Prior to contacting us for questions, we encourage you to check our newsletter on the Patient Service Plan and this FAQ page. If your question has not been answered, you may email firstname.lastname@example.org with “#PSP2023” in the subject line.
Why are you implementing the Patient Service Plan?
In order for us to provide such a high level of service, we find ourselves spending several hours a day providing administrative support as well as using technology that is rather expensive. Unfortunately, neither are covered by insurance. Due to the unpleasant trajectory of our economy, these services have become unsustainable. To ensure the quality of our non-medical services that make Heights Pediatrics stand out, we find ourselves needing to charge our patients for the services that are not covered by insurance.
Is the Patient Service Plan mandatory?
It is not mandatory, but highly recommended. If you decline the Patient Service Plan, you would be responsible for covering individual fees per non-covered service (as applicable).
If I decline the Patient Service Plan now, can I still accept it later?
You may accept this plan at any time. Since the pricing cannot be prorated, it will remain at $100 for the remainder of 2023.
If I have already paid for forms earlier this year, does the Patient Service Plan still apply to me?
We are unable to deduct any previous forms payments from the PSP payment. The PSP covers items for the remainder of the year.
Why are there fees for forms and letters?
All forms and letters we complete are not covered by insurance. The demand for forms and letters have increased over the years and our providers and staff have spent excessive time to ensure they are filled accurately and returned appropriately. Please note that for every well visit, each patient is still entitled to 1 free DOE health examination form and any necessary 504 allergy/asthma/accommodations forms. When not opted into the PSP, additional medical forms (camp/sports forms, school-specific forms, etc.) and written letters (FMLA, work certification, confirmation of diagnosis, etc.) are subject to fees.
What are the new fees and turnaround times for forms and letters?
Patient Service Plan (default – within 5 business days) = included in the annual fee
Patient Service Plan (expedited/same-day) = $30 each
Individual Fee (within 10 business days) = $50 each
Individual Fee (expedited/same-day) = additional $50 per request
What is the expedited fee for forms and letters?
If you need a form or letter to be completed within the same day it was requested (pending eligibility), there will be a $30 expedited fee for those who accepted the Patient Service Plan or $50 for those paying individually. To avoid incurring this fee, please notify us at least 5 days in advance for any forms or letters you may need.
If I pay for the Patient Service Plan, will all my children’s forms/letters be expedited?
By default under the Patient Service Plan, the forms/letters will be completed within 5 business days. If you need them to be done the same day, there is a $30 expedited fee per item per child.
I have several children at the practice. Do you offer payment plans for this fee?
Yes, to request a payment plan, please send an email to email@example.com with “PSP Payment Plan” and your children’s names in the subject line. We will contact you for more details.
If I have several children, can I choose differently for each?
Yes, each patient has the ability to opt in or out. You will need to fill out separate forms for the ones opting in and the ones opting out.
My child is too young or doesn’t usually need forms, medication refills, or prior authorizations. How will accepting this plan benefit me?
You will have access to our educational Zoom classes hosted by our own providers at no additional costs (they would be $30 each for those who opted out) and receive discounts on Infant/Toddler CPR classes and New Mom’s Group. In addition, your participation in the PSP ensures that our practice can continue to provide outstanding service and care for all patients. We strive to provide these high-quality services for everyone:
– Same-day sick appointments (as appropriate)
– On-call service after hours from our own providers
– Convenient check-in and questionnaire system
– Access to a secure, web-based patient portal
– Ample time with providers during your child’s appointment
– Excellent care coordination with other providers
If I decline the PSP, will I lose access to same-day sick appointments, doctors on-call, patient portal, etc?
You will not lose access to these.
Will this fee be submitted to my insurance in some form so that it is counted towards my deductible?
Unfortunately it is not. The PSP is designed to cover all the costs that insurance does not pay for and has left up to us as a practice to absorb the cost.
Is there a charge for a routine, non-urgent, non-sick prescription monthly refill if we are not on the PSP?
We will not charge for monthly refills that are clinically appropriate (meaning your child is up to date with the visit plan decided with your doctor). The requests should be submitted online via the portal and with a minimum of one full business week for the request to be fulfilled.
Example 1: Your child had an ADHD visit, the medication is stable and your doctor would like a 3 months follow up. You will have a refill at the visit and 2 others (enough for 90 days), but you should request the refills once your current supply is at about 7 pills left. Now let’s say that your 3 months follow up appointment is past due but you need a few days worth of medication for the child not to miss a day, then there will be a charge to send that refill. Or let’s say you forgot to request your next refill and now you are left with one pill and you need the meds immediately, then we will charge. Same charges for urgent, after hours requests to refill chronic medications.
Example 2: Your child has asthma, you came for the 3 months follow up, a refill is placed that day for 3 months of flovent and one albuterol which should be enough to cover a well managed patient. If you need refills outside those, then there will be a fee (the patient should be seen every 3 months as per best guidelines of care).
Refill requests fees (same day or after hours) – does this include refills requested directly from the pharmacy?
Yes, regardless of who is requesting a same day refill or after hours, whether it is the patient or the pharmacy, to fulfill the request in that timeframe, there will be a cost (if not opted into PSP). Now let’s say the message is automatically sent over the weekend, but we refill it during the week. Then, there is no cost as long the clinical visits are up to date as per prior explanation. There is also no charge in the case that there was a drug shortage and your initial prescription was not filled by the pharmacy.
Is this fee being rolled out to all patients of the practice or just the ones using the practice for psychiatric services only?
The Patient Service Plan is for all patients using Heights Pediatrics for any form of health care needed.
Would forms (aside from DOE and 504 forms requested during the visit) such as allergy or asthma forms have a cost?
When your child comes to the check up visit once a year, all pertinent forms are uploaded following the visit. DOE (has the immunizations listed), 504, NYDOH asthma and NYDOH allergies/medication administration forms at no cost regardless of you opting in or out of the plan. These forms are valid for 365 days. You will have them on the portal and can print or forward to a third party at your discretion.
What we usually find though is several requests in a given year period for “different kinds of forms” for medication administrations or asthma that your child’s school, camp, etc. chooses to use. These forms will have a cost if opting out.
If I am a self-paying patient, do I need the PSP?
The same rules apply for all patients – you may opt in or out.
Will my child be treated differently if I do not accept the PSP?
Absolutely not! However, you may be charged for non-covered services like forms completion, educational Zoom classes, prior authorizations, etc. as outlined in our newsletter and mentioned above.
[Page last updated 06/29/2023]