Frequently Asked Questions

A COB request is usually sent by your insurance company when they need to know if you have coverage through another health plan. This helps them decide which plan pays first. 

Respond promptly, you’ll help avoid delays in processing claims and ensure your insurance benefits are coordinated correctly. This is NOT something we can handle for a patient; the guarantor must complete and turn in the form to your insurance company. 

If you don’t respond to a Coordination of Benefits (COB) request, here’s what could happen:

1. Claim Delays or Denials: Your insurance company may put your claims on hold or deny them until they get the information they need. This can lead to delays in payment for medical bills.
2. Out-of-Pocket Costs: Without resolving the COB, you may end up being responsible for paying the full cost of your medical care upfront. You will then become responsible for the entire balance if there is no response to these requests after 90 days. 
3. Insurance Coverage Issues: If your insurance company assumes you have another plan and you don’t clarify, they might not process your claims correctly, potentially leaving you with unpaid bills.
4. Coverage Suspension: In some cases, insurers may temporarily suspend your benefits until the COB is resolved.

Tip: Respond promptly to COB requests to avoid these issues and ensure your insurance pays claims correctly. If you’re unsure about the process, contact your insurance company for guidance.

If you have questions regarding your COB, please contact your insurance company as soon as possible. However, please take the time to update us on your conversation with them and provide a reference number. Although it is still your responsibility to handle this in a timely manner and prior to the 90 days policy mentioned above, we do greatly appreciate and will continue to work with you as we know navigating the insurance world can be incredibly frustrating. 

Contact us via your child’s portal or call us at 746-7337 and select the billing prompt. 

Aetna

Blue Cross PPO - ***If you have PERS, you must call them to confirm we are in-network or you will be billed as out-of-network. For most accurate information, you may give them our NPI (provider ID) of 1750033411. DO NOT ask for Dr Randolph - she is employed at several facilities. 

Blue Shield PPO

Cigna

Key Medical - Not currently accepting new members. 

UHC 

Tricare West

Western Growers

**We DO NOT accept Medi-Cal. 

 Absolutely! We strongly encourage parents-to-be to schedule a prenatal visit with our office. This is a wonderful opportunity to get to meet us, see the office, and ask any questions you may have about your newborn’s care or our practice. Best of all, this visit is completely free of charge for expecting parents. 

Your child should not only see the pediatrician for an illness; it is also important to schedule well-child-care exams regularly, beginning in infancy. Also called well-care visits or checkups, these routine examinations provide the best opportunity for the doctor to observe the progress of your child's physical and mental growth and development; to counsel and teach parents; to detect problems through screening tests; to provide immunizations, and to get to know one another. 

Well-care visits are strongly recommended as part of preventive pediatric care.

Well-child visits are also a good time for parents to raise questions and concerns about a child's development, behavior, nutrition, safety and overall well-being.

The American Academy of Pediatrics recommends this schedule for routine well-care visits:

• 3 to 5 days
• 2 weeks
• 2 months
• 4 months
• 6 months
• 9 months
• 12 months
• 15 months
• 18 months
• 24 months
• 2.5 years
• 3 years
• 4 years

And once every year thereafter for an annual health supervision visit that includes a physical exam as well as a developmental, behavioral, and learning assessment.

 Immunizations have become a significant topic of discussion in recent years, and with so much information available through the media and online, it can be difficult for parents to know what information to trust. We understand that decisions surrounding vaccines can feel personal and, for some families, emotional.

At Milestone Pediatrics, our providers strongly believe in the safety and importance of childhood immunizations and recommend following the immunization schedule established by the Centers for Disease Control and Prevention (CDC).

We also understand that some families may have questions or concerns about vaccines, and we are always happy to discuss those concerns with you. In certain circumstances, we may allow an approved alternate vaccine schedule, which should be discussed with your child’s provider.

If you choose not to vaccinate your child according to the recommended schedule or one of our approved alternate schedules, Milestone Pediatrics may not be the right practice for your family. This policy helps us protect all of our patients, particularly newborns, young infants, and children who are immunocompromised or otherwise medically vulnerable to vaccine-preventable diseases.

We welcome your questions and want you to feel comfortable discussing childhood vaccines with your child’s healthcare provider.

A Nurse Practitioner (NP) is an Advanced Practice Registered Nurse (APRN) who has completed advanced graduate-level education, typically earning a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree. Nurse Practitioners also complete specialized clinical training and must meet national certification and state licensing requirements.

NPs are licensed healthcare providers who can examine patients, diagnose and treat illnesses, order and interpret diagnostic tests, prescribe medications, manage chronic conditions, and provide preventive and primary care.

Many Nurse Practitioners specialize in caring for a particular population, such as children, families, or adults. Pediatric Nurse Practitioners, for example, have advanced education and training focused specifically on the healthcare needs of infants, children, adolescents, and young adults.

One thing that makes Nurse Practitioners unique is their foundation in nursing. Before becoming an NP, they are trained as Registered Nurses, which brings a strong emphasis on patient education, prevention, health promotion, and caring for the whole patient and family.

At Milestone Pediatrics, our providers bring not only years of experience to the care of your child, but also years of trust in one another. Many of us have worked together and known each other for 15 years or more, and we entrust one another with the care of our own children. We believe that says a lot about the confidence we have in each other as clinicians and the standard of care we strive to provide every family who walks through our doors.