Our
nurses Anna and Kate have had several years of experience with
pediatric nursing. Our billing is done off-site by Midwest Medical;
Jeanne's telephone number is 709-0063.
Newsletter
OUR FALL 2006 NEWSLETTER
PARENT/TEACHER COMMUNICATION (Article taken from "very best kids" magazine Fall '06)
That
old saying is true - knowledge is power - for both kids and parents.
Which is why it's so important to know what to expect. Here are 9
questions to ask the teacher at your first conference. 1. What will my child be expected to accomplish this year in each subject? 2. What types of projects and assignments will help my child succeed? 3. How will my child be evaluated and how often? 4. How do your evaluation methods compare to other school districts? 5. What can I do at home to support what is going on in the classroom? 6. How do I know what/when homework has been assigned? 7. What if my child is easily bored, or easily frustrated? How do you accommodate differences in learning? 8. Are there programs available for students who may need extra help? 9. Can parents volunteer to contribute to classroom activities?
More questions by ages:
"Ages 2 to 5": What is a typical day like in the classroom? What if my child is shy or clingy to me when I drop her off? How do you handle disciplining the children in the classroom? How is developmental progress evaluated? How structured or unstructured is the classroom?
"Ages 6 to 8": What are some milestones for this age group? To what extent do kids use computers? How much homework is assigned each week? Are phonics skills and punctuation stressed in writing? Are there trouble signs to be aware of regarding learning pace?
"Ages 9 to 12": How are students prepared for future learning before high school? Is tutoring available for students who may need more help? Are children encouraged to think about career interests? How can I support the teachers in achieving higher academic standards? How much does peer pressure come into play in the classroom? How can we as parents address this issue?
SPORTS INJURIES PREVENTION
School
is back in session and your children may be playing fall and winter
sports. Remember, sports are supposed to be fun, and the risk of
injuries while playing sports can be prevented or reduced if you
remember some of the following guidelines.
"Opt for variety": Encourage
your kids to switch from one sport to another during the year. Be sure
to choose activities that don't stress the same muscles and joints.
"Take a break": Children
who focus on a single sport need to take three months to recover, even
if they're uninjured. The temptation to play year round is often great
in sunny places like Texas and California.
"Check out the coach": The best ones have an easy relationship with parents and children and they know which drills minimize the risk of injury.
"Don't forget the core": Strengthening muscles involved in maintaining balance can avoid many problems.
"Be aware": Pain
plus tenderness over a joint is often a sign of an overuse injury. Any
pain that lingers or interferes with performance should be evaluated by
a doctor.
DID YOU KNOW???
1. Burn away fat with ice-cold water. It's
calorie-free and fills you up, so you eat less. It can also help flush
away pre-menstrual bloating. Drink it ice-cold, and you'll even burn a
few extra calories as your body warms up.
2.Garden away the extra weight! As
you dig and mulch, your abs are twisting and contracting against
resistance. And all the bending, lifting and walking burns nearly 350
calories an hour.
3. Eating peanut butter appears to be almost TWICE as good for your heart as a very low fat diet. A
diet rich in monounsaturated fat- is just as good at lowering total
cholesterol and bad LDL cholesterol as very low fat diets. Clinical
studies have demonstrated that peanut butter is a very healthy
monounsaturated fat that can help you lose a significant amount of
weight-and lower your risk for heart disease and diabetes.
4. People who drink about 4 cups of green tea a day seem to get less cancer. A
compound called EGCG is a powerful antioxidant in tea. It inhibits an
enzyme that cancer cells need in order to grow big enough to divide.
VACCINE NEWS
1.
Flu Vaccine: for the 2006-2007 season, the Centers for Disease Control
recommends that children ages 6 months to 5 years of age receive
priority for the flu vaccine. Last year it was only ages 6 months to 24
months.
However, we are seeing the same problem with flu vaccine
distribution all over again! Pediatricians from all over the country
are either not receiving the vaccine supply that they had pre-ordered,
or the supply is being sent small portions at a time. Our office has
the same dilemma.
Unfortunately, there is only one manufacturer
that makes the vaccine for children under 4 years of age. In the Omaha
area, as of 10/01/2006, the Visiting Nurse Association's main office at
the Center Mall (42nd and Center) and Kohll's Pharmacy are the only 2
places that will offer flu shots to this age group.
FluMist:
the vaccine that can be given through the nose, is approved for healthy
non-pregnant persons ages 5-49 years. However, most insurance companies
do not cover payment for this vaccine, and will require prior
authorization.
2. Chickenpox vaccine: the government is
considering making recommendations that children receive a second dose
of the chicken pox vaccine (the first given at age 12-15 months, the
second at age 4-6 years)
3. Tetanus/Whooping cough vaccine: for
children ages 11 years and older, if their last tetanus booster was
given 2-5 years prior, it is recommended that they receive a one-time
dose of this new vaccine.
NEW VACCINES
There are 2 new vaccines recently approved for children. 1.
Rotavirus Vaccine: Rotavirus is a virus that causes severe diarrhea,
most commonly in babies and young children, and often accompanied by
vomiting and fever. Your child can be infected by being around other
children who are already infected. It is very contagious.
Children should get 3 doses of rotavirus vaccine. It is recommended at these ages: First Dose: 2 months of age Second Dose: 4 months of age Third Dose: 6 months of age The first dose should be given between 6 and 12 weeks of age and all 3 doses must be completed by 32 weeks of age. 2.
Human Papillomavirus Virus Vaccine: The HPV virus is common and affects
both males and females. The vaccine is currently approved only for
females ages 9-26. Anyone who has any kind of sexual activity involving
genital contact could get HPV infection.
HPV can lead to
genital warts in both males and females as well as cervical cancer in
females. For more information about these vaccines, please contact our
office.
Patient Financial Policy
Ai Lan Kobayashi, M.D. Midlands Pediatrics, P.C. 401 E. Gold Coast Road, Suite 325 Papillion, NE 68046
Tel. 402-592-1700 Fax: 402-592-3335
PATIENT FINANCIAL POLICY
Thank
you for choosing our practice! We appreciate your confidence in our
commitment in providing the best and most up-to-date health care to
your children. In addition to the brochure you received upon your first
visit to our office that explains our operations, we have prepared this
pamphlet to answer the most frequently asked questions about fees,
insurance claims and payments. If you need further information about
any of these questions and answers, please feel free to contact our
billing service (Midwest Medical) at 402-709-0063.
WHICH INSURANCE PLANS DO YOU TAKE? We
participate with most insurance plans that offer health insurance in
Nebraska and Iowa. United Healthcare, Blue Cross Blue Shield, Coventry,
Midlands Choice, and Nebraska Medicaid are some examples. The list may
change from time to time, so if you are not sure that we are a
"participating" or "preferred" or "in-network" provider, please call
our office at 402-592-1700. We may be listed as either "Ai Lan
Kobayashi, M.D." or "Midlands Pediatrics" under "Omaha", "La Vista",
"Papillion", or "Sarpy County" in your insurance plan's booklet.
WHAT DOES MY INSURANCE PLAN COVER? You
need to study the materials provided to you by your health insurance
plan. You should know what types of visits and services are covered,
what is the amount of your deductible per year (both per child and per
family), what is the amount of your copay for each visit, what is the
maximum limit per year for each child's well-baby exams or routine
physical exams.
WHAT SHOULD I BRING TO EACH OFFICE VISIT? You
should always bring your most current insurance card and your copay, if
there is any. You should also make sure that "Ai Lan Kobayashi, M.D."
or "Midlands Pediatrics, P.C." is on the line for "Primary Care
Physician".
WHO WILL SUBMIT THE INSURANCE CLAIMS? Our billing
service will submit the charges for your child's visit on your behalf
to your insurance company. Working with insurance companies is like
trying to find your way out of a complex maze, so this is a very
valuable service we provide to you as a courtesy. Please remember,
however, that your health insurance is a contract between you (via your
company's benefit plan) and the insurance plan you chose. Any charge
incurred from your child's visit is ultimately your responsibility.
WHAT HAPPENS AFTER THE INSURANCE CLAIMS ARE SUBMITTED TO MY INSURANCE COMPANY? Your
insurance company may take anywhere from 2 weeks to 8 weeks to process
the claims. After they have finished with this step, they will send you
and our office an "Explanation of Benefit" form ("EOB") explaining what
they have decided to pay, based on your contract. The EOB will show you
how much of the charges was "covered" by the insurance, how much of
that "covered charge" was paid directly to our office, and how much
will be your responsibility (due to copay, co-insurance, deductible, or
non-covered services, etc.). Occasionally, your insurance may ask you
to provide some additional information before they process your claim.
Please answer their questions promptly; otherwise they will not process
the claim, and the entire bill will be your responsibility.
WHAT HAPPENS AFTER THE EOB IS RECEIVED? You
will see how much is your responsibility, and we will send you a
statement during the same month that you receive the EOB. Please pay
your balance as soon as possible. We will send you a total of 3
statements over the course of approximately 2 ½ months.
WHAT IF I DO NOT PAY MY BALANCE? If
you do not send any payment, or make payment arrangement with the
billing service after the 3 statements, you will receive a notice that
your account will be turned over to the collection agency. If your
account must go to the collection agency, we will request "cash payment
only" at your child's next visit. An additional 30% to 50% (the service
fee that the collection agency charges our office to collect your
balance) will also be added to your balance. To avoid this additional
charge, please be sure to contact our billing service to make payment
arrangement as soon as you receive the "final notice".
IS THERE INTEREST CHARGED ON OVERDUE BALANCES? Beginning
January 1, 2006, there will be an interest charge on your balance at
the rate of 16% per annum if it is not paid within 30 days from your
first statement, as allowed by federal and state laws. The amount of
the original balance, interest, and new balance will appear at the
bottom of your statement.
HOW MAY I PAY MY BALANCE? We accept cash, check, VISA, and MasterCard.
WHAT IF I AM HAVING FINANCIAL HARDSHIP? Please contact our billing service for assistance.
WHAT IF I HAVE NO HEALTH INSURANCE? You
will be responsible for the entire amount of charges incurred from your
child's visit. Please contact our billing office for assistance. We
will also provide you with information regarding community resources
that you might contact for further assistance.
WHAT IF I HAVE MORE THAN ONE HEALTH INSURANCE PLAN? Please bring all insurance cards to each visit.
WHAT IF I NEED A REFERRAL? Depending
on your insurance plan, you may need a referral or prior authorization
to see a specialist (such as a surgeon or dermatologist), or to get
X-Rays or laboratory tests at a hospital. Make sure that these doctors
and hospitals are within your network; otherwise you will be
responsible for the entire bill. If your child has a medical emergency
and needs to be seen at an Urgent Care Center or an Emergency
Department after office hours, you may have to contact Dr. Kobayashi
before going to such facility to obtain prior authorization.
WHAT IF I AM UNABLE TO TAKE MY CHILD TO SEE THE DOCTOR? A
parent or legal guardian must accompany patients who are under 18 years
of age on their first visit. This accompanying adult is responsible for
payment of the account, even if he or she is not the insurance policy
holder. For subsequent visits, the parent or guardian can provide a
written permission to have another adult bring the child to the office.
We will see patients who are 16 years or older without the parent,
provided a parent or legal guardian has called our office regarding the
appointment, or if the patient needs to discuss a confidential
health-related matter without needing parental consent as allowed by
federal and state laws.
WHAT IF I MISSED THE APPOINTMENT? If
you cannot keep the appointment, we ask that you kindly call the office
to cancel the appointment at least 24 hours prior to the appointment.
If no cancellation notice is received, your account will be charged a
$10.00 "no-show" fee.
WHAT IF I NEED SOME FORMS TO BE FILLED OUT FOR MY CHILD? For
school physicals, school medication authorization, and other forms
required by schools and/or day care providers, there will be no charge
if these forms are brought to the office at the time of the visit, or
within 2 weeks of the visit. Otherwise, there will be a $10.00 fee for
each form.
WHAT IF I WISH TO TRANSFER MY CHILD'S RECORDS TO ANOTHER PHYSICIAN? There
is no charge if only immunization record or a summary of your child's
care at our office is prepared and sent to the indicated facility.
However, if you require copies of the entire health record, there will
be a fee for copying as allowed by state laws.
October 2005
Ai Lan Kobayashi, M.D. Midlands Pediatrics, P.C. 401 E. Gold Coast Road, Suite 215 Papillion, NE 68046
Tel. 402-592-1700 Fax: 402-592-3335
PATIENT FINANCIAL POLICY
I
have received and read Midlands Pediatrics' Patient Financial Policy. I
understand and agree that charges not covered by my insurance company,
as well as applicable copayments and deductibles, are my responsibility.
I authorize my insurance benefits to be paid directly to Midlands Pediatrics, P.C.
I
also authorize Midlands Pediatrics, P.C. to release my child's
pertinent medical information to my insurance company when requested,
or to facilitate payment of a claim.
I agree to notify Midlands Pediatrics, P.C. immediately of any change in my insurance.
____________________________________________ ______________________________ Signature of Parent or Legal Guardian Printed Name
____________________________________________ ______________________________ Relationship to Patient Date
Prescription Refills
If
you need a refill for your child's prescription, please ask your
pharmacy to fax our office their request for prescription refill (fax
number 592-3335). We will determine if the request is appropriate, and
fax the approved request back to the pharmacy.
In general, we do
not automatically refill a prescription for antibitotic. For
medications that your child takes daily or often (for example, allergy
or asthma medications), we will need to re-evaluate your child's
condition every 3 months or so in order to comply with the guidelines
required by your insurance company.
