Each patient must have a guarantor who is responsible for timely payment of:
- Co-pays and non-covered services
- Co-insurance and deductibles
- Fees for service, if private pay
- Additional fees for forms, missed co-pays, returned checks, missed appointment or collection charges
Our Business Services Office is available to help with questions and problems. Call our direct business service number at (475) 233-4045.
We may recommend sick visits, well visits, lab tests, or specialist evaluation based on our clinical judgment. These services may or may not be covered by your insurance company. Please realize our responsibility is to provide the best care for your child, and is not based on insurance payments. The guarantor is responsible for services not covered by insurance.
Certain insurance companies’ policy will limit your time with us to age 19. Please check to be sure your child is still covered under your insurance policy.
Patients who reach their 18th birthday are considered adults with regard to healthcare decisions. Their personal health information becomes protected from their parents regardless of the guarantor/insurance holder. If you choose not to remain with Pediatric Associates of Conn, PC after age 18, please arrange for transfer of care to an internist, family physician or gynecologist.
In order to protect Personal Health information (PHI) in accordance with government regulations, we may not share your PHI with schools, daycare, or camps without written consent via the “AUTHORIZATION FOR RELEASE OF PATIENT RECORDS Partial” form. We may share an immunization record only with verbal parental consent. All other medication, health, sports, camp or absence forms require a written release form. We appreciate your understanding that our staff must follow government requirements.
Patient Rights & Responsibilities
You and your child have the right to privacy and confidentiality. People who are not involved in your care may not receive information about you without your permission. You and your child are entitled to know what role any observer has in your care and to have any observers unrelated to your care leave if you so request. You and your child have the right to a copy of your medical record within a reasonable time frame (approximately 10 days) after your written request has been received by us.
You and your child are important and unique, and we will respect you, introduce ourselves to you, explain our role in your care, and listen to you. We will respect your individual values and your religious beliefs. Each patient has the right to the best medical care required and available, without consideration of race, color, national ancestry, age, sex, physical or mental disability, religion or ability to pay.
You and your child have the right to be fully informed about your health status, recommended treatment, alternatives, benefits and risks and to be involved in your plan of care and treatment. You and your child may ask questions about your care at any time and we will answer them honestly and clearly.
Trained professionals will work together to care for you. You and your child have the right to know the name of the physician responsible for your treatment and to speak with that physician and others involved in your care.
You and your child have the right to request a second opinion regarding your treatment and to request the names of other physicians able to provide such a second opinion.
In the event of a conflict concerning the care of a patient, the practice manager, along with the doctor if necessary, will work with the patient and family to reach a resolution.
No Show Policy
Timeliness: Our practice makes every effort to run on time with appointments, as we believe everyone’s time is equally valuable.
As a courtesy, we will remind you of your upcoming appointments via e-mail, phone and same day text messages.
We ask that you arrive 15 minutes before your scheduled appointment time. We understand sometimes things happen beyond our control that may cause you to be late. However, we reserve the right to ask you you reschedule if you arrive late for your appointment.
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. Please call 203-755-2999.
Multiple missed appointments may results in discharge from the practice.