your child. We are more than willing to discuss any questions you may have about vaccines, but do require all new patients to our practice to adhere to the vaccination schedule endorsed by the American Academy of Pediatrics (AAP).

We firmly believe in the effectiveness of vaccines to prevent serious illness and to save lives.

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 (CDC) and the American Academy of Pediatrics (AAP).

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, a preservative that has been in vaccines for decades and remains in some vaccines, does not cause autism or other developmental disabilities.

We firmly believe that vaccinating children and young adults may be the single most important health promoting intervention we perform as health care providers, and that you can support as parents/caregivers.

The recommended vaccines and the schedule of administration are the results of years and years of scientific study and data-gathering on millions of children by thousands of our brightest scientists and physicians.

The vaccine campaign is truly a victim of its own success. It is precisely because vaccines are so effective at preventing illness that we are even discussing whether or not they should be given. Because of vaccines, many of you have never seen a child with polio, tetanus, whooping cough, bacterial meningitis, or even chickenpox, or known a friend or family member whose child died of one of these diseases. Such success can make us complacent or even lazy about vaccinating. But such an attitude, if it becomes widespread, can only lead to tragic results.

Over the past several years, many people in Europe have chosen not to vaccinate their children with the MMR (measles, mumps, rubella) vaccine after publication of an unfounded suspicion (later retracted) that the vaccine caused autism. As a result of under-immunization, there have been small outbreaks of measles and several deaths from complications of measles in Europe over the past several years. The United States experienced a record number of measles cases during 2019, with 1282 cases from 31 states reported to CDC's National Center for Immunization and Respiratory Diseases (NCIRD). This is the greatest number of cases since measles elimination was documented in the U.S. in 2000.

Furthermore, we firmly believe that by not vaccinating your child, you are taking selfish advantage of thousands of others who do vaccinate their children, which decreases the likelihood that a child will contract one of these diseases. We feel such an attitude to be self-centered and unacceptable. Even delaying or “breaking up the vaccines” to give one or two at a time over additional visits goes against expert recommendations, is not supported by any scientific data, can lead to unnecessary delays and errors, and can put your child, other children, and adults at risk for serious illness (or even death). It is therefore against our medical advice as professionals at St. Rose Pediatrics.