Our Policies

Age Policy

Summit Pediatrics will begin seeing your child as a newborn. We will continue to see your child until he or she is 18 years old. At that point, we ask that you transfer their records to a physician specializing in adult care.

Appointment Policies

Sick Visits

Summit Pediatrics sees patients on an appointment-only basis. We do reserve same-day appointments for sick children. During regular office hours, if your child is ill and needs to be seen, we appreciate your calling in advance in order that we may see patients most efficiently.

Scheduling Newborn visits

If you are a parent of a newborn, please call the office as soon as possible to make your baby's first appointment.

Well Checkup Schedules

These are the ages that we typically do well checkups. Please call at least 2-3 months in advance to schedule routine physicals. We recommend annual checkups on all children over two years of age.

• Newborn  • 1 month • 2 month • 4 month • 6 month

• 9 month  • 12 month • 15 month

• 18 month  • Annual checkups for ages 2 years and up

Cancellation Policy

Missed appointments for routine/preventive care are very disruptive to our office and deprive others from an appointment to see the doctor. 24-hour cancellation notification is appreciated.

Financial Policy 

For your convenience we accept cash, check, Visa, MasterCard, American Express and Discover. There is a service charge for returned checks. Patients with an outstanding balance 60 days or more overdue must make arrangements for payment prior to scheduling appointments. Please contact our business department for assistance. 

Financial arrangements for balances due can be made through a payment program. Failure to resolve any past due accounts, including returned checks, will result in referral to a collection agency. You may be responsible for any fees associated with the costs of collections in addition to the amount owed on the account. Any family whose account is forwarded to a collection agency may be discharged from our practice.

Due to frequent changes in health insurance coverage, we require that you provide proof of insurance coverage at each visit. 

ALL PAYMENT IS EXPECTED AT THE TIME OF SERVICE

All co-payments and coinsurance are due at the time of service unless other arrangements have been made in advance. These fees cannot be waived. If you do not have insurance, are unable to provide proof of insurance coverage, or are on a plan that we do not participate in, full payment is required at the time of your visit.

INSURANCE  Please read

Missed Appointments / Late Cancellations

Missed appointments for routine/preventive care are very disruptive to our office and deprive others from an appointment to see the doctor. Excessive abuse of scheduled appointments may result in discharge from the practice.

Medical Records / Forms

An immunization record can be provided at no charge for active patients. There is no charge for forms. Please allow 3-4 business days for forms to be completed. Completed forms may be picked up at your home office or mailed to the home when a self-addressed envelope is provided.

Divorce, Separation & Custody Agreements

Summit Pediatrics collect copays from the attending parent at the time of service. Copies of these charges are available at the request of the attending parent. 

Each parent is responsible for providing correct billing information for their child. Incorrect billing information or lack of billing information will necessitate billing the attending parent at the time of service. 

Summit Pediatrics is here as an advocate for your children, but, it is not our responsibility to become involved in parental disputes.

If a parent is legally excluded from participation in any form of medical care for their child, Summit Pediatrics requires documentation from the court as part of our medical records.

HIPPA - Notice of Privacy

Click here to download our HIPPA - Notice of Privacy form.

Prescription Refill Policy

ADD/ADHD Medications

Some children in our practice receive prescriptions for Attention Deficit Hyperactivity Disorder. As you know these medications cannot be refilled by phone. When calling for your child’s refill we will be verifying the medication as well as the strength and daily instructions; please have this information available at the time of the phone call. We will be writing your prescription for a 30-day supply unless you instruct us to do otherwise. 90-day prescriptions are done only with your insurance’s mail order program, the physician’s approval and good practice attending med checks as scheduled. Thank you for understanding.

Most ADD/ADHD meds are controlled medications under New York State Law. There will be no reissuing of monthly scripts due to loss of script printed or medications misplaced/lost/destroyed.

PLEASE MAKE YOUR REQUESTS AT LEAST A WEEK IN ADVANCE, SO YOUR CHILD WILL NOT RUN OUT OF MEDICATIONS.

ANNUAL PHYSICALS AND ALL SCHEDULED MED CHECKS MUST BE DONE TO REFILL THESE MEDICATIONS.

Other Prescription Refills

It may be necessary to call the office or have your pharmacy check with our office about refills. Please be aware that in most cases antibiotics will not be refilled. However, if you are asking for a routine refill it is expected that you are current with your office visits. Prescriptions are monitored for all patients, especially our asthma patients. If refill requests are too frequent we will require you to come in and discuss with your physician a new comprehensive asthma action plan.

Policy Regarding Forms

We have included a forms portion to this site. Feel free to print any of those off and complete them in full. You may fax or mail these or other form requests to your home office.