The office telephone, (480) 839-9097, is answered by a member of the East Valley Children's Center staff during regular office hours. The remainder of the time, the phone is answered by an answering service and messages are taken. The answering service is able to contact the pediatrician 24 hours a day, seven days a week.

FEES AND INSURANCE: Professional fees will be discussed when requested. The pediatricians and office staff of the East Valley Children's Center have an earnest desire to provide you with pediatric services that are unexcelled, yet at a fair fee. The professional fees are determined by the time spent with you and your child, by the complexity and severity of the problem, and by the time required to prepare the medical record. Fees for consultation, prolonged care, involved or serious problems, and complete histories and physical examinations required for new patients are higher than the fees for routine office visits. A nominal additional fee is charged for office visits which are after regular business hours, on weekends, and on holidays.

It is the policy of this office to request payment when services are rendered, and for those with health plan copays, the copayment is expected at the time of the office visit. Special consideration may be extended in the event of unemployment, or other unusual circumstances. To avoid misunderstandings, we encourage you to discuss any financial problems with our office management early in the course of treatment. The business office is available to answer your questions from 8:00 AM to 3:00 PM Monday through Friday.

The form given to you upon request during your office visit serves as an insurance report, statement, and receipt. In addition, as a service to you but only at your request, we will file all of your insurance claims for office visits directly with the insurance carrier if you will provide us with current and complete information. However, you remain responsible for payment of your account, not your insurance company. For each month that there is an outstanding balance on your account, we will send you an itemized statement showing charges, including finance charges, payments, and the total amount due.

The pediatricians and nurse practitioners of the Children's Center are members of a number of HMO and PPO health plans. If you are a member of a health plan, please let us know by supplying us with all the necessary information.

TELEPHONE: With limitations, the telephone can be a great help to both you and to the pediatrician. Most initial contacts concerning a sick child will occur on the telephone. Counseling for simple problems such as feeding and sleeping behavior can efficiently be handled on the telephone during office hours. Most importantly, it is a useful way of getting in touch with the pediatrician in the event of an emergency.

Because of its usefulness and familiarity, parents and physicians may come to depend on the telephone more than they should. Accurate diagnosis of a child's illness cannot be performed on the telephone. For example, even an accurate description of most skin rash is of little value in trying to determine the cause. A parent's report of the severity of symptoms is often colored by the fears and anxieties natural in a concerned parent, making an accurate assessment of an illness difficult, if not impossible, on the telephone.

Consider the telephone as a way of getting in touch with us. Do not attempt to use it as a way of diagnosing and treating illness. A child ill enough to require medication is usually ill enough to deserve an examination. For this reason, our practitioners and physicians will not call in a new antibiotic prescription for illness. This does not mean that every time you call an examination is necessary. Your accurate report of symptoms is the most important single factor in helping to decide what needs to be done. Communication should be as specific as possible. Such statements as "he is terribly sick", or "he is burning up", are of little value in determining how ill your child is. It is more helpful if specific data is provided, such as "he has vomited five times in the last hour and is listless."

When you call during office hours, you will speak with one of the staff, or one of the Nurse Practitioners who have been trained to handle parent's questions. Trust the person who answers the phone....we do! Many times, the person with whom you are speaking will ask one of the pediatricians your question and will then call you back. Frequently, you will be called back by the Nurse Practitioner. Depending on the nature of your concern and your personal request to the receptionist, the pediatrician will call you back personally. If there is any question concerning the severity of your child's illness or concerning the possibility of complications, you will be asked to bring the child in for evaluation. Please, if you feel that your child should be seen, tell the receptionist immediately. This will save many unnecessary questions.

Because time on the telephone is a valuable service and uses costly resources (secretaries, answering services, beepers, and sometimes long distance or cellular charges), there is a small charge for telephone calls to the physician after 5 PM weekdays and on weekends. Calls during office hours are not billed unless they are unusually complex or lengthy.

Please remember that many parents have questions and it may take awhile to answer the phone or you may be put on hold...but if you will wait, you will always get through.

PRESCRIPTIONS: Because we do not have ready access to your child's records after hours, prescription refills cannot be "called in" when the office is closed.

EMERGENCY CALLS AND AFTER HOURS CARE: After hours calls will be directed to an answering service. The answering service staff has no medical training and will be unable to answer your medical questions. They serve strictly to direct your call to an appropriate resource for emergency problems. When you call, they will ask your name and your child's name and age, your phone number, and the nature of the problem. Within a short period of time, your call will be returned.

Calls will be returned by one of the East Valley Children's Center pediatricians on call. We do not use outside physicians nor a triage service. For calls placed after 11 PM, you will be requested to take your child to the hospital Emergency Room. The Emergency Room personnel will then contact the East Valley Children's Center pediatrician on call to discuss the problem and determine the proper treatment. This limitation of telephone access is for your child's protection. It is very difficult during the light of day to ascertain over the telephone the severity of illness and the necessity for immediate versus somewhat delayed evaluation. It is even more difficult when the physician is awakened from sleep. It is far better to have an ill child assessed by examination from an awake physician than by telephone from a drowsy physician, as this is when potential problems may arise. Under such circumstances, the only safe response to a concern sufficiently serious to warrant a middle of the night call is to recommend immediate evaluation by a physician in the Emergency Room.

It is better to anticipate problems, rather than wait until concern has escalated into an emergency. Illness that has been present several days should be discussed during office hours. We would much rather discuss minor problems with you during the day than more serious concerns in an Emergency Room.