Patient/Parent Rights and Responsibilities
- You have a right to be seen in a timely manner. You will be informed of any delay, and you have the right to reschedule if a delay is too lengthy.
- You will be informed of my child/children’s test results in a timely manner.
- You agree to be on time for appointments.
- You understand that you are responsible for understanding the benefits of your insurance plan. It is your responsibility to determine what services are covered and/or not covered by the insurance plan. You understand that Sandhills Pediatrics does not provide care based on what your insurance does or does not cover. You hereby assign your insurance benefits to Sandhills Pediatrics and Adolescent Clinic.
- You understand copayments are to be taken at check-in for any appointment and failure to pay the copayment amount at this time will result in a Billing Fee.
- You are ultimately responsible for the payment of the services your child/children receive. You understand co-payment, co-insurance and deductible are due at the time services are rendered. Sandhills Pediatrics accepts cash, checks, Visa, Master Card and Discover.
- You understand any questions or disputes about your bill must be addressed with the Billing Department (803-788-6146). You understand if you cannot afford to pay in full a bill received, it is your responsibility to contact the Billing Department to set up a monthly payment plan.
- You understand that Sandhills Pediatrics participates in the VFC program and you are responsible for determining whether your child/children are eligible to receive vaccines through VFC.
- You understand there is a charge for copying medical records.
- You agree to pay a returned check fee for any check that is returned from my bank for insufficient funds.
- You understand that if you owe Sandhills Pediatrics or any SCPA business a balance on your account for greater than 150 days you may be turned over to a collections agency. You agree to pay all costs related to assigning your account to an outside collections agency. You understand that if you are turned over to an outside collection agency you will be dismissed from all SCPA businesses.
- You understand that Sandhills Pediatrics can only bill for the diagnoses and procedures documented in your child/children’s medical records and asking the doctor to change a diagnosis or procedure to secure insurance payment constitutes fraud.
We strongly encourage all parents and guardians to fully immunize their child(ren) according to the recommended immunization schedule published by the Center for Disease Control (CDC) and the American Academy of Pediatrics (AAP). As of June 1st, 2015, we now require for our patients to be fully immunized against the vaccine preventable diseases listed below within the timeframe listed below. Failure to immunize the patient as below will be considered a voluntary termination of the doctor patient relationship and result in the patient having to transfer to another practice.
We recognize that some parents wish to pursue an “alternative” or delayed immunization schedule. We do not recommend this approach as it needlessly delays important protection against serious disease. We strongly encourage all parents to fully immunize their child(ren) according to the recommended immunization schedule published by the Center for Disease Control (CDC) and the American Academy of Pediatrics (AAP.) However, we are willing to “work with” parents who intend to meet our requirements by the required age on a case-by-case basis.
DTaP: Must begin series by four months of age. Must receive three doses by nine months of age, four doses by second birthday, and five doses by school entry or sixth birthday (if not in school.)
Polio (IPV): Must begin series by four months of age. Must receive two doses by nine months of age, three doses by second birthday, and four doses by school entry or sixth birthday(if not in school.)
Hemophilus Type B (HIB) and Pneumococcal vaccines (Prevnar): Must begin series by four months of age. Must receive three doses by nine months of age, and four doses by second birthday
Measles, Mumps, Rubella (MMR): Must receive first dose by 16 months of age, and second dose by school entry or sixth birthday(if not in school.)
Varicella (Chickenpox): Must receive first dose by 16 months of age, and second dose by five year kindergarten entry or sixth birthday(if not in school.)
Tdap: Must receive by seventh grade entry (as required for school attendance) or thirteenth birthday.
Meningococcal vaccine (Meningitis): Must receive one dose by thirteenth birthday and second dose by eighteenth birthday.
Hepatitis B: Must meet state of South Carolina requirements for daycare and school attendance.
Children under age five but above one year of age who are not yet immunized are required to begin the MMR, Varicella, Polio and DTaP immunization within ninety days of receipt of this policy and be “up to date” with the recommended CDC “catch-up” schedule within one year of beginning these immunizations.
Older children (above age five) and teens who are just beginning to be immunized are required to begin the MMR, Varicella, Polio and appropriate Pertussis (Tdap or DTaP) immunization within ninety days of receipt of this policy and complete the recommended CDC “catch-up” schedule within one year of beginning these immunizations.
We do NOT require Rotavirus, HPV or Hepatitis A vaccines at this time, however we do strongly recommend them at the appropriate ages.