Office Policies & Procedures

We are committed to providing the best possible care for our patients. Your clear understanding of our office policies is important to our professional relationship.

Our goal is to provide a medical home for our patients, where they are seen for yearly physicals as well as sick visits. Yearly physicals allow us the opportunity to monitor growth and development, update vaccinations and provide anticipatory guidance. Our office policy and Dr. Ciufalo’s philosophy is that our patients must complete one physical exam per year. The American Academy of Pediatrics recommends that children are seen yearly for a physical exam. Failure to be timely with yearly physicals will result in a discharge from our practice.

Routine physical appointment schedule:

* Initial visit within 48-72 hours of birth *15 months old

2 weeks old 18 months old

2 months old 2 years old

4-months old 2 1/2 years old

6 months old 3 years old

9 months old 4 years old

12 months old then annually until to 18-21 years old

Yearly physicals can be booked up to 4 months in advance.
Sick visits can only be scheduled day of phone call.
Missed or canceled appointments, without 24-hour notice, will be subject to a fee of $50.00.
We do not use e-mail for patient related matters per HIPPA protection of patient information, please utilize portal for communication.
Patients under 18 must be accompanied by a parent/guardian, unless a note is sent to the office ahead of time authorizing patient to receive medical treatment without a parent/guardian being there.
Randolph Pediatrics does not delay or separate vaccines and we follow the recommendations of the American Academy of Pediatrics immunization guidelines.

Billing Policies

We are committed to providing you with exceptional care, as well as making our billing process as efficient as possible. Randolph Pediatrics requests that all patients keep an active credit card on file. Your card information will be kept confidential and secure.

Co pays are due at time of service.
If you carry a family balance at the time of an office visit, the balance must be paid that day.
The accompanying parent or adult is responsible for all co pays and balance due at the time of service and must have the proper insurance card. Our office will not get involved in divorce arrangements. The parent bringing in the patient is financially responsible.
Any patient balances are due within thirty days to avoid a late fee of $10.00. Any balance remaining unpaid after 120 days of first bill date will automatically be sent to collections.
Credit cards kept on file will automatically be charged for balances up to $150.00.
In the event this account needs to be placed with an attorney or collection agency because of an unpaid balance, the undersigned agrees and promises to pay a collection fee of $100.00 or 25% of the total balance due, whichever is greater, upon placement with an attorney or collection agency because of unpaid balance remaining on their account.

CREDIT CARD ON FILE POLICIES

Please complete the credit card authorization form to keep a credit card on file and return form to office. Please indicate on the form if this is an HSA account card.
Credit cards kept on file will be automatically charged for any co-pay, co-insurance, or deductible balances of up to $150.00.
You can authorize use of the credit card on file for balances above $150.00 by indicating the max amount allowed (i.e., $200.00). Otherwise please call the office to authorize payment.

COMPREHENSIVE MEDICAL CARE

FROM INFANCY TO YOUNG ADULTHOOD

At Randolph Pediatrics, we are committed to providing a sensitive and personal environment for pediatric care.

Office Policies & Procedures

We are committed to providing the best possible care for our patients. Your clear understanding of our office policies is important to our professional relationship.

Routine physical appointment schedule:

* Initial visit within 48-72 hours of birth *15 months old

2 weeks old 18 months old

2 months old 2 years old

4-months old 2 1/2 years old

6 months old 3 years old

9 months old 4 years old

12 months old then annually until to 18-21 years old

Yearly physicals can be booked up to 4 months in advance.

Sick visits can only be scheduled day of phone call.

Missed or canceled appointments, without 24-hour notice, will be subject to a fee of $50.00.

We do not use e-mail for patient related matters per HIPPA protection of patient information, please utilize portal for communication.

Patients under 18 must be accompanied by a parent/guardian, unless a note is sent to the office ahead of time authorizing patient to receive medical treatment without a parent/guardian being there.

Randolph Pediatrics does not delay or separate vaccines and we follow the recommendations of the American Academy of Pediatrics immunization guidelines.

Billing Policies

We are committed to providing you with exceptional care, as well as making our billing process as efficient as possible. Randolph Pediatrics requests that all patients keep an active credit card on file. Your card information will be kept confidential and secure.

Co pays are due at time of service.

If you carry a family balance at the time of an office visit, the balance must be paid that day.

The accompanying parent or adult is responsible for all co pays and balance due at the time of service and must have the proper insurance card. Our office will not get involved in divorce arrangements. The parent bringing in the patient is financially responsible.

Any patient balances are due within thirty days to avoid a late fee of $10.00. Any balance remaining unpaid after 120 days of first bill date will automatically be sent to collections.

Credit cards kept on file will automatically be charged for balances up to $150.00.

CREDIT CARD ON FILE POLICIES

Please complete the credit card authorization form to keep a credit card on file and return form to office. Please indicate on the form if this is an HSA account card.

Credit cards kept on file will be automatically charged for any co-pay, co-insurance, or deductible balances of up to $150.00.

You can authorize use of the credit card on file for balances above $150.00 by indicating the max amount allowed (i.e., $200.00). Otherwise please call the office to authorize payment.

Office Policies & Procedures

We are committed to providing the best possible care for our patients. Your clear understanding of our office policies is important to our professional relationship.

​

Routine physical appointment schedule:

* Initial visit within 48-72 hours of birth​ *15 months old

*2 weeks old *18 months old

*2 months old *2 years old

*4-months old *2 1/2 years old

*6 months old *3 years old

*9 months old *4 years old

*12 months old *then annually until to 18-21 years old

​​

Yearly physicals can be booked up to 4 months in advance.

Sick visits can only be scheduled day of phone call.

Missed or canceled appointments, without 24-hour notice, will be subject to a fee of $50.00.

We do not use e-mail for patient related matters per HIPPA protection of patient information, please utilize portal for communication.

Patients under 18 must be accompanied by a parent/guardian, unless a note is sent to the office ahead of time authorizing patient to receive medical treatment without a parent/guardian being there.

Randolph Pediatrics does not delay or separate vaccines and we follow the recommendations of the American Academy of Pediatrics immunization guidelines.

​

Billing Policies

We are committed to providing you with exceptional care, as well as making our billing process as efficient as possible. Randolph Pediatrics requests that all patients keep an active credit card on file. Your card information will be kept confidential and secure.

Co pays are due at time of service.

If you carry a family balance at the time of an office visit, the balance must be paid that day.

The accompanying parent or adult is responsible for all co pays and balance due at the time of service and must have the proper insurance card. Our office will not get involved in divorce arrangements. The parent bringing in the patient is financially responsible.

Any patient balances are due within thirty days to avoid a late fee of $10.00. Any balance remaining unpaid after 120 days of first bill date will automatically be sent to collections.

Credit cards kept on file will automatically be charged for balances up to $150.00.​

CREDIT CARD ON FILE POLICIES

Please complete the credit card authorization form to keep a credit card on file and return form to office. Please indicate on the form if this is an HSA account card.

Credit cards kept on file will be automatically charged for any co-pay, co-insurance, or deductible balances of up to $150.00.

You can authorize use of the credit card on file for balances above $150.00 by indicating the max amount allowed (i.e., $200.00). Otherwise please call the office to authorize payment.

* Initial visit within 48-72 hours of birth *15 months old

2 weeks old 18 months old

2 months old 2 years old

4-months old 2 1/2 years old

6 months old 3 years old

9 months old 4 years old

12 months old then annually until to 18-21 years old

Credit cards kept on file will automatically be charged for balances up to $150.00.