299 Carew St Suite 430, Springfield MA 01104
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Appointment Policies

Appointment policies
All appointments

Double appointments will be scheduled on a case by case basis.
Bring insurance card to each visit. Please inform the front desk with any changes to your insurance.
Copay is due at the time of visit.
If you arrive 15 minutes or later than your scheduled appointment time, you will need to reschedule.
Patients under the age of 18 must be accompanied by an adult for all visits. The front desk can have you authorize persons over 18 to bring your child in for visits (except annual physicals). *adult must be familiar enough with child to be able to speak with the doctor. Cell phone conferences with the parent are not permitted in exam rooms.
Reminder calls will be made to your telephone number on file the day before your appointment. This is a courtesy call, you are responsible for keeping you appointment if we are unable to call.
Please inform the office with any changes to your contact information, especially your telephone number.

Emergency room visits/urgent care walk-in clinic visits

If your child requires emergency care for a non-life threatening condition during normal business hours, please contact the office at 413-734-6461 prior to seeking care.
*please note that referrals will not be made to a walk-in clinic unless it is an after hours/weekend visit, and you have notified us that the visit took place.
If this occurs after hours, or on a weekend, please contact the office at 413-734-6461. Your call will be transferred to a nurse triage that will evaluate and determine if your child needs emergency treatment.
For potentially dangerous medical conditions, seek treatment immediately, and contact the office as soon as possible for follow-up.
Refill policies

Please allow 24-48 hours to process routine refill requests.
Controlled substances refills must be picked-up in the office by a parent/legal guardian. ID is required. Please call the office prior to coming in for the prescription, to ensure that it has been prepared for you to pick-up.
Regular appointments must be kept in order for the providers to provide refill.
Test results

Specialist testing results should be read by the performing specialist. Please contact any specialist directly if you have been referred out for special testing.
Taking photographs or videos

Stafford pediatrics does not allow the taking of photographs, or videos in our office or exam areas.

Moving on to adult medicine

Pediatric offices may only treat patients until their 23 rd year. Patient should begin the process of transitioning to an adult provider after their 22 nd year annual physical.

Records request to transfer out of practice.
Privacy Practices

The rules having to do with protected health information (PHI) are binding. Stafford Pediatric Associates may not make exceptions regarding the handling of PHI.
-Records requests must be signed by the parent/legal guardian for patients under 18 years of age
-Patients that are over 18 years of age must give Stafford Pediatrics permission to discuss their PHI with their parents/legal guardian.

Notice of Privacy Practice

Permission to discuss PHI (18 year old patients)

Forms Policy

*Forms should be requested/given to the receptionist at check in, please do not hand to the provider in the room.
Physical forms/lead screening results/immunization records- You will be provided with a physical form on the day of your physical. Please retain this for verification for school, camp etc. If you loose or misplace this form, please allow 3-5 business days for replacement.
College forms- College forms will not be accepted without the patient information filled out completely. Please allow 3-5 days for completion.
Sports forms- The patient portion of the form must be completed prior to review. Please allow 3-5 days for completion.
All other forms- Disability, housing, and utility health statements will be completed at the providers discretion. All patient information must be completed prior to review. Forms will be processed in the order that they are received. All forms require 3-5 days to process.
Financial Policies

Payment for all services is the responsibility of the parent or guardian who presents to the office with the patient and is due and payable at the time services are rendered.
When private health insurance coverage is with a company for which Stafford Pediatric Associates
is a participating provider, Stafford Pediatric Associates will submit a claim to the insurance carrier. If this claim is not paid within a timely manner (60 days) by the insurance company, then it becomes the responsibility of the parent or guardian.
Private insurance contracts and coverage is between the subscriber and their insurance company. To use insurance benefits to cover any ordered tests, procedures or visits to specialists it is the responsibility of the parent or guardian to contact the subscriber's insurance company to verify benefits and participating facilities and specialists.
The parent or guardian is responsible for requesting any necessary referrals prior to seeing any specialists, and prior to having any tests or procedures performed. When possible these requests should be made 5 days prior to the appointment date with the specialist. It is up to the discretion of a Stafford Pediatric Associates provider whether or not to issue a referral requested after the appointment or procedure date. Any denial of payment for ordered tests from an insurance company is between the subscriber and their insurance company, realizing referrals are not a guarantee of insurance benefits or payment.
The parent or guardian is responsible for all co-payments at the time of service unless prior arrangements have been made with Stafford Pediatric Associate's billing department.
All co-payments are due at the time of service when checking in the patient. Any co-insurance, deductibles or rejected claims should be paid to Stafford Pediatric Associates within 30 days of receipt of a bill from Stafford Pediatric Associates.
For your convenience we accept Cash, Check, MasterCard or Visa.
(Any checks returned unpaid by your financial institution will be subject to a fee of $20.)

Parent/Patient code of conduct

Parents/guardians are not allowed in the lab for weighing and measuring with the exception of parents/guardians of children who do not yet walk.
Parents/guardians, and patients are expected to follow the policies of Stafford Pediatric Associates. Argumentative/disrespectful behavior regarding these policies, or disrespectful language/shouting or swearing will not be tolerated by Stafford Pediatric Associates, and may result in termination.