Policies

Appointment Policy

We do not accept walk-ins at this time.

Appointment reminders are via text and phone call. We cancel appointments that are not confirmed

Arrival time: Arrive 10 minutes before your appointment to fill out paperwork for appointments. We have a 10 minutes grace period after which your appointment will need to be rescheduled. If you are running late, please call us to let us know so we can tell you if you can be accommodated.

Visit Requirement: We need INSURANCE CARD & ID are required at EVERY visit.

Cancellations: A call 24 hours before appointment is required in case you need to cancel your appointment and to avoid a ‘no-show’ fee.

Missed Appointments/Late Arrivals: Not showing up to a confirmed appointment without canceling before 24hrs or you are more than 10 minutes late requiring rescheduling. This will incur a fee of $30 for sick visits/office visits and $40 for well child visits. 2 or more missed appointments can result in dismissal from practice

Vaccines

Fairfield Pediatrics values the importance of vaccines and their ability to prevent diseases. Fairfield will recommend and discuss vaccines at every visit.

You will be required to sign a Vaccine Refusal Form if vaccines are refused.

We do not provide waivers unless they are medically necessary.

Vaccines will only be given to established patients who have had a recent/updated well child check.

Phone Consultation

Phone consultation/advice will incur a service fee that will be charged to your insurance company. You will be responsible for any additional co-pay for this service.

Forms

A fee of $15 will be charged for forms including school health appraisal forms and sports physical forms not completed at the visit. All other forms including school medication/surgery clearance forms from $25-50 depending on the complexity of the forms. Please allow 2-5 business days for the completion of medical forms.

A fee of $40 will be charged for expedited forms.

 

Preventive Visits/ Well Child Checks

Preventive care, such as check-ups or wellness visits, is vital for preventing serious health problems. This care includes regular wellness exams, health screenings, and vaccinations.

Please note that your insurance only covers preventive services during well-child visits. If we need to address any other health concerns during these visits and our schedule allows, additional charges may apply, including deductibles, copays, or coinsurance. For specific issues like constipation, bedwetting, headaches, or other focused concerns, we suggest booking a separate appointment.

To remain an active patient at Fairfield Pediatrics, it’s important to attend Preventive Care Well Child Visits according to the Bright Futures/American Academy of Pediatrics (AAP) guidelines.

Sports Physical: Not covered by all insurances and require out of pocket payment.

ADHD

Fairfield Pediatrics follows American Academy of Pediatrics guidelines for Attention Deficit/Hyperactivity Disorder.

ADHD appointments require up-to-date Well Child Visits per the Bright Futures/AAP schedule. At all ADHD visits, consults and follow–ups, Vanderbilt forms are required from parents and teachers. Please provide both Teacher and Parent Vanderbilt forms 24 hours prior to your appointment or you may be asked to reschedule. Due to the medication side effects used to treat ADHD, rechecks are mandatory every 1-3 months.

Behavior Policy

Fairfield Pediatrics prohibits verbal or physical abuse or threats of any kind to our providers and staff. Harassment and profanity will not be tolerated. This type of behavior will lead to immediate dismissal from the practice. Firearms and knives are prohibited on our property. Any item that could be used as a weapon (razor blade, box cutter, etc.) is prohibited.

Financial Policy

Understanding your insurance benefit is key.

Copays, coinsurance, self-pay and out-of-network payments are due at check in

Whoever brings your child in is responsible for payment. Patient refunds will be reviewed on a per claim basis.

We will not be involved  in custody/payment issues.

A $15 service fee will be charged in addition to your co-pay if your co-pay is not paid at the time of service.

See our New Patient Packet for more details about our financial policy.

Newborn Insurance Coverage & Visit Policy

Our goal is to make sure your newborn receives timely care while insurance enrollment is being completed. Please review the following policy before your baby’s first appointment.

Before Your Baby’s First Visit

When scheduling your baby’s first appointment, our staff will ask which insurance plan your baby will be added to.

Parents or guardians should contact their insurance company or employer as soon as possible to enroll their newborn. Please request a reference or confirmation number and keep it for your records. Fairfield Pediatrics may request this information while enrollment is pending.

At the First Newborn Visit

Please bring the parent/subscriber’s insurance card to your baby’s first visit.

You will also be asked to complete the Newborn Insurance Enrollment & Financial Responsibility Acknowledgment.

If you have already contacted your insurance company, please provide the date you contacted them and your reference or confirmation number.

Commercial Insurance

Parents or guardians are responsible for promptly enrolling their newborn in their commercial insurance plan.

Fairfield Pediatrics may follow up with the family and request documentation related to the enrollment.

By the 1-month well-child visit, commercial insurance must be active and verifiable. If coverage cannot be verified by the 1-month visit, payment for that visit will be required at the time of service.

HMO / BCN and Plans Requiring PCP Selection

For insurance plans that require a primary care provider (PCP) to be selected, the parent or guardian is responsible for selecting Dr. Adeyemo / Fairfield Pediatrics as the baby’s PCP when required.

Payment may be required while enrollment or PCP assignment cannot be verified.

If payment is collected and the insurer later confirms eligible coverage, accepts the claim, and pays Fairfield Pediatrics, the applicable patient payment will be refunded or credited according to the billing policy.

Medicaid Newborns

Newborns expected to have Medicaid will not be required to pay out of pocket solely because Medicaid processing is pending.

Fairfield Pediatrics will continue verifying coverage while the Medicaid process is being completed.

Insurance Follow-Up

Our office may contact your family to request updated insurance information, the date you contacted your insurer, or your reference or confirmation number.

Please respond promptly and provide your baby’s insurance information as soon as it becomes available.

Financial Responsibility

Providing parent insurance information or a reference number does not guarantee successful enrollment or payment by the insurance company.

Parents or guardians remain responsible for charges that are not covered by the insurer, subject to applicable law and the terms of the insurance plan.

Important Reminder

Do not wait until your baby’s 1-month visit to add your baby to your insurance.

Please contact your insurance company or employer as soon as possible after your baby’s birth and keep your confirmation or reference number for your records.

Questions?

If you have questions about your newborn’s insurance coverage or this policy, please contact Fairfield Pediatrics before your baby’s appointment.