You chose us to provide medical care for your child(ren) and we are committed to providing the best care available. As with any other business relationship, we each have expectations and we would like to make these clear so there are no misunderstandings.
Most importantly, you are financially responsible for the care we provide.
- What you can expect from us:
- We will maintain agreements with managed care plans where appropriate to our business.
- We will file your insurance claims for plans with which we participate for you after each visit.
- We will assist you in getting answers to your questions about your coverage (remember- we don’t make the rules of your plan!).
- W\4e will happily provide you with the fees associated with your care whenever you request them.
We will work with you in the event of a special financial need.
What we expect from you:
- You will know and understand your own benefits.
- You will bring your insurance card to each visit.
- You will pay your copay, co-insurance, deductible, or any outstanding balance at the time of service (we accept Visa, Mastercard, checks, and of course, cash).
- You will pay in full at the time of service if you are not covered by a plan with which we maintain an agreement or if the services provided are not a covered benefit.
- You agree that the parent who brings the child(ren) for care will pay the co-pays, etc. (The financial arrangements that are the result of a divorce/separation are between those two parties and are not binding on us.).
A couple of other small items: We don’t file secondary insurance claims, but we will provide you with a claim for you to file yourself. If we can’t verify your coverage at the time of service, you will pay in full at the time of service.
This policy constitutes our agreement with each other on the financial aspects of the medical care we provide.
These links will allow you access to printable office forms. Note these forms should not be emailed back to the office. If you prefer, you can fax these to us at 770-772-6099, or bring them with you on your next visit."
- Patient Information Sheet - Attention New Patients - This form is now done in the office on one of our iPads. Please come in 20 minutes before your scheduled appointment so we can get your child in our system and keep them on time for their first appointment with us.
- Consultation Form
- Medical Record Release
- Vanderbilt ADHD ADD Parent Form
- Vanderbilt ADHD ADD Teacher Form
Use these links to find more information about topics listed:
- American Academy of Pediatrics
- American Diabetes
- Centers for Disease
- Children's Healthcare of
- Children and Adults with Attention Deficit and Attention Deficit Hyperactivity
- The Cord Blood
- Immunization Schedules from the
- US Dept of Health and Human Services
- Vaccine information from the CDC