New Patient Forms

Summit Pediatrics is enrolled in most managed care insurance programs. We are pleased to provide this service to our patients; however, it is impossible for us to keep track of each plan's individual requirements. Please make sure you understand the benefits and requirements of your plan and be aware of any changes that may occur. Plans differ depending on the type of contract your employer may have negotiated. Some plans require wellness visits to be at least one full calendar year from the last wellness exam in order to be covered. 

Newborns - It is important that you add your newborn to your insurance policy within the first 30 days of life. This will prevent any lapse in coverage. Contact your human resources department for the proper paperwork and their guidelines.

Primary Care Physician - If you have a plan that requires a primary care physician (usually an HMO or POS), you must specify your selection to the insurance company. Please select an individual physician by name, as the insurance plans do not recognize group names. Most companies will not back date a primary care physician selection, so it is important that this is specified before you are seen by one of our providers in order for the claim to process correctly. Some of the newer plans have an option where a primary care physician is not required; however, specialist copays may apply.