Fair Lawn (201) 791-4545
Hackensack (201) 342-4001
Pompton Plains (973) 831-4545
Woodland Park (973)-256-4545

Office Parent Policy

We are committed to providing the best possible care to our patients and their families, and feel this goal is best achieved if everyone is aware of our office policies. Your clear understanding of our financial policy is important to our professional relationship.

Payment for services is expected at the time of your child's visit. This includes co-pays, deductibles and payment in full when we are not contracted with your insurance carrier. We accept cash, check and credit card (Visa, MasterCard, Discover and American Express). The accompanying parent or other adult is responsible for full payment and providing current insurance information.

We bill participating insurance companies as a courtesy to you. You are expected to pay your deductible or co-payment at the time of service. You are expected to pay for all services not paid by your insurance carrier within 10 days of receipt of notification from our office by letter or billing statement. If we have not received payment from your insurance company within 60 days of the date of service, you will be expected to pay the balance in full. You are responsible for all charges.

If you have questions or need assistance, please contact any of our offices between normal business hours, Monday through Friday.

Missed Appointments/Late Cancellations
Missed appointments and appointments cancelled last minute are a cost to us, to you and to other patients who could have used the time set aside for your child. Please call at least 24 hours ahead to make any scheduling changes you need. First appointments missed by new patients will not be rescheduled. Excessive missed appointments may result in dismissal from the practice.

You can reach our Receptionist to reschedule or cancel appointments between 9:30 AM and 12:30 PM, & 2:00 PM and 4:30 PM., Monday through Friday at each of the offices. You can leave us a message to cancel an appointment at night by calling 201-791-4545 and leaving a message with the answering service.

Managed Care
If you are enrolled in a managed care insurance plan you must receive an authorization or referral from our office before seeing a specialist. NO retroactive referral will be given. You should allow 3 to 5 business days for the processing of authorizations/referrals. You will be notified by mail when the authorization has been approved. In general, we will not agree to a referral for a problem we have not been consulted about first.
If you have questions or need assistance with an authorization or referral, please contact each of our offices during normal business hours.

Medical Records
A records release form must be completed or a signed note from the parent, with your name, complete address, the names of each patient whose records are to be released and the Practice name and complete address to whom the records are to be released. Records will be released within one month. Requests to have charts copied are subject to a fee of $1.00 per page, up to $50. We do not fax medical records.

Camp and School Forms
A completed generic camp/school form is provided at every well visit for each of your children free of charge. This form can be used for all school and camp applications. There is a $10 charge for completion of forms not presented at the time of a visit for that child. Fee must be paid in advance. Processing of forms can take up to 10 days.

A divorce decree is a legal agreement binding only upon two parties who made the agreement. Therefore, PediatriCare Associates is not a party to that contract. Both parents remain responsible for the child's bills and that responsibility will be determined by which parent accompanies the child at the time of the visit.

As stated above, all fees are due at the time of service. Any charges remaining unpaid sixty (60) days after the date of service are considered past due. In this case, we will make every effort to contact the person responsible for the delinquent balance, and arrange an equitable payment schedule. However, if no effort is made to pay the balance due, it may be sent to a collection agency. In this situation, the responsible person will be asked to seek medical care for their child/children elsewhere.

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