What are the office policies?

ONLINE REGISTRATION

To register as a new patient, you will need to register each child separately in the family.  They will have their own individual patient portal account, which can later be merged under one login.

After registration, patient portal services are available online and include: encrypted (HIPPA compliant) lab information at your fingertips, the ability to change demographic information and insurance information online, upload/update medication information, access vaccine records, email correspondence, provide current health history before the appointment, and access pertinent medical documents.

EMAIL POLICY

Electronic Communication via email THROUGH THE PATIENT PORTAL:
The patient portal provided allows you to communicate with our staff to quickly determine your needs and respond appropriately.

  • DO NOT USE email request for urgent appointments.
  • DO NOT USE email for URGENT matters needing a same day response.

*USE email ONLY for:

  1. Non-urgent matters
  2. Administrative issues
  3. Recent clinic visits that you may have a question about plan of care
  4. Lab result requests or to have your child’s results attached to the patient portal
  5. Copies of vaccine records or school notes
  6. Billing questions or concerns
  7. For your information: the patient portal is NOT ABLE TO ATTACH DOCUMENTS through the patient portal.

PLEASE BE COURTEOUS

We appreciate and expect that you will treat our staff and healthcare providers with courtesy and respect. We reserve the right to dismiss you from the practice for non-compliance of this policy.

We are a busy practice with complex patients and complex medical histories. We expect you to be prepared at the time of your visit. Any documents that require the healthcare provider’s signature, we ask that you either submit those PRIOR to your visit or bring them with you at the time of your visit.

PLEASE NOTE: If your child has seen a specialist, has been prescribed medications for chronic conditions, required surgeries, is being seen in our office due to a chronic or ongoing medical issue for the first time or our front desk asks you to complete the questionnaire, please complete this questionnaire PRIOR to your visit. This will allow your first visit to be high quality, efficient, and rewarding.

INSURANCE

We accept most major insurance plans; however, this does come with certain limitations. For example, we must physically see your child in order to prescribe medications or make diagnoses. Please be sure to bring your insurance card with you and to alert the practice of any changes in your insurance status or mailing address. Please note, high deductible insurance or limited coverage policies means the financial guarantor of the patient is responsible for any balance not covered by insurance. Some full coverage policies will not cover all lab costs or office visits. This will be the responsibility of the financial guarantor.

It is the responsibility of the patient/parent to ensure that Randy Naidoo M.D. is a participating provider for their insurance plan. If Randy Naidoo M.D. or Rahima Afroza M.D. at 3600 Shire Blvd., Suite 110, Richardson, TX 75082 is not a participating provider for your particular plan, you may still select our office for your medical care, but “out of network” benefits will apply. In that case, patients will be responsible for the full cost of their visit on the day of service and can submit a receipt for reimbursement to their insurance plan. It is not Shine’s responsibility to know or advise you on your insurance benefits. Patients/parents with questions about their coverage should contact their particular insurance carrier’s customer service representatives. Dr. Naidoo has practiced or practices at other locations that are not affiliated with Shine Pediatrics and Wellness Center, PA. Therefore, providing the address to the insurance company will ensure no mistakes in proper coverage for your visit. Additionally, we do accept cash pay clients into the practice.

If you are utilizing Shine Pediatrics and Wellness Center, PA for your child’s preventative care and you also have another provider that your child sees, you will need to ensure that your visit with Shine Pediatrics and Wellness Center, PA is a covered benefit prior to your visit.

FINANCIAL/PAYMENT POLICY

Shine Pediatrics and Wellness Center, PA can accept cash, checks or credit card payments (Visa, MasterCard, Discover and American Express) for your convenience. Patients are required to pay the full amount of their co-pay, co-insurance, or deductible fees for their visit at the time of the visit. It is understood, and agreed, that if an outstanding balance is not paid by your insurance company, the financial guarantor is personally responsible for the payment of all charges due.

Checks can be written to Shine Pediatrics and Wellness Center, PA at the time of the visit. In the event of a returned check, there will be a $35 dollar non-refundable fee in addition to the amount originally owed.

Medical Records are available on the patient portal for free, but requests for a hard copy will be charged a $25 fee.

AFTER HOURS PHONE CALLS

Please note that you always have the ability to contact a SHINE medical professional after hours for medical advice regarding non-critical care. Phone calls after office hours will have a $25 charge from 5pm-10pm and a $60 charge from 10pm-9am. Phone calls related to ongoing medical care regarding that day’s care of your child in the office or by phone will not be assessed a charge.

Additionally, there will be a $25 charge for any phone calls during the day that require a nurse practitioner or physician to review the patient’s chart before replying back to a request from the parent through our nurse’s triage line. This also involves any rashes where pictures are required for the provider to review and phone calls that require a nurse practitioner or physician to spend extensive time reviewing the chart or making detailed recommendations.

LATE ARRIVALS

Please call if you are running late to your scheduled appointment. If you are more than 15 minutes late for your appointment, we may ask you to reschedule for another time.

NO SHOW/CANCELLATION POLICY

Your appointment time is reserved especially for your child. A missed appointment leaves an empty slot that could have been used by a patient in need of medical care. Not cancelling an appointment in a timely fashion is unfair to other patients. Therefore, we request that patients who are unable to keep their scheduled appointments notify us at least 24 hours in advance, so the time might be made available for another patient.

For established patients, a missed appointment will be rescheduled upon request. A second missed appointment within 12 months will result in a $35 no show fee, which is not covered by insurance. Three missed appointments for each respective child in a family within 12 months may result in dismissal of that individual from our practice.

MULTIPLE CONCERNS AT A PREVENTATIVE VISIT

If your child’s visit to Shine Pediatrics and Wellness Center, PA is scheduled as a Well Check-up visit, that visit needs to be focused on child development, readiness or performance in school, screening measures for hearing and vision if appropriate, as well as various other tools and measures depending on your child’s age. If your child is sick, dealing with chronic medical conditions, requesting blood work or further workup for a chronic disease (i.e. autism, neurosensory issues, allergies, asthma, eczema, ADHD, nutritional concerns, significant concerns with development regarding unintended weight loss or gain, endocrine dysfunction, etc.), it is at the provider’s DISCRETION if your child can be seen for that additional complaint in the allotted time for a Well Check-up visit. If your child is seen for these other complaints, your insurance may be billed for TWO services at that preventative visit, which may cause lack of coverage and responsibility of payment by the financial guarantor. PLEASE BE AWARE OF THIS SITUATION, and if possible, schedule a subsequent visit to be respectful of the provider’s time and other patients who will be seen following your appointment. Thank you for your understanding in this matter.

PATIENT VISITS WHEN THE PATIENT IS NOT IN ATTENDANCE

Insurance coverage stipulates the patient must be in attendance for coverage to incur. When a parent would like to schedule a visit WITH A PROVIDER to review labs, discuss any health care concerns, vaccine discussions, or any other matter that does not require the patient to be in attendance, there will be a fee of $50 for 15 minutes and $100 for 30 minutes for the provider’s one-on-one time.

PRESCRIPTIONS AND TRIPLICATE REQUESTS

All prescription refills should be requested during regular office hours. Please have the pharmacy address and telephone number available when calling for the request. Any ADD/ADHD medications that require an in-office pick-up, require a 72-hour notice and will NOT be available for same day pick-up. Controlled Substance Requests for refills will be charged a $10 service fee for any changes that have to be made after the initial prescription has been written due to insurance coverage or other reasons for changes. Please make sure you are clear on your insurance coverage regarding type of medication coverage, 1-month vs. 3-month supply, and whether you are doing a mail-in-order program. Those concerns are not the responsibility of Shine Pediatrics and Wellness Center, PA.

Please call for refills a few days before your prescription runs out rather than waiting until the last moment. Routine prescription refills will generally be phoned in within 48 hours. The medical provider will not routinely prescribe antibiotics over the telephone without recent examination; this will ensure that your child receives the appropriate medication for his/her condition.

LAB/RADIOLOGY RESULTS

We try to do our best to establish total cost of lab testing in advance, however costs are an estimate and can vary depending on the type of testing completed and insurance coverage. Parents are responsible for all lab fees if insurance does not cover or does not apply the balance to the deductible. It is highly recommended that patients/parents check with their insurance to see if lab tests are a covered benefit. Most ROUTINE lab tests are covered, but some SPECIALTY labs are not covered and will require some out of pocket expense.

Lab results will need to be discussed in the office with the provider. The parent and child shall be present at the visit. In the event of NORMAL lab values, a follow-up visit is not required and the results will be available online via the patient portal.

We have specific charges for lab tests for self-pay patients. If you choose to have lab tests submitted through your insurance or use a different lab facility, your cost could be higher due to deductibles not being met or due to tests being a non-covered benefit under your plan.

HOSPITAL AFFILIATIONS

Randy Naidoo M.D. and Rahima Afroza M.D. have hospital privileges at Baylor Medical Center at Frisco and Texas Health Presbyterian Hospital Plano for newborn infant care and non-complex, inpatient care. In the event that a patient requires admission to a hospital for a complex issue requiring continuous observation and care, patients will be admitted to a free-standing pediatric medical facility under the direction of pediatric hospitalists. Dr. Naidoo will work closely with these hospitals to coordinate your child’s care, but is not involved in the decision-making for your child’s day-to-day care.

EMERGENCY CARE

In the event of a serious emergency, you should go immediately to the nearest hospital emergency room or call 911. Should your child have an urgent matter, we will do our best to respond to your issue promptly. In a less serious situation that needs to be addressed, you may call the office and you will be contacted as soon as possible. If you have any doubt about the seriousness of the emergency, it is best to go directly to the emergency room.

GROUNDS FOR TERMINATION

A physician may terminate a relationship with a patient at any time by giving 30 days’ notice during which the physician is responsible only for responding to urgent medical matters. Dr. Naidoo will reserve this action for patients who demonstrate a lack of respect for themselves and the practice by repeatedly missing appointments, failing to pay their bills, disregarding the stated policies of the practice, or acting in a way that is deceptive, dishonest or abusive.

We are all working to a common goal of caring for your family and encouraging them to be healthy…so they can SHINE!!!!