General Office Policies
Our goal at the office is not only to provide you with excellent care but also to give you timely and efficient service. These policies are designed for the benefit of all our patients.
In scheduling appointments, it is our intent to see your child as soon as possible. Our staff and physicians will make every effort to accommodate urgent add-on requests. We will make every effort to see your child on time at your scheduled visit. For scheduling purposes, every sibling will need to have an appointment in order to be seen by the physician. Please arrive on time for your appointment.
Bring your child’s current insurance card: For HMO plans or Medicaid, ensure that the physician
listed as your PCP is Dr. Vilma Junio or Jennifer Nichols, NP
If someone other than a legal guardian or parent accompanies your child, we must have a signed letter on file stating the relationship to the child and authorization for that person to approve any medical care that may be necessary.
Sick visits usually focus on a single problem. We recognize that children become your child is sick, you want them seen. Please call us early in the morning as possible as we have openings available during the day for sick visits. The phone line opens at 730AM. You can also schedule through the patient portal.
The first time you visit our office, there are some forms you must fill out prior to being seen by a physician. For your convenience, all these new-patient forms can be found here on our Web site. Please download, print and complete all forms prior to your scheduled appointment. If you are unable to fill out the new patient forms before you come, please arrive 30 minutes prior to your appointment so that you will have ample time to complete the forms. You can also fill the forms online through the patient portal. For user ID and password, please call our office to provide us your email address.
After your baby is born, the first visit should be 2-3 days after bringing the baby home or when the baby is 3-7 days old. If your newborn was discharged from the hospital with special follow-up instructions from the doctor, please call us and schedule your appointment accordingly.
You should contact your insurance company as soon as possible after your child is born. Most health plans allow 30 days to add your newborn to your insurance plan. Please remember to bring all newborn discharge papers including vaccination record.
Well-child visits are vital to ensure your child is meeting normal developmental milestones. At these routine visits, you will be educated on normal development, nutrition, sleep, and safety guidelines.
Make the most of these visits by writing down important questions and concerns to bring with you.
Well-Child visits (immunizations and checkups) are conducted at 1 week, 2 weeks, 1 months, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, 30 months, 36 months, and yearly at age 4 – 18 years. We prefer you make these appointments at the time of the earliest visit to ensure proper preventive care. If this is not possible, you may also call to schedule the appointment at least two weeks in advance.
Please fill up and print your child ’s age-specific Risk assessment and Developmental Milestone forms found on our website and bring it with you on your child’s appointment. You can also fill up the form online through the patient portal.
Follow-up care after emergency room, urgent care or specialist visit will be provided in a timely manner and can be arranged by contacting our staff directly. We will be monitoring your child’s medical needs and will proactively contact you to schedule follow-up appointments at a convenient time for you. Please bring a copy of laboratory procedures, imaging, and medication lists if available.
Our staff will help to coordinate your follow-up and specialty appointments as you request.
Missed Appointment /No-show
We, as an office, prepare for your child's visit. It is very important when you make an appointment to keep it.
For well child visit, our office will notify you either by phone or email through the patient portal one week before and one day before your scheduled visit.
Our providers only have limited time slots during the day to see patients. By not keeping a scheduled appointment, our providers' ability to provide services to other patients is limited. As a result, in the event you cancel an appointment without giving 24 hours notice or fail to come to your scheduled appointment, the visit will be marked as a “No Show.”
In the event you are counted as a “No Show” to an appointment, a letter will be sent to you stating the appointment you missed and reminding you of our policy. There will be a $25.00 fee for “No Show” on confirmed well-child care visits. If there are three unpaid “No Show Fee ” or if you RESCHEDULED five times in a one-year period,
your relationship with our practice may be terminated. A warning letter will be sent to you after the 2nd no-show or fourth rescheduled visits.
If you are late, you may be seen when the schedule allows. If you are more than 15 minutes late, you may be asked to reschedule.
In the event of an emergency, dial 911 and then contact our office.
If you suspect your child has swallowed medicine or poison, dial 1-800-222,1222 first, and then contact our office.
After Hours Calls
Our physician or nurse practitioner is available to answer questions after hours. Please call 315 591 4908 These calls should be limited to urgent problems that cannot reasonably await regular office hours. If you are asked to leave a message, please give the full phone number where you can best be reached. Allow 30 minutes for our provider to return your call.
Prescription refills, referrals, and appointments are handled only during office hours.
Office Hours Calls
Our phones are answered from 730AM to 4PM, with a break for lunch between 12pm and 1pm Monday through Thursday and 730AM-12NN on Fridays
If you do have an urgent question during office hours, you may call our office at 315 342 4217.
Please inform the receptionist as soon as your call is answered if your case is extremely urgent.
If you have an emergency, call the office before you arrive to expedite your care.
Leave a message with the receptionist if you have a question for the nurse or doctor. Nurses will return routine calls throughout the days; doctors will call back during breaks or after hours.
Let us know when making your appointment if you or your child has special needs (e.g., wheelchair, multiple disabilities, autism) so that we may make arrangements before you arrive.
Please be familiar with the requirements of your health insurance plan (i.e., co-payments, emergency care, hospital care, and pharmacy services).
If more than one family member needs to be seen, please be certain to let us know beforehand so that we may allow the proper time for the visit.
For any medication refill, call our office or you may contact your pharmacy to fax appropriate paperwork for the physician to fill out. Please allow 24 hours for refill requests to be completed. No refills will be called in after business hours.
If your child is taking medications for ADHD and needs a refill, call the office 48 hours in advance:
Request for medication refill can also be made online through the patient portal.
In our office, we take pride in the coordination of your care. If your child needs a referral to a specialist, these referrals will be completed as soon as possible. In the event our doctors deem an emergency referral is necessary, it will be done within the same day.
The Referrals Coordinator will carefully assess your physician's orders, always keeping in mind the special needs you as a parent may have. We have a list of specialists that we recommend on a regular basis that has been compiled based on positive experience with their service.
After the completion of your child's visit, a referral request form will be issued to you if needed. Once our referral coordinator made the appointment, she will call you and inform you of your child’s appointment to the specialist.
All children must be up to date on their well checks to get a new referral.
Please contact the specialist’s office two business days prior to your visit to verify that the referral process has been completed. This will ensure no complications occur on the day of your specialist visit. We cannot guarantee a paid claim to the specialist for retroactive referral requests. Please contact your insurance carrier for information regarding claim denials or verification regarding the specialist designation
Request for referral can also be done through the patient portal. The doctor might need to see your child first to address your concern before doing the referral. All referrals need to be deemed appropriate by your primary care physician.
School & Camp Forms
You can drop or mail school or camp forms at our office. Please be advised that the doctor will only complete these forms if your child has had a physical that year. Make your request at least 48 hours in advance. Forms are available for pick-up, faxed to school or mailed to your address.
Request for school form can also be done through the patient portal.
Please allow at least 48 hours for WIC forms to be completed. Have the patient’s name, date of birth, and any other requested demographics filled out when dropping off the form.
If you need a copy of your child’s shot record, the office requires 24 hours advanced notice prior to pick up.
Request for immunization form can also be done through the patient portal.
The office requires two weeks advanced notice for copies of medical records. A release form must be signed before records are sent to the receiving doctor, lawyer or any third party. Charges may be applied.
Laboratory and Radiology Results
All lab and radiology results will be reported to the patient once we receive the information from the laboratory. Please remember that it usually takes 48 – 72 hours to return results from your insurance-contracted lab. There are some tests, however, that are sent out and take 4 – 6 weeks to be returned.
You can also request for a copy of results through the patient portal.
New Patient Policy
Our office currently accepting new patients! If you are interested in registering your child or children as patients in our practice, please call our office. You will be given an appointment to meet and greet our providers and staff and have a tour of our office.
New parents: If you are looking for a pediatrician for your new baby, we offer complimentary appointments so you can meet our providers and staff.
Once accepted in our practice a Request for release of medical records form must be signed.
Then please follow the following:
Download the New Patient Registration packet from our website (www.juniopeds.com). The packet includes a patient and parent information form, a treatment authorization form, and privacy, financial policy, and procedural information for new patients. Complete the forms and bring them with you to your first appointment. You can only fill up the forms online through the patient portal. For userID and password, please call our office.
Gather the necessary documents. Bring the following to your first appointment:
Any medical records you may have on-hand
Arrive early. Please plan to arrive about 15 minutes before your scheduled appointment so we can process your paperwork.
Transition of Care Policy for Youth and Young Adults
Our office believes that a smooth transition from adolescence to young adulthood includes the clear and deliberate transition from a pediatric to an adult healthcare model. This process requires joint planning and preparation beginning about age 16. We expect this transition to be completed around age 18-20 years of age. We honor the preferences of the patient and family regarding the best time to transfer to an adult office and will make modifications as needed for youth with special health care needs. We will make every effort to help coordinate this transfer of care to the patient’s new adult office. Our office’s transition policy is based on a joint clinical report on transition endorsed by the American Academy of Pediatrics and by Bright Futures.
Message to the Teen/Young Adult
At age 18 you will be considered an adult, both medically and legally. Our office wants to prepare you to take responsibility for your health care as you approach this important milestone. Starting at age 16, we will begin the process of helping you transition from a “pediatric” care model (where your parents make all the decisions about your care) to an “adult” model of care (where you take full responsibility for medical decisions about your body and your health.) During this process, we will teach, answer your questions, spend more time with you alone when appropriate, and ask you to take more responsibility, as you grow closer to adulthood. We want you to have a lifetime of the best health you can have.
A Note about Privacy
Our approach to the care of young adults age 18 and older meets standard HIPPA and state privacy requirements making the young adult the sole decision-maker about their care and about the sharing of personal health information. Exceptions to this approach require legal authority through the signed consent of the young adult, legally valid custodial care or power of attorney documentation, or a court-ordered guardianship arrangement.
Coordination of Care Policy
Care Coordination Visits
A care coordination visit is an appointment scheduled between your child and your PCP. It is NOT a routine well-child exam, sick visit or medical re-check. It is a very special appointment set aside and arranged in advance. This type of appointment addresses the special and specific concerns related to your child’s medical care. Should you and your physician schedule this visit, expect a prior call from our office. Our Care Coordinator will review and update pertinent medical information in your child’s chart - i.e. possible changes in medications or recent events at the emergency room or hospital admissions. She will help you organize and prepare for this visit. You and your physician can then collaboratively accomplish the best plan of care possible to meet your needs. This is just an example of how our office strives for excellent healthcare service.
Care Coordination Program
If your child has a special health care need; for example, a chronic illness, a disabling condition, or a frequent need for medical technology, it can be difficult and frustrating to get the information, care, and services needed. This program provides care coordinators whose job it is to help you navigate the system to obtain the programs and services available
The Care Coordinators can help you:
Identify the needs of your child and family
Understand the full range of available public benefits
Identify community resources to assist you
Gain access to specific programs and services
Become a more effective advocate
Connect with other families who face similar challenges
Access and Communication Policy
Our practice would like to be available when needed. Please let us know if there are any special communication or access needs that you or your child might have. We will try to provide interpreter services for foreign language and sign language if needed
Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IIHI). In our office, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We are also required by law to provide you with this notice of our legal duties and privacy practices that we maintain in our practice concerning your IIHI. By federal and state law, we must follow the terms of the notice of privacy practices that we have in effect at the time.
Policy for Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorder (ADHD) Medications
Medications for your child’s attention disorder are an important part of his/her health care and we are happy to help you manage them. It is our policy that all children on medications for ADD or ADHD must have a yearly physical exam with our physicians, as well as medication check-ups every 3-6 months. At that time, our physician will review your child’s health and the effectiveness of the medicine.
Prescriptions for your child’s ADD or ADHD medicine(s) can be written for up to a 30 day supply as your health insurance allows or 90 days(often through a mail-order pharmacy program). Please check the pharmacy coverage with your health insurance. You will need to call for a renewal at the end of that time.
Please call at least 1 week before your child’s medicine runs out. When you call, please leave the following information on the voicemail:
Your child’s name and date of birth
The name of the medicine
The dose of the medicine
How many times your child takes the medicine in one day
You can also request for refill through the patient portal.
Each time you will need to come to the office to pick up the prescription; these prescriptions cannot be called into the pharmacy. (Note: StratteraTM is one medication sometimes prescribed for ADD/ADHD that can be called into the pharmacy.)
Almost all ADHD medications are regulated/controlled substances. Given the current medico-legal environment and need for a psychiatrist to assess for comorbidities we may require your child to see a psychiatrist. In addition, your child may need behavioral therapy which we will make an arrangement for him/her to be seen.
Our office is committed to providing you with the best possible medical care for your child. Therefore, in our effort to communicate, we offer you our Financial Policy in writing to keep with your family’s medical receipts.
The following information is provided to avoid any misunderstandings or disagreement concerning payment for professional services.
I understand that whoever brings my child in for visits is authorized to receive financial and medical information.
FINANCIAL INFORMATION: Payment is required at the time services are rendered. If you are unable to pay your bill today, please ask to speak with our Office Manager. He/She will assist you with arranging a payment plan, discussing financial assistance, or rescheduling an appointment for a time when you are prepared to pay. Regardless of your insurance coverage, you are ultimately responsible for full and timely payment of all charges incurred at our office. If you fail to make payment in full or arrange for a payment plan with our financial department for the services that are rendered to you, your outstanding balance may be sent to a collection agency and you may be terminated from our Practice. You may be responsible for the fees assessed by the collection agency.
Insurance & Billing Arrangements
Our office is pleased to participate in most insurance plans. For your protection, we suggest that you verify our participation in your particular insurance plan at check-in prior to every visit. For a complete listing of insurance plans in which we participate see our website or contact our office.
The following information is helpful for parents to keep in mind:
Please bring your insurance card with you for each visit. We will verify that your coverage is effective
New Patients will have insurance coverage verified prior to the visit.
Our office will gladly file your primary insurance for you, accepting your co-pay and deductible at the time of your visit.
We only file secondary insurances we are contracted to do so with. While we do not file most secondary insurance, we will be more than happy to provide you with the necessary statements to do so or file at your request.
If we do not have a billing contract with your insurance provider, we will list you as "self-pay" and will anticipate full payment at the time of your visit.
Because we have several contracts and the status of providers is always changing, we do not and cannot know with certainty whether a given provider or medicine is approved by your insurance company. You are responsible for knowing whom you can and cannot use according to the information provided by your insurance company.
Please remember, while we will work with you on getting paid by your insurance company, ultimately, the financial responsibility for medical treatment rests with you - the policyholder.
Insurance and Payment
If you have insurance, please bring your insurance card to each visit. Some companies pay fixed allowances for certain procedures, and others pay a percentage of the charges. You should become very familiar with the specificity of your coverage, exclusions, deductibles and co-payments for sick and well-child care visits. We will assist you in obtaining the largest reimbursement to which you are entitled. We must stress that financial responsibility for our service rests with the patient and his/her family, regardless of any insurance coverage.
We accept cash, check, debit and credit cards (Visa, MasterCard, and Discover).
Many insurances require a co-pay at the time of service. If you do not pay your co-pay at the time of service, a bill will be sent to you.
Please Bring Your Insurance Card
We will submit a claim to all primary and secondary insurances. Please remember to bring your current insurance cards to your appointment. Once your insurance company has processed your claim, we will bill you for the remaining balance. Payments are expected upon receipt of your statement. We accept Visa, MasterCard, Discover, Cash, Checks and Debit Cards.
If You Are Uninsured
If you are uninsured, or if we are unable to verify coverage, we require your payment at the time of service.. Our office offers a discount at the time of visit for uninsured patients. We offer a 35% discount on physician’s services if paid within 30 days of an office visit.
We assign all unpaid accounts to an outside collection agency that report to a national credit bureau. They will add additional penalties and interest to the unpaid amount.
Physicians must follow accepted national guidelines when determining what your charges (level of service) will be. They must code your visit based upon what services were provided and cannot take into account particular health plan benefit designs. Consequently, we are unable to switch the diagnosis and reason for the visit in order for a claim to be covered by your insurance. If you think there is an error on your account, please contact the billing office immediately. We will review your concern with the physician and let you know the outcome.
We strongly recommend utilizing the immunization schedule as is recommended and determined by the AAP and CDC.
All children must receive all vaccines recommended by the AAP that are mandated for school entry by the State of NY.
All children must begin receiving vaccines by age 2 months.
If parents/guardians elect to give less than the recommended number of vaccines at a visit, the child must return to the office at 2-4 week intervals to stay within the recommended “window” for the vaccines. A follow-up vaccine only appointment should be made when leaving the office after a child’s checkup.
All parents/guardians who do not follow the exact AAP vaccine guidelines must sign a waiver that they are utilizing an alternate vaccine schedule, approved by a physician or nurse practitioner and completed at the time of the visit.
In order to make the alternate schedule clear to providers, staff, and caregivers, and to minimize vaccine administration errors, providers will enter “refused vaccine” into a patient’s EHR immunization record if they didn’t get the recommended vaccines on that day.
If a patient misses a “vaccine only” appointment, a receptionist from our office will call to reschedule the appointment. Parents/guardians who are following an alternate vaccine schedule who do not adhere to their agreement and who don’t have a medical reason for their child missing the vaccine appointment will be given a warning, and their child’s provider will be notified of the missed appointment. If parents/guardians fail to keep a 2nd vaccine appointment, the patient will be discharged from the practice.
Parents/guardians who do not agree with the vaccine policy and do not plan on immunizing their children within the time frame specified will be given a 1-month grace period to find another pediatric practice.