Policies
Late Arrival Policy
Patients who arrive to their appointment greater than 10 minutes late will be asked to reschedule their appointment. We recognize the inconvenience, but this policy is to ensure that we have sufficient time to complete your visit without delaying the care of our other patients. We appreciate your understanding.
Financial Policy
For your convenience, you may now pay your bill online at InstaMed.com!
Pediatric Associates will submit all claims to any insurance carrier we are contracted with. Any balances due after insurance payment are the responsibility of the patient and are due upon receipt. Re-billing outstanding balances are subject to additional fees. If we are not contracted with your carrier, or you are uninsured, then payment is expected at time of service. When payment is made in full at the time of service, a 30% discount will be applied. We can supply you with a copy of your bill containing all information necessary for processing your claim for you to submit if you do carry non-contracted insurance. We cannot guarantee payment or amount paid by your insurance carrier. Patients should check with their insurance carrier before any services are provided. All co-pays and co-insurances are due at the time of your visit per your agreement with your insurance carrier. Co-pays not made are subject to a rebilling service charge. We accept cash, checks, Visa, MasterCard, and Discover for your convenience. We are only able to bill the person listed on your child’s account. We cannot be responsible for any other reimbursement arrangements made between parents or other individuals. LARGE PATIENT BALANCE POLICY: An account balance of $500 or more may prevent non-medically necessary appointments from being scheduled until the balance is below $500. Account balances under $500 will not prevent appointments from being scheduled, however, should be paid upon receipt of the bill. If you have a balance, please speak with our front office staff to discuss payment options. RETURNED CHECK POLICY: Checks returned to our office for insufficient funds will result in a $25.00 fee being charged to your account. A balance due resulting from a returned check is due within 10 days to avoid further collection activities.
NO-SHOW/SHORT-NOTICE CANCELLATION & LATE ARRIVAL TO APPOINTMENT POLICY:
We request that you arrive 15 minutes prior to your appointment to allow sufficient time for check in and rooming by our staff. Patients who arrive 10 or more minutes after their scheduled visit time may be rescheduled to the next available appointment that is convenient to the family AND the provider.
A missed appointment, short-notice cancellation (less than 24 hours notice prior to scheduled appointments), and repeated late arrivals will be assessed a fee as outlined below. Missed and late arrivals to appointments delay care to those who are on time and waiting.
The following is our policy on missed appointments, short-notice cancellations, and repeated late arrivals.
First Occurrence per Family: $25.00 Service Charge
Second Occurrence per Family within 12 months: $50 Service Charge
Third Occurrence per Family within 12 months: $100 Service Charge and possible Patient/Family Discharge
Updated 08/14/2025
Divorced/Separated Parents Policy
At Pediatric Associates, our goal is to partner with parents for healthy kids. We appreciate that child(ren) with divorced or separated parents may present with unique challenges, and we require parents to work with us through those challenges. This policy was developed to avoid any misunderstandings going forward. 1. The providers, medical assistants, nurses, office, and billing staff will not be put in the middle of domestic issues or disagreements over the phone or in the office. 2. Please make decisions regarding appointments, vaccinations, and/or any office procedures prior to visiting our practice. 3. Only in situations where there is a documented court order will one parent be denied access to the minor’s health record or visits at the office. Pediatric Associates of Hampton and Portsmouth must have a copy of the court order on file in the minor’s electronic medical record. 4. It is both parents’ responsibility to communicate with each other about the patient’s care, office visit dates, and any other pertinent information relevant to the patient. It is not the responsibility of Pediatric Associates of Hampton and Portsmouth to communicate visit information to each custodial parent separately. 5. Our providers will not call the other parent prior to an appointment to gain consent regarding appointments scheduled, nor will they take a call from the other parent following an appointment. We will not restrict either parent’s involvement in the patient’s care unless authorized by law; however, we also will not duplicate information delivery unless directed by law. 6. We will send reminders of upcoming appointments by text and/or phone call. We can send this reminder to only the primary phone number listed on the patient’s account. 7. All copays, deductibles, coinsurances, and any other fees are due at the time of the visit and are the responsibility of the parent accompanying the patient to the appointment. If there is an arrangement between the parents about split payment, it is the responsibility of the parent attending the appointment to collect from the other parent. Should the issues that come between parents become disruptive to our practice or there is non-compliance with this policy, we reserve the right to discharge the family from our practice.
Vaccination Policy
Childhood immunization was one of the greatest advances in public health in the 20th century. It has saved millions of children and adults throughout the world from developing meningitis, encephalitis, brain damage, severe respiratory problems, poliomyelitis, paralysis, and other severe illnesses, which can require hospitalization or cause death. And to this day, childhood immunization remains a cornerstone of pediatric care and public health.
Immunizations are most effective when an entire community participates. In recent years, localized outbreaks of mumps, measles, whooping cough, and polio have occurred in the United States in communities with low vaccination rates. When you immunize your child, you are not only protecting your child from serious disease, but you are also helping to protect your entire family, your friends and your neighbors.
At Pediatric Associates of Hampton & Portsmouth we strongly believe in the importance of immunizations and fully support the childhood immunization schedule established by the American Academy of Pediatrics. Therefore, our policy requires that every patient within our group receive the vaccinations listed below in the time frame indicated:
Age 2 Weeks: first dose of Hepatitis B if not received in the hospital. Age 2 Months (must be given by 3 months of age): Diphtheria, Tetanus and Pertussis (DTaP); Inactivated Polio Vaccine (IPV); Haemophilus Influenzae type B (Hib); Pneumococcal Conjugate Vaccine (PCV); Hepatitis B; Rotavirus. Combination vaccines available. Age 4 Months (must be given by 5 months of age): DTaP, IPV, Hib, PCV, Rotavirus. Combination vaccines available. Age 6 Months (must be given by 7 months of age): DTaP, IPV, Hib, PCV, Hepatitis B. Combination vaccines available. Age 12 Months (must be given by 13 months of age): Measles, Mumps, and Rubella (MMR); Varicella Vaccine (Chicken Pox) Age 15 Months (must be given by 16 months of age): DTaP, Hib, PCV. _______________________________ Required within 1 month of 5 year check-up: A fifth dose of DTaP A second dose of MMR A fourth dose of IPV A second dose of Varicella _______________________________ Required for Preteens / Teens (within 1 month of 11 & 16 year check-ups): Tetanus, Diphtheria, Pertussis (TDaP): 1 dose at age 11 years Meningococcal Vaccine: 2 doses at ages 11 and 16 years _______________________________ In addition, we highly recommend (but do not require) the following vaccinations: Hepatitis A: 2 doses, beginning at 12 months of age HPV: 2 or 3 doses, eligible starting at age 9 years Meningitis B: 2 doses, between the ages of 16 and 19 years Influenza Vaccination: 2 doses the first year if under age 9 years, otherwise 1 dose annually COVID Vaccination: dosing regimens vary by age and manufacturer _______________________________ We are aware of the concerns about vaccine safety that has been voiced by a very small yet vocal minority. These claims have no scientific or statistical bases. To date, there have been over 30 scientific studies which have proven, conclusively, that vaccines are safe.
Teen Policy
As your child moves toward adulthood, we aim to partner with you in encouraging their independence in managing their own health and health care. We ask now that you review New Hampshire law and our practice policies regarding health care consent for minors. Minor Consent Laws in New Hampshire The age of majority in New Hampshire is 18; anyone younger than age 18 is legally a minor. Young adults age 18 or older are allowed to consent for their own health care; their right to consent may be limited if they are cognitively impaired and unable to give informed consent. For adolescents who are minors, the consent of a parent or another authorized adult is generally required. However, there are exceptions to this requirement contained in New Hampshire’s “minor consent laws,” including emergency care, sexually transmitted infection care, HIV testing, treatment for drug dependency or problems related to drug use, and community mental health services. Additionally, although New Hampshire does not have an explicit law authorizing minors to consent for contraception, it also does not have a law prohibiting them from doing so or explicitly requiring parental consent for contraception. We prefer a parent or guardian of every child under the age of 18 years to accompany their child to each appointment when possible so that they can be updated on non-confidential aspects of the visit and treatment plan. However, once your child is able to drive themselves, you and/or they may wish for them to come alone to some appointments, or for them to be accompanied by a non-guardian. If this is the case, Pediatric Associates requires written permission to see the child without a parent/guardian. This can be sent to us via the patient portal or faxed to our offices PRIOR to the appointment.
Health Form Policy
*You/your child must be up to date with their routine physical exam (seen in the past 12 months) in order for our providers to sign off on any form*
Please allow up to 5 business days for all school and camp forms or any other administrative paperwork. Relevant sections of forms should be filled out by the parent or patient to the best of their ability before giving them to our staff. If you have a more urgent need, we will try our best to get it done but are unable to guarantee this.
Medication Refill Policy
We require at least 48 hours advance notice for any refills to be completed, though we make every effort to fulfill them same day. There are two ways to request a refill:
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Send a portal message at any time – If you have already signed up for a portal account, you may access it via our website. (Check out the upper righthand corner of this browser window!)
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Call our Refill line during business hours – Please be sure to leave complete information about the patient, and specifically identify all medications that need refills.
If after hours, please do not page the on-call physician, as they must remain available for emergencies.
Please review the following carefully to ensure that we can provide your child with the highest quality care, and that there are no delays in obtaining your child’s refill. Pediatric Associates of Hampton and Portsmouth is here to partner with families for healthy children. Our medication refill policy is designed in line with this message. Routine medication refills are handled Monday through Friday from 8am to 5pm, excluding holidays. You may call our office selecting option 3 and leave a voicemail, send a message through the Patient Portal, or contact your pharmacy directly for your routine medication refills. Please be sure to request your refill with at least 48 business hours of notice. In order to refill the patient’s medication, the patient must be up to date with all routine wellness exams and any required medication follow up visits. If the patient requires a refill prior to the patient being up to date with these appointments, we reserve the right to only fill the prescription up to that appointment date. If that appointment is not kept or is rescheduled, we reserve the right to not fill the prescription again until the visit occurs. If an electronic prescription needs to be resent to a pharmacy due to lack of supply, insurance coverage, cost, or any other reason, Pediatric Associates will resend the prescription one additional time. If the second pharmacy does not work out, a paper prescription will need to be physically picked up by the patient/parent/guardian. Medications for ADD/ADHD require regularly scheduled medication check appointments. Our guide for these appointments is: 6-8 years old, appointment at least every 3 months. 9-12 years old, appointment at least every 4 months 13 years old and up, appointment at least every 6 months. Any of these medication follow up appointments may be needed sooner than the guideline if adjusting of the medications is needed or if indicated by your child’s provider. Medications for other conditions may also require medication check appointments if indicated by your child’s provider (e.g. contraception, anxiety, or depression medications). In order to provide the highest quality healthcare to your child, we will review the medical record to determine if a routine wellness exam or medication follow up visit is needed before refilling the prescription at the pharmacy you choose. Failure to make or keep these necessary appointments may prevent the patient’s medication being refilled. Please note: While some medications for ongoing or chronic care may be refilled if your child is current on routine wellness or medication follow up exams, most acute care medications will require an office visit to further assess your child’s condition and the need for continuing medication. We reserve the right not to fill requested medications when the patient is not able to be examined (to include when a patient is traveling).