EXCITING ANNOUCEMENTS

We Are Very Excited to Announce …

Anderson Hills Pediatrics is very excited to announce that we have recently received our certification as a Level 3 Patient-Centered Medical Home (PCMH) through the National Committee for Quality Assurance (NCQA)! This is a rigorous 18-month process to improve our practice to provide even better and more cost-effective care for our patients. What does this mean for you? It means:

• AHP acts as the hub or “home” for all your child’s medical needs – we are your first call  or visit when your child needs care or treatment. We will also assist you when it is necessary to refer your child to a specialist or other resources for treatment. This helps to avoid unnecessary or duplicated tests/labs/procedures and save you money.

• Engaging you and your child in a partnership in caring for your child and making their care and treatment fit their personal needs as much as possible.

• Providing the best and up-to date treatment possible for your child based on guidelines and protocols from the American Academy of Pediatrics and other highly respected resources.

Caring for your child is the most important goal of AHP’s Patient-Centered Medical Home. The entire medical home team (the doctors, nurses, and office support staff) are here to work together with you to help your child get healthy, stay healthy, and receive the care that is best for them.

Sports Injury Appointments Now Available at AHP

Beginning in May, appointments for sports-related injuries and musculoskeletal issues are available with Dr. Pamela Lachniet. Dr. Lachniet has completed Fellowship training with a Certificate of Added Qualification in Primary Care Sports Medicine at Cincinnati Children’s Hospital.

AHP will also be stocking medical products at both of our locations, such as crutches, splints, braces, and walking boots to care for and treat many of these injuries, saving our patients an extra trip to another facility.

Certified Lactation Consultants

Anderson Hills Pediatrics now has two international board-certified Lactation Consultants, Amy and Darla, to assist our breastfeeding babies and moms. We are one of the few pediatric practices in the area that provide this service. Amy and Darla are available, either on the phone or in the office, Monday through Friday, and are very happy to answer questions and help with your breastfeeding concerns. They work closely with your child’s primary care doctor to ensure your baby is growing and developing in the healthiest way possible. You may reach them by calling our office at 513.232.8100.

INSURANCE INFORMATION

Well-Child Services Policy

Good health care for newborns, infants, children, and adolescents begins with the well-child visit (checkup) and other services that help keep children healthy. These are preventive services. Our doctors and staff provide these services based on a plan called Bright Futures. The American Academy of Pediatrics (AAP) made this plan to help doctors and families know what preventive services children should receive from birth to 21 years of age, such as screening tests, and advise about staying healthy and safe. This plan can be altered to suit each child as needed. We also follow the AAP vaccine schedule for newborns, infants, children, and adolescents.

Because preventive services are important to keeping children healthy, the Patient Protection and Affordable Care Act (health care reform law) includes a rule that all preventive care screenings and services included in the Bright Futures plan and vaccine schedule must be covered by most health plans. This is not always true, though, as some older plans, called grandfathered plans, do not have to pay in full for preventive services.

There may also be times when a child needs a service that is not considered preventive on the same day as a well-child visit. If a child is not well or a problem is found or needs to be addressed during the checkup, the physician may need to provide an additional office visit service (called a sick visit) to care for the child. This is a different service and is billed to your health plan in addition to the preventive services provided on that day. If you have a co-payment for office visits or coinsurance or deductible amounts that you must pay before your health plan pays for these services, our office will charge you these amounts.

We value your time and want to make the most of each appointment for the child. This is why we will address any problem that needs a doctor’s care during well-child visits so that only one trip is needed. Some services that may be provided and billed in addition to preventive services Include

• The doctor’s work to address more than a minor problem, which will be billed as an office visit (e.g., if the doctor gives a prescription, orders tests, or changes care for a known problem) • Medical treatments (e.g., breathing treatments) • Any surgery (e.g., removing splinters or something the child put in his or her nose or ear) • Tests performed in the office that are not included in the Bright Futures plan

Our office does not want you to be surprised by a bill but must always bill your health plan based on the actual services provided. Please feel free to ask questions about services that may not be paid in full by your health plan on the day of your visit. It is our pleasure to help.

Health Plan Terms to Know

Co-payment: A fixed amount that you pay for certain health services before the health plan pays

Coinsurance: The portion of the charge that is not paid by the health plan (usually a fixed percent of each amount paid by the plan)

Deductible: An amount that must be paid before the health plan pays for covered services

Important Vaccine Update

The physicians at Anderson Hills Pediatrics strongly recommend the HPV (Gardasil 9) vaccine for both our male and female patients as early as age 9 and routinely by age 11-12 years. The CDC and ACIP (Advisory Committee on Immunization Practices) have modified the previous 3 dose regimen to endorse a 2 dose regimen for patients who have received their first dose prior to their 15th birthday. The two dose schedule with proper spacing between vaccines and within the appropriate age group has shown to be as effective as the three dose schedule.

More information about this change can be found on the CDC website

AgeRegimenSchedule
9 years – 14 years 2 dosesDoses need to be 6-12 months apart
3 dosesGiven at 0, 2, and 6 months apart (this needs to be followed only if 5 months or less between the first and second doses)
15 years-26 years 3 dosesGiven at 0, 2, and 6 months apart

 

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